Overuse injuries are a growing concern in all high school sports – particularly in baseball with overuse injuries to pitchers in the sport.

Ulnar collateral ligament surgery, more commonly known as Tommy John surgery, is being performed on an increasing number of high school pitchers. Top Velocity, a pitcher-specific baseball website, published an article that stated that 85 percent of high school students who underwent the surgery were overused in their roles. (67% threw breaking pitches before the age of 14.)

In 2015, the NFHS convened a joint meeting with its Sports Medicine Advisory Committee and USA Baseball’s Medical Safety Committee to discuss risk of injuries with high school baseball pitchers. What these groups knew heavily outweighed what they didn’t about the main cause of pitching injuries – overuse. As a result, the NFHS Baseball Rules Committee, at its 2016 meeting, approved a new pitch-count restriction rule.

To protect the arms of high school pitchers, high school rules now require a pitching-restriction policy based on the number of pitches t hrown in a game and a require d rest period. Each NFHS member state association is required to develop its own pitching-restriction policy based on pitches thrown in a game rather than innings pitched.

“We are happy at a national level that our member associations have implemented ways to limit risk to pitchers for longevity in their interscholastic athletic careers,” said Elliot Hopkins, NFHS director of sports and student services and staff liaison for baseball.

Hopkins said most of the feedback from states has involved logistics. What is the magic pitch number? How many days rest is required after you hit the number? Can there be different increments of pitch counts? Ultimately, the final decision rests with each member state association.

Vermont has been using a pitch-count restriction for 20 years. Currently, 44 states have developed pitch-count restrictions for this sea son with others pending approval. “The numbers we have seen are fair. I think they will be adjusted because of hard data and concerns regarding pitching in postseason tournaments,” Hopkins said.

The previous restriction of limiting innings pitched still created overuse issues as innings vary in terms of pitches thrown. It also allowed players to pitch consecutive days on a fatigued arm, thereby increasing the risk of soreness and injury. On top of overuse, hot weather in the South, or cool temperatures in the North play into injury risk as well. Hopkins hopes the new rule will protect high school pitchers’ arms and allow the proper rest period between pitching appearances.

“A byproduct of the new rule is the growth in the pitching staff that also puts less stress on one pitcher,” Hopkins said. “The new pitch restrictions will incentivize coaches to have a deeper bullpen to avoid ineligible pitchers and provides for participation growth in baseball and, if managed well, a successful pitching rotation.”

In the end, Hopkins believes coaches have an obligation to protect their pitchers, not to overuse or abuse them. “No single win is worth the unnecessary risk of injury to a young player. The overuse risk factor as well as other risk factors for pitchers are avoidable with proper education and guidance,” Hopkins said.