quote:Originally posted by MidAtlanticDad:
Skylark,
I went through this with my 2015 when he was 13. Now he's a catcher.
First, I heartily agree with you that there are too many factors involved in elbow and shoulder injuries to point to a single factor, or even multiple known factors. All the studies I've ever read say the same thing. There simply aren't enough comprehensive studies yet.
However, I don't think Josh's doctor told him that he "tore" the ucl at 9, he probably surmised that the ligament was gradually damaged over many years. The ucl is not likely to tear until the growth plate has fused to the bone. I know several young pitchers who have torn that plate loose. One had surgery to screw it back in place, the others let it heal on it's own.
Now as far as most college pitchers starting at a young age, I'll give you an intentionally outrageous analogy. All of the elderly smokers that I know started smoking at a young age, and they're still going strong. :-)
I've compiled some reading material over the years. Let us know if this is what you're looking for.
http://www.hopkinsortho.org/ucl.html
"These stresses create microscopic tears in the ligament, which can add up to one big tear over time. (Figure 2) This gradual stress causes the ligament to stretch and become too long. Once it gets too long, it no longer holds the bones tightly enough during throwing activities."
http://ajs.sagepub.com/content/30/4/463.full.pdf
Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers
http://www.abe.msstate.edu/Too...eball%20Pitchers.pdf
Prevention of Arm Injury in Youth Baseball Pitchers
"In the age group 9 to 14 years, a high pitch count and also breaking pitches (curveball, slider) were significantly associated with an increased risk of elbow and shoulder pain. The study was statistically underpowered to show a significant risk of joint pain related to pitching mechanics. An increasing pitch count and cumulative count through the season was linearly associated with an increased risk of joint pain. It was therefore recommended that not only should pitch count be limited but season cumulative pitches as well."
http://www.littleleague.org/As...s/media/UNCStudy.pdf
The Learning Curve: Little League Seeks to Address Concerns, Answer Questions about Curveballs and Overuse
http://ajs.sagepub.com/content/33/11/1716.full.pdf
Biomechanics of the Shoulder in Youth Baseball Pitchers
http://www.chw.org/display/PPF/DocID/41203/router.asp
"LLE (Little League Elbow) may be used to describe a spectrum of disorders from a stress reaction to avulsion fractures of the medial epicondyle to osteochondritis dissecans of the capitellum and loose bodies. It occurs most often between 8 to 15 years of age."
"After physeal fusion, the ulnar collateral ligament and ulnar nerve are more likely to be injured."
They are all good articles and I also am aware of overuse injuries. The articles main evidence points to overuse which we all know as being the main factor in injury. There really is no direct link between when a pitcher starts throwing to injury. The only direct link we know of through the various studies such as ASMI's is pitchers who pitch year round who also pitch while fatigued or injured. This isnt an age related problem as to "when" pitchers start throwing but in actuality an "overuse" issue. Other factors such as improper or lack of conditioning, lack of proper rest, poor mechanics, poor diet and exercise also contribute to injury issues. Young pitchers who get proper rest, have good mechanics, not overused, etc, are in my opinion, much healthier when they do get older into high school and beyond. I hear it over and over again with parents of injured players or from older injured players themselves wishing they would have waited a few more years before they started pitching as if their "age" was somehow the main factor. I dont buy into it and I think it is an excuse for the true issues. How many of these injured pitchers pitched at some point through obvious pain? How many of them played more than 8 months out of the year? How many of them pitched in games while fatigued? How many of these injured pitchers were throwing over 80mph leading up to the injuries?
According to the studies, all of those things were the "main" factors leading up to surgery. Maybe they need to stress the real reasons such as I wish I hadnt allowed myself to pitch in that tournament with such severe pain or- I should have told coach to remove me in those games when I was so fatigued and tired. Or- I really shouldnt of played in all those expensive travel leagues year round just to hopefully get noticed.etc, etc, etc.
Back when my son was 11 I saw the writing plain as day and promptly put him on a different team that wasnt going to abuse his arm just for a win. Parents and players at "any age" regardless of how many seasons they have under their belt, need to be aware of the causes, symptoms, etc, that lead to injury. Those articles you posted are good articles. I HAVE read much of ASMI's work and believe most of their research. The trends they are finding are breaking down all of the previous myths we have heard in the past from myriads of parents and coaches. It all comes down to pretty much one word- "overuse". That can happen at any age. Injury has everything to do with overuse and not he age at when one starts throwing.