In high school baseball, many athletes wear more than one hat—or in this case, more than one glove. A player might pitch one day, then catch or play shortstop the next, chasing exposure and opportunity. But new data show that one combination in particular carries real danger. A 2018 prospective cohort study by Hibberd and colleagues in The Journal of Athletic Training followed 384 high school pitchers over the course of a season and quantified, for the first time, the risk of pitching and catching within the same athlete. The results were unequivocal: pitchers who also played catcher were almost three times more likely to sustain a shoulder or elbow injury.

This finding challenges a deeply ingrained developmental norm in amateur baseball—the belief that versatility equates to resilience. When that versatility includes the two highest throwing-volume positions on the field, the cost may outweigh the benefit.

The Primary Problem

Baseball’s throwing economy operates under a cumulative load principle: the more throws an arm makes, the higher the total stress on the soft tissue structures that stabilize the shoulder and elbow. Pitchers and catchers both occupy the far end of that spectrum—but in fundamentally different ways.

Pitchers throw with high intensity and moderate frequency; catchers throw with moderate intensity and extreme frequency. When those workloads overlap, the connective tissue—particularly the ulnar collateral ligament (UCL), flexor-pronator mass, and posterior shoulder structures—faces repeated submaximal stress with minimal recovery.

Prior to this study, that relationship had been assumed but never measured prospectively. The question was whether pitchers who also caught were actually more likely to be injured, or if existing guidelines (like those from USA Baseball’s Pitch Smart initiative) were overly conservative.

What the Study Found

The research team tracked 384 high school pitchers across 51 programs for one season, recording athlete exposures, position workloads, and injury incidence. Only 2.6 percent of the cohort (n = 10) were pitcher-only players, while 8.3 percent (n = 32) played both pitcher and catcher, and the remaining 89.1 percent (n = 342) played a non-catching secondary position.

Despite similar exposure counts between groups (P = .488), the pitcher/catcher group sustained throwing-related shoulder or elbow injuries at a rate of 15.2%, compared to just 5.0% in the pitcher/non-catcher group—a 2.9× increased risk (RR = 2.9; 95% CI: 1.03–8.12).

Most of those injuries were not acute—60% involved the shoulder and 20% the elbow, with nearly all categorized as overuse-related rather than traumatic. This indicates that the risk stems not from singular high-effort throws, but from cumulative volume across multiple throwing contexts.

Notably, there were no significant differences in age, total playing experience, or years of pitching between groups. That isolates the dual-role load itself as the primary driver of injury risk.

Why This Matters

From a coaching and developmental standpoint, this data sharpens a long-standing intuition: fatigue is not just about pitch count—it’s about total throw count.

Catchers might not throw with the same velocity as pitchers, but the sheer number of throws—from warm-ups to between-inning exchanges to back-picks—creates a relentless exposure profile. When a pitcher doubles as a catcher, they eliminate recovery days designed to restore tissue integrity, particularly in the forearm flexors and posterior shoulder. Over time, those micro-stresses accumulate into measurable decrements in tissue elasticity, joint stability, and scapular rhythm.

Even though the study found no difference in acute injury mechanisms, the dominance of overuse-related pathology highlights how subtle accumulation can outweigh intensity in predicting breakdown. In this light, volume management becomes more critical than simply enforcing rest days.

The Hidden Risk of “Rest Days” That Aren’t

One of the most deceptive practices in amateur baseball is labeling a day as “rest” when a pitcher spends it catching. Physiologically, this is not rest—it’s active overuse.

The arm may experience lower torque per throw in the crouch position, but the frequency and repetitive deceleration demands on the elbow flexors and shoulder stabilizers remain constant. Each throw reinforces fatigue patterns rather than alleviating them.

The Hibberd study’s lack of difference in athlete exposure between groups underscores that workload isn’t about innings—it’s about throws. Catching simply redistributes that stress across a different mechanical context without allowing structural recovery.

This concept mirrors findings from broader overuse literature, where prior injury consistently predicts future injury. The compounding nature of incomplete recovery—especially when it occurs before bone or tendon maturation—is what transforms mild soreness into chronic pathology.

How Velo University Applies This

At VeloU, we treat throwing workload as a unified system, not segmented by position. Whether an athlete is throwing 90-mph fastballs or 60-mph return throws from the crouch, the forearm and shoulder tissues interpret both as load events.

Our approach integrates three principles derived from this and similar research:

1. Unified Load Tracking: All throws count. We quantify total throw volume, not just mound pitches.
   
   
2. Position-Specific Recovery Windows: Pitchers who also play catcher receive extended off-days or modified workload blocks emphasizing isometric and low-load recovery movements for the shoulder complex.
   
   
3. Movement Literacy Over Role Versatility: Rather than glorifying the “two-way player” model, we emphasize mechanical literacy—teaching athletes how to move efficiently within their role before layering volume.
   
   

These measures ensure that high workloads are supported by adequate strength, tissue resilience, and energy system recovery—preventing the subtle accumulation that this study found to be the true injury driver.

Closing Thoughts

The instinct to keep athletes “in the game” by moving them behind the plate on their non-pitching days may seem harmless, but the data tell a different story. Hibberd et al. (2018) quantify what many clinicians and coaches have long observed anecdotally: the arm doesn’t forget its last outing.

A 2.9× greater risk of shoulder and elbow injury is not a marginal difference—it’s a signal. For developing pitchers, recovery isn’t optional; it’s part of performance. By redefining rest as an active, measurable phase of training rather than simply a lack of innings, programs can finally begin to reduce the preventable injuries that derail long-term development.

In the end, it’s not about keeping kids from playing multiple positions—it’s about understanding what each throw costs. And when the same arm handles both the mound and the crouch, that cost multiplies fast.

References

Hibberd, E. E., Oyama, S., & Myers, J. B. (2018). Rate of Upper Extremity Injury in High School Baseball Pitchers Who Played Catcher as a Secondary Position. Journal of Athletic Training, 53(5), 510–513. https://doi.org/10.4085/1062-6050-322-16