Dr. Andrews Offers Some Advice to Baseball

If you are a coach or the parent of a pitcher, here's an important article with some words of wisdom from Dr. James Andrews, considered by many to be the leading orthopedic surgeon in the world. Here are some highlights of what he has to say:

• Radar guns should be outlawed. Trying to throw harder increases the chance of injury.

• Young pitchers throwing at high velocities are putting too much stress on their elbow.

• Year-round baseball should be banned. Ligaments need rest to develop.

• Pitchers should never pitch on consecutive days.

• Pitchers should never finish an inning when they are tired or sore.

• Playing on multiple teams is a risk factor, especially when the coaches do not communicate.

Reason Enough To Back Up the Mound

Braydon Salzman was extremely lucky to avoid serious injury on Friday at the Little League World Series. Watch the video if you haven't seen it. Little League's days with a 46 foot mound are hopefully numbered.

Five-Year UNC Curveball Study Complete

A study of over 1,300 youth pitchers has been concluded by the University of North Carolina and Little League Baseball. The results: overuse, not curveballs are to blame for arm injuries.

As mentioned before on this site, it's the young pitchers that repeatedly push themselves to the limit without enough rest in between outings that risk hurting themselves. And previous studies have indicated that curveballs don't put any more stress on the arm than fastballs.

Still, the calls for banning curveballs in Little League have persisted. But Little League President and CEO Stephen Keener has now concluded that a ban won't be necessary.

Playing Catch With a Purpose

I read a good post at The Pitching Academy about the benefits of throwing often when done with a purpose. Baseball is fun, and it's fun to just go out a throw the ball around. But when teams are warming up for practice, players - especially pitchers - can gain a lot from working on their mechanics.

Far too often I see a kids that have been taught to pitch or throw correctly, some by me, go out and warm up for practice with poor mechanics - not closing up, glove flying out, no follow through. They get nothing out of those ten minutes other than getting their arm loose. But if they would focus on what they're doing during that time like they would the rest of practice, they could improve their arm strength, their mechanics, their control, their various fastballs and their changeup or other offspeed pitches.

Mechanics can be learned at an early age. Once players get in the habit of throwing correctly, they'll never lose that skill. It's like riding a bike. But until the good habits fully take over, players will continue to fight against the bad habits on the mound and in the field. If they don't close the shoulder, or tuck the glove, etc., during those 30 throws before practice, how can we expect them to do it in a game?

And that changeup grip takes months, if not years, to get comfortable with. Pitchers who practice it during long toss or while cooling down can speed up that time significantly. Play "catch" with a purpose and some focus and the progress will show.

Recommended Reading for Serious Pitchers

Here's a link to a NY Times article on Harvey Dorfman, former MLB "Mental Performance Coach" who helped the careers of countless pro baseball players. Dorfman lived in North Carolina at the time of his death in February. He authored one of my favorite baseball books, The Mental ABC's of Pitching, which is guide to controlling your thoughts and emotions as a pitcher. I highly recommend it.

The Root of Big League Arm Trouble

I just read an important blog post by Eric Cressey of Cressey Performance about the importance of limiting the amount of pitching by youth baseball players: Your Arm Hurts? Thank Your Little League, AAU and Fall Ball Coaches.

This is another strong warning to coaches and parents that the high school, college and professional pitchers that end up having arm surgery are often the ones that threw too much at a younger age. Many times the damage is done earlier in their careers, even though the pitcher may not feel any pain until years later.

As Cressy reminds us, pitching a baseball overhand is a violent, fast, unnatural act. Unless you're this guy, your arms hang down and your shoulders are rounded. Throwing underhand is more natural for the human body.

Throwing overhand is a complex motion. There's a lot that can go wrong over time. That's why we need to ensure that our youth pitchers are taught proper mechanics. And we have to be careful that they don't throw too many pitches, and see that they get enough rest, both between outings and during various shut-down periods throughout the year.

Cressey stresses the importance of strength training and playing other sports. Kids need to develop their overall athleticism and strength, and should not specialize in one sport until their late teenage years, if then.

Little League pitch count regulations are beneficial to protecting young arms. But they don't prevent a player from participating on multiple teams. And not every 11- and 12-year-old can handle 85+ pitches in a game. The doctors that Little League consulted when that number was put in place recommended less. So it is up to coaches and parents set the rules. Just because a kid loves to pitch, it doesn't mean he should always push himself to the limit.

Here again is the link to the article. If you are a coach or a parent of a pitcher, I recommend taking a couple of minutes to read it.

How to Protect Pitchers from Injury

I came across an important article from last year by Eric Cressey: Understanding Elbow Pain - Part 4: Protecting Pitchers. Cressey is a expert in the field of physical training for amateur and professional athletes. He works with a lot of baseball players and knows what he's talking about. He has a useful blog that I read occasionally, which our high school pitchers might also be interested in.

The article is wordy, but here are essentially Cressey's four primary ways to protect pitchers at any level:

1. Good Mechanics. No two pitchers are alike, but there are certain angles and timing issues to avoid, which exert more stress on the elbow. Visit my Lessons page for additional info on learning proper mechanics at a young age.

2. Avoiding Overuse. This has been discussed by about everyone. See the post below.

3. Long Term Physical Preparation. I think flexibility is most important for youth pitchers, but strength training is beneficial as well.

4. Short Term Physical Preparation. Pitchers should warm up their bodies first, then their arms. And don't forget the stretching and cool down period afterwords.

There's much more in the article, including some good links in each section.

Five Ways to Prevent Overuse Injuries

Here is a link to a timely article at Mom's Team on how to prevent overuse injuries. According to the National Athletic Trainers Association, 50% of youth sports injuries are caused by overuse / repetitive stress. Their top five ways to prevent such injuries are:

1. Education and supervision;
2. Pre-participation physical exams;
3. Participation limits;
4. Training and conditioning; and
5. Delayed specialization.

Check out the article for all the details.

Easton Unveils New Pitching Helmet

Easton-Bell Sports has introduced a prototype for a safety helmet to be worn by pitchers, and the company expects nationwide use of the product to begin in youth leagues by fall.

The product was unveiled and will be initially worn by Gunnar Sandberg, a Marin (CA) Catholic High School senior who was seriously injured by a line drive while pitching a year ago. Sandberg no longer pitches because of an arm injury, but he plans to wear the 5 1/2 ounce padded helmet while playing the field as a 1st Baseman this season.

Easton-Bell and the Sandberg family hope that widespread use of the new product catches on. Stephen Keener, president and CEO of Little League Baseball, Inc., says that he will support it. Easton is the official team equipment supplier for Little League, and the organization has been a leader in safety modifications throughout its history. So don't be surprised to see the pitching helmet on the field at some point over the years to come.

Another Study on Youth Pitching

The results of a 10-year study on youth pitching have been published by The American Journal of Sports Medicine. This one, which began in 1999 before pitch counts were the norm in youth baseball, used innings pitched as the primary risk factor to be measured. The study also looked at pitchers who played the position of catcher and those who threw curveballs before the age of 13.

The study found that youth pitchers throwing more than 100 innings per calendar year were 3.5 times more likely to experience a serious arm injury. It found a small increase in injuries for those pitchers also playing catcher. But it was unable to find a correlation between curveballs and injuries.

The details of this study, as well as a good summary on youth pitching and previous research on the subject, are in the AJSM publication. This is not exactly new information - we know quite a lot more about overuse injuries than we did in 1999. But it is further confirmation and another reminder of how careful we need to be about the number of pitches our boys throw, how fatigued they get when pitching, and how much rest they get between outings. Taking these precautions, which are mostly mandated by Little League rules, and teaching proper mechanics will go a long way toward keeping our pitchers safe.

Arm Care and Velocity Development Clinic

Tickets for the 2nd annual Arm Care and Velocity Development Clinic are on sale at the South Charlotte Sports Report. This clinic is led by Alan Tyson of Architech Sports & Physical Therapy. Tyson is considered one of the leading arm care specialists in the region.

This clinic is highly recommended by many baseball people in the area. It is for serious pitchers, age 12-18. It is a non-throwing event, since many pitchers have shut down their arms for the winter. But the information provided by Tyson and the other speakers is said to be extremely beneficial.

The event is on Saturday, December 4th from 8:00 am to 12:00 pm at Ardrey Kell High School. The cost is $90 per player-parent combo. Visit the South Charlotte Sports Report website for more information.

Article on Overuse Injuries

Tommy John, then of the Los Angeles Dodgers, was the first to undergo ulnar collateral ligament (UCL) replacement surgery. Since that initial procedure performed by Dr. Frank Jobe in 1974, Tommy John Surgery has become a common fix for serious elbow injuries. And as previously mentioned in this blog, it has become far too common in young pitchers.

Here is a link to another article about overuse, or "repetitive stress" injuries in young athletes. Amanda Schoenberg writes in the Albuquerque Journal about author Mark Hyman's experience with his own son's injury, and his book on the subject, "Until It Hurts."

I am currently reading the book and will comment on it later. But for now, there is some useful information on overuse injuries in this article. The more informed we are, the better.

What's Causing the Arm Injuries?

This guy on the left is not the only one having significant arm trouble these days. He's just the most prominent. Stephen Strasburg of the Washington Nationals was the #1 overall pick in the 2009 MLB Draft. His college and pro coaches were careful with him because he was widely considered to be the best pitching prospect in years, if not decades. But apparently it was too late. Perhaps the damage was done before he even got to college.

Strasburg is one of many elite pitchers having to undergo surgery and take months off these days due to UCL or shoulder injuries. But the trend is not limited to the best in the world. Youth pitchers are blowing out their arms at a high rate too. But why? Is it flawed mechanics? Curveballs? High pitch counts? According to the doctors and the studies, there are several factors.

Gregg Doyel of CBS Sports blames it on youth coaches and parents. His article from August 26, 2010 may be on to something. Doyel is no expert when it comes to arm care, but he can connect the dots based on what the experts say. Among the primary experts are Dr. James Andrews and Dr. Glenn Fleisig of the American Sports Medicine Institute (ASMI), among other credits.

ASMI conducted a study with some important conclusions - mainly that while arm injuries often do not rear their ugly heads until high school or college (or later), they can begin in youth leagues. How do they begin in youth leagues? Overuse at a young age. Not a new term - that's why we have pitch counts. The study says that arm fatigue is the primary factor involved: "When regularly pitching despite arm fatigue, the risk for injury requiring surgery increased 3600%." That's almost a guarantee.