The Association of Sport Participation Behaviors with Throwing Arm Health in Little League Baseball Pitchers

Abstract Background and Hypothesis: There is increasing concern about the role sport specialization might play in the increasing injury rates observed among youth baseball pitchers. However, existing research on specialization in baseball has focused on high school and professional baseball populations. We hypothesized that pitchers who were highly specialized, reported pitching more than eight months in the past year, received private coaching, or pitched with pain or fatigue in the previous year would report worse throwing arm health. Methods One-hundred and eighty-four Little League pitchers (male N=181, age 9.8±1.6 years old) between 7 and 12 years old completed an anonymous, online questionnaire with their parent’s assistance. The questionnaire consisted of participant demographics, sport specialization status, months of pitching per year, whether they traveled regularly to participate in showcases, if they received private coaching, whether they pitched with elbow or shoulder pain, whether they pitched with fatigue, and the Youth Throwing Score (YTS), a valid and reliable patient-reported outcome measure for youth baseball players. The associations between variables of interest and YTS were examined using multivariable linear regression, adjusting for covariates. Results Sport specialization, pitching year-round, and receiving private coaching were not associated with the YTS (p>0.05). Pitching with pain in the previous year was associated with worse YTS score than pitching without pain (LS-Means [SE]: 49.6 [1.8] vs. 57.8 [1.1], p Conclusions Pitching with pain or fatigue were associated with worse throwing arm health in Little League baseball pitchers. While traveling at least once a month to participate in showcases was also associated with worse throwing arm health, specialization and private coaching were not related to worse throwing health. Clinicians working with pediatric patient populations should be aware that while the factors examined in this paper were reported relatively infrequently, screening for Little League pitchers who participate in showcases or pitch with pain or fatigue may be an effective strategy for identifying these individuals who are at higher risk of injury.