Background: Overthrowing injuries in youth baseball players have been linked with pitching behaviors such as as high pitch counts, inadequate rest, and participating in throwing activities throughout the year. Pitch Smart guidelines were developed as an initiative between Major League Baseball and USA Baseball to provide recommendations for youth baseball athletes to help decrease the risk of injuries from overthrowing. Purpose: The purpose of this study was to perform a quantitative analysis of pitch counts in youth baseball players and evaluate compliance with Pitch Smart guidelines. Methods: Local youth baseball teams competing in nine and under (9U) to fourteen and under (14U) age brackets were recruited to track pitches during the summer baseball season. A tablet with a pitch counting application was used to record pitches for each pitcher of the study team and their opponents. Days of rest between games was calculated for the study teams only and not opponents. Pitch counts and days of rest for each pitcher were compared to the recommended Pitch Smart guidelines. Continued prospective collection of data is ongoing through the 2019 summer. Results: Interim review of 23 youth baseball teams using a tablet allowed analysis of 181 pitchers of the 23 study teams using tablets and 285 pitchers of 98 opponent teams. Violation of Pitch Smart guidelines occurred in 14 (60.9%) study teams and 29 (16.0%) pitchers. Of these violations, 27 (93%) pitchers had insufficient rest between games while 2 (7%) pitchers exceeded daily maximum pitches. Further, 8 (35%) teams had more than one player violate guidelines. Pitch smart daily maximum pitch counts were violated in 2 of 98 (2.0%) opponent teams and 2 of 285 (0.7%) of opponent pitchers Conclusion: A total of 61% of youth baseball teams and 16% of pitchers in this study violated Pitch Smart guidelines at interim analysis. The vast majority of guideline violations were due to inadequate rest between games. The high rate of Pitch Smart violations suggests that further education of coaches, parents, and athletes regarding these guidelines, with emphasis on rest recommendations, is necessary to prevent overthrowing injuries in youth baseball players. Table:. Age Group # Study Team Violations # Study Pitcher Violations (Rest) # Study Pitcher Violations (Daily Max) # Opponent Team Violations # Opponent Pitcher Violations (Daily Max) 9U 5 / 6 (83%) 10 / 52 (19%) 1 / 52 (2%) 1 / 20 (5%) 1 / 58 (2%) 10U 4 / 5 (80%) 10 / 42 (24%) 0 / 42 (0%) 0 / 30 (0%) 0 / 101 (0%) 11U 0 / 0 (0%) 0 / 0 (0%) 0 / 0 (0%) 0 / 0 (0%) 0 / 0 (0%) 12U 0 / 3 (0%) 0 / 21 (0%) 0 / 21 (0%) 0 / 7 (0%) 0 / 18 (0%) 13U 5 / 8 (63%) 7 / 60 (12%) 1 / 60 (2%) 0 / 32 (0%) 0 / 87 (0%) 14U 0 / 1 (0%) 0 / 6 (0%) 0 / 6 (0%) 1 / 9 (11%) 1 / 21 (5%) 14 / 23 (60.9%) 27 / 181 (14.9%) 2 / 181 (1.1%) 2 / 98 (2.0%) 2 / 285 (0.7%)
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