Chambana Sun

Illinois high school baseball pitchers now face a pitch limit following a mandate by the National Federation of State High School Associations (NFHS) for the 2017 season. 

The policy came about in the wake of warnings by the American Sports Medicine Institute (ASMI).

The NFHS required Illinois High School Association (IHSA) teams to set a pitch limit, which the latter decided would be 105 pitches per game. In addition, a pitcher must rest for four days after throwing between 76 and 105 pitches in one game. These guidelines are the same as the 2010 Little League Baseball regulations included in the 2013 ASMI position statement.

“I’ve got some general notes that coaches have sent my way through phone calls or emails and even talking to some of them at the state finals,” Sam Knox, IHSA baseball administrator, told WJBC AM 1230. “Some of them feel like maybe that number 105 is too low, especially as we get later in the year and it’s warming up. Every kid’s different and we don’t know, maybe 105 for one kid is a great limit, maybe 102 for another kid is a great limit, too. You have to draw the line somewhere.”

The ASMI released a warning in 2013 regarding the increase in elbow and shoulder injuries in adolescent baseball pitchers. The position statement pointed out that overuse was a principle risk factor. Poor physical fitness and poor pitching mechanics were also suggested as contributing to the risk of injuries. It also discouraged early use of the curveball, which can lead to arm fatigue.

Other recommendations by the ASMI included no overhead throwing for at least two or three months -- preferably four -- and no competitive pitching for at least four months per year. It also recommended limiting pitching to a maximum of 100 innings in a calendar year, following the suggested limits for pitch counts and rest days and, if the pitcher complains of pain, having the elbow or arm evaluated by a sports medicine doctor.

The sharp increase in overuse injuries included young athletes requiring Tommy John surgery, a reconstructive elbow procedure. The American Journal of Sports Medicine published a 2015 study that showed nearly 60 percent of Tommy John surgeries in the United States were for 15- to 19-year-old athletes.

"Everybody who follows baseball is worried about the rise in Tommy John procedures in the Major Leagues, and rightly so," Dr. Christopher Ahmad told Medical Xpress in March 2016. "But we should also be worried about the 6 million children and young adults in the U.S. who play this game and are at risk for significant pitching-related injuries. We need to determine why these injuries are so common and what can be done to prevent them."

Ahmad is a study leader, professor of orthopedic surgery at Columbia University Medical Center, head team physician for the New York Yankees and chief of sports medicine at New York-Presbyterian/Columbia University Medical Center.

Prior to the ASMI warning, the Illinois high school baseball rules included the following: "A player may not pitch more than nine innings in any one day, except, if a pitcher is pitching in the game when the score is tied at the end of the regulation period of play, the pitcher shall be permitted to continue pitching until he is relieved or the conclusion of the game, whichever occurs first."

The IHSA had been discussing a pitch limit since early 2016. The recent NFHS policy change mandated that each state implement a pitch limit for the 2017 baseball season.

"It's great, especially at the high-school level because we sometimes lose sight of what really matters, which is the kids and their arms," United Township coach Tyson Blaser told the Dispatch-Argus QCOnline.com in June 2016. "We get into the 'we-have-to-win' mode, and guys throw too many pitches."