Why the Medical Community Doesn't Understand How to Decrease Risk of Injury to Pitchers
A few weeks ago I came across an article discussing the newest policy statement on youth baseball released by the American Academy of Pediatric’s Council on Sports Medicine and Fitness. This statement is being shared with pediatricians across the country proposing new recommendations to help promote “safe participation” in youth baseball (and softball). As I was reading some of the proposals from the Council my immediate reaction was that they truly have no clue how to prevent baseball pitchers from getting injured. With all the brilliant medical minds that are sure to be on the Council, nobody understood the actual nature of why so many athletes are getting injured.
Sure these doctors have studied the stress that the overhand motion puts on the skeletal system, the tendons and ligaments, and soft tissue in a pitcher’s arm, but they don’t have any idea how to PREVENT injury – only how to treat a player after an injury. Some of the suggestions of the Council include limiting the number of pitches for pitchers under the age of 10 to 75 or fewer; pitchers will take at least 3 months off each year; throwing curveballs should not be done until age 14 and sliders until age 16; and last, but certainly not least, all young pitchers will get instruction on “proper throwing mechanics.”
Of all these recommendations, I have to admit, the last one sounds pretty great – get all young pitchers instruction on proper throwing. But realistically this is impossible. I have been in the same room with some of the sharpest pitching minds in all of baseball and I’m not sure they could all agree on what proper throwing mechanics look like. I think that most would agree that there are certain positions that need to be reached at different stages of the delivery, but how to get to those positions is up for debate. I am of the opinion that mechanics in and of themselves shouldn’t really be taught, especially not in an assembly line/cookie cutter process. It is more important to create drills that will naturally allow pitchers to reach the critical positions in the delivery. But I suppose to doctors in a class room any longtime pitching coach will be able to teach “proper throwing mechanics.”
Now I want to address the real heart of the problem that shows just how far away the medical community is from understanding how to prevent injury. The Council’s other recommendations are all essentially of the same nature – limit the number of pitches that an athlete throws in order to help keep him healthy. Now this may make sense to some – the fewer pitches thrown means less stress on the arm which means less risk of injury. But this is not fixing or addressing the problem of too many injuries in youth pitchers, it is simply a way of masking the problem. For example, if you wanted to decrease the number of accidents involving 16 year old drivers you could simply raise the driving age to 17. You haven’t fixed the source of the problem you’ve only delayed the results until they turn 17.
This is essentially what the medical community believes will be best for pitchers – to pitch less and rest more, thereby delaying any odds that you get hurt. This will not fix the problem of injuries to youth pitchers. At some point, that pitcher will break down, but it might be at age 17 instead of 15. This really helps no one. This is not a solution to the problem of why so many pitchers are injured.
As for pitch counts, they are, in theory, not a bad idea as every pitcher reaches a point where he is no longer prepared – either in terms of physical conditioning, arm strength, or mental/concentration stamina – to continue pitching without risk of injury. But the problem with setting a fixed number applicable to all pitchers is that for many youth pitchers they will not be able to handle even 50 pitches without a risk of injury, and therefore, even 75 pitches are too many. For others, 75 pitches is no problem because of the shape they are in and the strength of their arm and could readily handle 100 pitches before fatigue sets in. An arbitrary number such as 75 will surely protect some arms, but at the same time will leave players who aren’t ready for 75 pitches still at serious risk of injury.
Of all the suggestions mentioned by the Council the worst is the recommendation that all pitchers rest for at least 3 months a year. The way I read the recommendation is that it means to take this period of time off from any intense throwing in general, which is the type of suggestion that will lead to more injuries. What pitchers, especially youth pitchers, need is to throw more, not less. Now I don’t necessarily mean pitch more, but they need to throw more. Most pitchers these days throw too little and pitch too much. We need to teach pitchers the benefits of throwing a baseball everyday, whether it is long toss or simply a nice easy game of catch. Throwing more will help condition the arm for the stress of pitching. This may seem obvious, but the reality is that in most cases when a pitcher tells a coach his arm is tired or sore the response is to take the day (or a few days) off to rest.
This would be like telling a runner training for a marathon who feels tired or sore to take some time off from running in order to be better prepared for the marathon. If the runner did this there is no doubt that he/she would be further from the goal of running the marathon. Instead, when runners are tired/sore form intense training they don’t rest, but instead they go for a nice and easy 3 or 4 or 5 mile run instead of the longer 10+ mile run they had planned on. This analogy should equate to pitchers. When a pitcher is sore or tired the best thing for him is to play catch, even if it never reaches more than 50 or 60 feet.
To take 3 months, which is one fourth of a year, off from pitching is a travesty. This will only lead to more underprepared and out of shape pitchers taking the mound who will be far more likely to get injured.
Until the medical profession recognizes, like many elite baseball coaches already have, that the way to reduce injury is to better prepare/train for the act of throwing, pitchers of all ages will continue to frequently get hurt. Any pitching athlete, no matter the age, should specifically train for the explosive movements made during a throw. Further, all baseball players need to throw MORE not less in order to strengthen their arms and improve its stamina.
The first step to reducing injury lies mostly in the hands of coaches. Research and develop better warm up and conditioning exercises for your athletes to perform every day. Allow more time during practice for athletes to throw. No more of the “you have 5 minutes to throw and get loose” mentality. Instead, give players a minimum they must throw, such as 20 minutes, every day at practice. Give them the option depending on how their arm feels that day as to how far they want to extend it, but make sure they throw at some distance for at least a certain amount of time. Furthermore, more throwing for young baseball players is beneficial to teaching mechanics because the more opportunity a youth athlete has to throw the more able he will be able to innately find a more efficient way to throw the baseball. This too will help decrease risk of injury.
These are the ways that arm injuries will decrease. Not by simply setting pitch limits and encouraging lots of rest.
Until next time,