(WOMENSENEWS)—The wear and tear Major League Baseball tries to save its pitchers from by requiring them to rest and embracing new pitching strategies isn’t also being applied to adolescent female softball players, who are increasingly showing up at my clinic with serious repetitive strain injuries.

I have treated female patients as young as 13, and the overwhelming majority have one thing in common: upper extremity repetitive motion. One outcome of this can be thoracic outlet syndrome, a mechanical compression of the artery, vein or nerve to the arm. But my patients aren’t flutists or violinists, they are usually athletes. Whether it be from playing baseball, softball, basketball, swimming or tennis, this chronic nerve compression can lead to tingling or numbing sensations and arm or hand weakness. Worse still, mechanical pressure constricting blood vessels can cause a blood clot or inadequate blood flow to the arm. Ultimately it may require surgery and physical therapy.

But while boys are just as likely to get the syndrome and prone to injury as girls, there are less safeguards in place to prevent these adolescent female athletes, in particular softball players, from getting injured.

As my patients come to me with stories assuring me they started throwing a ball as soon as they could walk, I sit back with a smile as I remember my days in Little League. I would go to school, come home to do my homework and then ride my bike across town to softball practice. We would typically have practice twice a week to prepare us for our Sunday game.

No Longer Playing for Fun

But kids’ sports today are a different game altogether. Most young athletes practice daily, often twice daily as the years go on. Weekends are consumed with traveling for tournaments. Do kids still play for fun in this country? Some would say it depends on the age. Toddlers and children under 5 still play sports for fun, but once grade school hits, it changes. It’s a life decision at age 6. With the massive consumption of video games and cell phones, the backyard game of soccer between neighbors is of historical note only. With physical education and “gym” quickly disappearing from the public school curriculum, fewer kids play sports. But for the kids who are training, many of them girls, they’re doing so at Olympian fervor these days.

In this quest for a college scholarship and ultimately a million-dollar professional contract, there is a cost. The human body is not designed to take such a beating. This has led to the idea of a pitch count for baseball pitchers, a rule that’s implemented to protect the pitcher. USA Baseball and Little League provide easy-to-read charts to guide coaches on how many pitches an athlete should throw based on their age. For example, if a 14-year-old throws 51 pitches in a game, he requires a three-day rest.

A Different Standard

So imagine my surprise as I listened to one of my female patients and her father tell me she pitched nine games straight without any rest days. “But how can that be?” I asked. Because it seems that pitch counts are only for boys. In fact, there are no pitch count limitations in softball, commonly played by women and girls, at any level.

Many sports enthusiasts and commentators say this lack of pitch counts is because of a difference in the type of pitching. Girls pitch softballs in an underhanded windmill delivery, which they propose is a more natural motion. But because thoracic outlet syndrome is found in virtually every sport involving the upper extremity, that argument does not hold water. Sherry Werner, who has a doctorate in biomechanics and runs a Fastpitch Academy in Fort Worth, Texas, agrees that that theory is wrong. She urges young girls to take care of themselves and not be afraid to speak up if they are being overworked.

But what if the coaches don’t listen? My patient’s father explained, teary-eyed, how his daughter has told her coaches and trainers about her pain and numbness for over two years.  He was met with assurances that she is OK, and “She can pitch.”

This isn’t acceptable. As sports, including baseball and softball, continue to intensify for our young men and women, we must remember that what’s good for the pros  — rest, diversifying sports and remembering to have fun — is also good for our girls.