When it comes to kids and sports injuries,  concussions — especially among football players — get all the press. But each year more than 60,000 young athletes get hurt on the baseball diamond. Their injuries can include knee injuries, such as tears in the anterior cruiciate ligament (ACL) muscle while rounding the bases, and yes, even head trauma from colliding with another player.

But the majority of injuries among young baseball players are elbow and shoulder injuries in pitchers and catchers, “due to the throwing motion and the sheer number of throws they make in each game,” says Tracy R. Ray, MD, a sports medicine physician at Duke University Medical Center. Ray specializes in youth baseball injuries and is a member of the American Medical Society for Sports Medicine.

“These are repetitive stress injuries caused by the throwing motion and the sheer number of throws made in each game,” explains Ray. Pitchers are particularly at risk of serious shoulder injuries. These injuries are on the rise, largely because youth baseball has become so competitive.

“Almost all youth baseball leagues have rules to prevent pitching injuries,” says Ray.  Little League baseball and USA Baseball have age-specific guidelines for the number of pitches players are allowed to throw per game, how many days they should take off between games and so forth, for example. The problem is, many kids play in multiple leagues. This means that the coach of one team isn’t aware of how often a kid is pitching for the other team. It doesn’t help, adds Rocco Esposito, who coaches recreational baseball in Montclair, New Jersey, that kids aren’t always honest about how much they pitch. “A devoted pitcher is going to want to be on the mound as much as possible,” he says.

What’s more, coaches don’t always put kids first, says Esposito. A recent study found that 46 percent of baseball players between ages 8 and 18 said their coaches had encouraged them to keep playing even when they were feeling pain.

A related study found that more than half of parents of baseball pitchers didn’t know about safe pitching guidelines. But it’s up to moms and dads to advocate for a kid’s safety on the diamond. This playbook should help.

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Team up with the coach

young pitcher

If you’re worried a coach is going to have your kid pitch too much, step in. “You don’t need to be argumentative or posturing,” says Ray. “Just say, ‘Hey coach, this is what I’ve learned and I’m concerned about my son.’” Make sure your child doesn’t catch during the same game he pitches.

Don’t let your young pitcher get too fancy, either. Kids under 12 should stick to throwing fastballs and change-ups, says Esposito. Only players 14 and up should throw breaking balls, such as curveballs and sliders, which require turning and snapping the wrist in a way that can injure elbows.

Related: Are Indoor Trampolines Safe?

Warm up, cool down and stay fit

No matter what position your kid plays, he should warm up before every practice and game. Staying hydrated before, during and after play is important, too. Strength training is a great way to prevent injury, even for kids as young as 8, according to the American Academy of Pediatrics, as long as workouts are supervised and tailored to a child’s age and ability.

According to Safethrow.org, young pitchers can greatly lower the risk of shoulder injury by doing a particular shoulder stretch after each game and practice session. The stretch helps to loosen up the posterior-inferior glenohumeral ligament — the ligament that gets dangerously tight from repeated overhead throwing. Tightness in the ligament can lead to serious injuries, such as tears in the rotator cuff. (Photo: Rob Hainer/Shutterstock)

Urge your kid to play the field

The sports field, that is. Intensive year-round training in just one sport greatly increases your child’s risk of injury. Playing a variety of sports during different seasons can help prevent overuse injuries because it means working different muscles in different ways.

Never play through the pain

Pay close attention to how your child is feeling after practice and during games. Tell the coach to take him out if he seems to be hurting in any way, and if he’s really injured, work with his doctor to make sure he stays off the field until he’s fully healed, which can take as long as six to eight weeks. “I tell young patients, ‘If you continue to play this much, you’re going to be the kid who everyone says could have gotten to the next level but never did because of injuries,’” says Ray. “The most important thing is that you stay healthy.”

Related: Don’t Let Your Child Scoot His Way Into the Emergency Room