Adam M. Smith, M.D.

Adam M. Smith, MD, is a board-certified orthopedic surgeon at West Tennessee Bone & Joint Institute’s location in Jackson, Tennessee, specializing in shoulder and elbow conditions.

Dr. Smith earned his Doctor of Medicine from the University of Kentucky College of Medicine in Lexington, Kentucky. Following graduation, he completed his residency at Wake Forest University Baptist Hospital Medical Center in Winston Salem, North Carolina.

After his residency, Dr. Smith participated in a fellowship in shoulder and elbow reconstruction at the Mayo Clinic in Rochester, Minnesota. His practice focuses on shoulder and elbow reconstruction, including standard reverse total shoulder replacement, elbow replacement, ligament reconstruction such as UCL reconstruction, joint preservation arthroscopy, traumatic and post-traumatic reconstructions, range of motion restoration, as well as nerve disorders of the upper extremity.

Dr. Smith is a member of several notable professional organizations: The Society of the American Shoulder and Elbow Surgeons, the American Academy of Orthopedic Surgeons, the Tennessee Medical Association, the Tennessee Orthopedic Society, the West Tennessee Consolidated Medical Assembly, and the West Tennessee Physicians’ Alliance.

1. In general, is baseball a dangerous sport for young athletes?

No — baseball is generally considered one of the safer organized youth sports, especially when compared to high-contact sports like football or soccer. Overall injury rates for young players (ages 5-18) typically range from 2-8% per year, with most issues being minor (contusions, sprains, or strains from fielding, batting, or base running). Serious acute injuries or fatalities are rare.

The biggest risks are overuse injuries to the shoulder and elbow (especially for pitchers and catchers), which account for a large share of problems but are highly preventable with the highest being for catchers who also pitch. Baseball does have the highest fatality rate among sports for children ages 5-14 (about 3-4 deaths per year nationally, usually from being hit by a ball or bat, or rare commotio cordis), but these events are extremely uncommon relative to the millions of kids who play.

2. What should pitchers do to avoid injury?

The vast majority of pitcher injuries are felt to be overuse-related and tied to too much throwing without recovery. Other factors involve growth plate injuries during a child’s rapid growth period.

MLB/USA Baseball Pitch Smart and Little League guidelines recommend coaches follow age-appropriate pitch-count limits and rest requirements. For example, 9-10 year-olds max out at 75 pitches per day; 11-12 year-olds at 85; 13-14 at 95. Required rest days increase with higher pitch counts (e.g., 66+ pitches often require 4 days rest). A period of rest each year for  3-4 months from competitive pitching.

We also recommend that coaches avoid high-risk behaviors such as catching and pitching on the same team (or even the same day in most cases) and playing on multiple overlapping teams/leagues.

3. Are younger players more prone to pitching-related injuries than adults?

Yes — younger pitchers are more vulnerable to certain pitching injuries than adults, primarily because of open growth plates, weaker surrounding muscles/tendons, and higher rates of year-round specialization. Overuse injuries like “Little League elbow” (medial epicondyle issues) and “Little League shoulder” (growth-plate stress in the humerus) are unique to kids whose bones are still developing.

Data shows a sharp rise in youth UCL (ulnar collateral ligament) injuries and Tommy John surgeries over the past 15-20 years. Adolescents (15-19) now account for a large percentage of these procedures in the U.S., whereas they were once rare in anyone under 20. Youth who pitch excessively early often carry micro-damage into adulthood. Adults have closed growth plates and better-conditioned bodies, so while pros still get hurt, the physiological risks differ.

4. What would you tell a parent whose child is considering the pitching position?

Pitching can be incredibly rewarding — it builds mental toughness, precision, and leadership — but it demands the highest arm workload on the team. The key message is: Protect the arm first; everything else (velocity, wins, college scholarships) follows. Treat pitch counts, rest days, and off-seasons as sacred rules (not suggestions).

Prioritize multi-sport participation — playing other sports in the off-season reduces injury risk and builds better overall athletes.

Watch for any arm soreness, fatigue, or drop in velocity, and stop throwing immediately.

Seek coaches who emphasize mechanics, fun, and long-term development over short-term results.

Consider having the child play other positions when not pitching to give the arm a break.

General prevention for all players (not just pitchers):

• Proper warm-up/stretching, strength training (focus on legs/core), good helmets and face guards, safe sliding technique, and hydration/nutrition.
• Teach kids to communicate openly about how their body feels.
• Parents & coaches as partners: Track pitches across all teams, attend preseason meetings about safety rules, and model balance.

Dr. Smith grew up playing baseball and then played in college.