Why Elbow Injuries Increase in Baseball Pitchers During Spring Training

Posted on: March 28th, 2026 by Our Team

Every year as spring training begins in Major League Baseball, pitchers across all levels—from youth leagues to the professional ranks—start ramping up their throwing programs. The return to high-volume throwing after an offseason break is an exciting time for players and fans, but it also represents one of the most vulnerable periods for elbow injuries in pitchers.

Medical staffs across Major League Baseball pay particularly close attention to pitchers early in the season because this is when the stress placed on the elbow begins to increase rapidly. When throwing workloads escalate too quickly, the tissues around the elbow may not have sufficient time to adapt, increasing the risk of injury.

Why the Pitching Elbow Is Vulnerable

The act of pitching places extraordinary forces on the elbow. During the late cocking and acceleration phases of the throwing motion, the elbow experiences valgus stress that attempts to pull the joint apart on the inner (medial) side.

The primary structure resisting this force is the ulnar collateral ligament (UCL), a small but critically important ligament that stabilizes the inner elbow. In fact, the forces generated during a professional fastball often approach or even exceed the strength of the ligament itself.

Fortunately, other structures—such as the flexor–pronator muscles of the forearm—help share this load. When these muscles fatigue or become overloaded, however, more stress is transferred to the ligament and surrounding tissues.

Common Elbow Injuries in Pitchers

Several elbow conditions frequently develop in pitchers during periods of increased throwing volume.

One of the most well-known is UCL injury, which may range from a mild sprain to a complete tear requiring surgical reconstruction. This procedure, commonly referred to as Tommy John surgery, has become increasingly common in high-level pitchers.

Other common conditions include flexor–pronator strains, which involve the muscles that help stabilize the inner elbow during throwing, and ulnar neuritis, where irritation of the ulnar nerve can cause numbness or tingling in the ring and small fingers.

Younger pitchers may also develop medial epicondyle apophysitis, often called “Little League elbow,” which involves irritation of the growth plate on the inside of the elbow.

Why Spring Training Is a High-Risk Period

The early part of the baseball season represents a transition period for the throwing arm. During the offseason, many pitchers significantly reduce their throwing workload. As spring training begins, the number of throws, the intensity of those throws, and the frequency of throwing sessions all increase.

If this progression occurs too quickly, the elbow structures may not have sufficient time to adapt to the increased stress. Fatigue, decreased shoulder mobility, and inadequate conditioning can further increase injury risk.

For this reason, many teams follow carefully designed progressive throwing programs that gradually increase both volume and intensity.

What Pitchers at All Levels Should Remember

While professional pitchers have access to full-time medical and performance staffs, the same principles apply to youth and recreational athletes. Gradual progression in throwing workload, proper conditioning of the shoulder and forearm muscles, and attention to early warning signs are essential for protecting the elbow.

Persistent medial elbow pain, loss of velocity, decreased command, or numbness in the hand should never be ignored. Early evaluation can help identify minor injuries before they develop into more serious problems.

The Bottom Line

The start of baseball season is an exciting time, but it is also a period when elbow injuries can occur if throwing workloads increase too quickly. Understanding how these injuries develop—and respecting the importance of gradual progression and recovery—can help pitchers stay healthy throughout the long season ahead.