Dylan Fosnacht of Rochester (Wash.) High School worked 14 of the team’s 17-inning victory on Tuesday, racking up 17 strikeouts on 194 pitches. Yes. 194 pitches.

If 194 sounds like a lot of pitches, it is, even at the major league level. Since 1914, there have been only six games in which a pitcher has thrown 190 or more pitches in a game, and none since Sandy Koufax in 1961.

Player Date IP Pitches
Joe Hatten 09/11/48 12.2 211
Robin Roberts 04/16/57 12.0 190
Herm Wehmeier 05/02/57 12.0 203
Sandy Koufax 05/28/60 13.0 193
Stan Williams 05/17/61 11.0 207
Sandy Koufax 09/20/61 13.0 205

“He never really got too deep into counts to anybody,” Rochester Coach Jerry Striegel said Thursday in a telephone interview. “He did not lose any velocity. Things had not changed for him. We talked about it every inning, not only with him but with our two assistants, and just had decided he was strong and could keep going.”

“Everyone is different,” explained Glenn Fleisig, research director for the American Sports Medicine Institute, which was founded in 1987 by orthopaedic surgeon James Andrews. “One hundred ninety four pitches for one kid might be the same as 160 for some other kid or 250 for some other kid because everyone is a little different. Needless to say, 194 pitches is an awfully high number of pitches for one game.”

The American Sports Medicine Institute studied 476 baseball pitchers ages 9 to 14 for one season and found “there was a significant association between the number of pitches thrown in a game and during the season and the rate of elbow pain and shoulder pain.” The group did a 10-year study to quantify the cumulative incidence of throwing injuries in young baseball pitchers that recommended “pitchers in high school and younger pitch no more than 100 innings in competition in any calendar year.”

“I think he has probably thrown about 25 innings on the season” until Tuesday’s 194-pitch game, Striegel said. “We consider him our number two starter. We play three games a week, so generally he gets one start a week. He really didn’t start playing until the first of April.”

While it doesn’t appear Fosnacht carries a heavy workload in terms of innings or pitches on a regular basis, throwing an overabundance of pitches during a start could cause long-term damage.

“Let’s say you pitch a moderate amount — whatever moderate means — you get these microscopic tears, and then you rest; your body repairs them,” explained Fleisig. “However, if you pitched a lot one day and then a few days later it is your turn to pitch and your body hasn’t repaired, you are starting the game with some damage. And whatever you pitch today is going to build on last week’s damage. If you do so much damage or don’t allow it to rest, these tears are actually too big to recover. You can rest a week or 10 years and you will not recover. The tears just become too big to repair.”

“That is what Dylan would do,” Striegel said when I read him Fosnacht’s tweet. “That’s what I would expect from Dylan. He is a competitor.”

“People want a guy like that on their team and as a high school boy you feel fairly invincible,” Fleisig said. “In general, it is not just the player, it is the parents and the coach that have to be on the lookout. It’s ultimately, I believe, the parents’ responsibility — especially at the youth level — because coaches come and go, but you are that kid’s parents forever.”