Twelve-year-old Brendan Everton is mowing them down, cruising through the lineup in the second inning of a late-season Willow Glen Little League game between his Yankees and the Giants.

Ball one, high.

His dad is the manager. And his mom is watching closely from the spectator side of the fence at Bramhall Park.

Foul ball, strike two.

"I don't know that I was really aware of pitch counts until they put the rule in place," Deanne Everton said. "But I think it's good to have so you don't overextend a pitcher just to win a game. You can use and misuse a pitcher."

Because of that potential misuse, Little League Baseball recently became the first and only youth program to adopt strict pitch limits and to refine its rules on how many days must pass between starts. Both moves are designed to cut down on what doctors say is an alarming rise in the number of injuries to young elbows.

But the impact of the new system goes beyond looking out for the welfare of kids as young as 7. It challenges the win-at-any-cost mentality that critics see as a problem in the increasingly competitive world of youth sports.

And that's fine with Jim Thompson, executive director of the Palo Alto-based Positive Coaching Alliance, who praised Little League's leadership on an issue that can put coaches in a bind because of their desire to win.

"When we really want something, our judgment is in danger," Thompson said. "Sitting in a restaurant talking about it, a coach might say, `No, I'd never over-pitch a kid.'

"But when you're in a game, and it's maybe the third inning and the pitch count is high," he continued, "because you want to win so badly, your judgment is marred."

Adjustments, Thompson added, will be made.

"Coaches are going to work to win within whatever rules there are."

More than 2.3 million players worldwide compete in youth leagues operated through the Little League organization, based in Williamsport, Pa. In the past, rules limited a pitcher's innings — but not the number of pitches.

In formulating the rules, Little League worked closely with James Andrews, the orthopedist who has succeeded Frank Jobe as the surgeon pro athletes seek out for the elbow repair known as Tommy John surgery.

The pitch limits vary by age:

—10 and under — 75.

—11 and 12 — 85.

—13 through 16 — 95.

—17 and 18 — 105.

Once the limit is reached, a pitcher finishes throwing to that batter. Then the bullpen takes over.

In addition, any player under 16 who throws more than 60 pitches must wait three days between starts; a pitcher who throws from 41 to 60 must wait two days; and anyone who throws from 21 to 40 pitches must wait one day.

"We still see it as a work in progress, though we're extremely pleased how well it's gone," Little League spokesman Lance Van Auken said.

Two years ago, Little League chose 50 of its 6,500 leagues to test the new program. That went smoothly enough to open it up on a voluntary basis for all leagues last season, and 500 signed up — including Willow Glen's. This year the program became mandatory.

Some remain skeptical about local enforcement of the national rule.

"The people in Williamsport cannot travel to every Little League game," said Doug Abrams, a law professor at the University of Missouri who writes about youth sports. "Will there be some cheating? Of course. But most parents and coaches don't want to go out and hurt the kids."

Much of the impetus for change came from Andrews and colleagues at the American Sports Medicine Institute in Birmingham, Ala.

Andrews told Little League officials at a 2007 gathering in Houston that the number of Tommy John — or ulnar collateral ligament reconstruction — surgeries he has performed on adolescents has risen dramatically from five annually between 1995 and 2000 to 55 in 2003 and 61 in 2004.

Pitch count, however, is only part of the reason for what he called a "dramatic escalation of these injuries."

Year-round baseball was the No. 1 factor, he said, and encouraged parents to keep their kids away from the game three months each year. He expressed concern about top pitchers competing on "traveling" teams where no limits are in place. He mentioned the emphasis on velocity and the danger of throwing too many consecutive curveballs.

Mininder Kocher, associate director of the division of sports medicine at Children's Hospital in Boston, said he also has seen a major jump in the number of teenagers with elbow and shoulder injuries, some of whom are already at risk for arthritis.

And he has encountered more than a few young pitchers pushing for Tommy John surgery when it isn't needed. "There's this sense that this is sort of a rite of passage," Kocher said. "And they've heard they can throw harder after the operation."

Kocher gave Little League's limits a qualified thumbs-up: