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Was watching my youngest son play in a game. They are facing a kid that throws a great fastball. Our kids, and most at this age, having a hard time catching up to it. Then, he break out the curveball. Not the little league kind, but the full on, twist your wrist and elbow kind.

The game progresses, the kid having a little control issues and when all is said and done, throws 111 pitches in our game. I am furious that coaches and dad would let this happen. Come to find out, he pitched in the game prior to ours and had a couple rough innings. He had to throw over 150 pitches. An opposing coach who plays this team often says, "Don't be surprised to see him pitch tomorrow" Oh my! This isn't my first time with travel ball and have seen pitchers abused, but nothing like this.

Shame on the coaches, shame on the dad (who was soooo proud of his son), and shame on Super Series for not having limitations to prevent this.
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I did some quick research and came up with this from the Super Series Rule Book:

Rule 7.01.08 PITCHING LIMITATIONS: Super Series does not have a pitching limitation rule. While Super Series advocates safe and reasonable pitch count limitations for all pitchers, our organization believes such limitations are the responsibility of the player's parents; and also the adult manager and coaches. An organization has no way of accurately knowing how much a player may have pitched in the days prior to a tournament. Therefore, parents are in the best position to make an informed decision regarding the health and safety of their child.

So, there you have it. A rule that indicates that there is no rule.

"Pitch him all you want Dad/Coach; if he gets hurt it's your fault, not ours."

This is the reason pitch count limitations exist; to protect the kids (especially the young ones) from injury by protecting them from the overzealous and irresponsible parents and coaches who want to win, win, win and don't care if they hurt a kid doing it.
I have a couple of questions because it doesn't add up to me:

1. How many innings did they play?
2. If he had little control issues and was throwing it past the batters...how did he accumulate 111 pitches? That seems like a lot..

Now, I am a coach of a 16u team and I never let any of my pitchers get past 90 pitches in any given game...thats just the way I coach. It is absurd to me to be pitching 100 plus pitches at the 16 year old level much less 10 year old??
It can happen, especially if a game starts to get away from a pitcher.

I have one incident from my son's childhood. He was playing in a tournament game (just a local tourney) and was struggling. He only gave up maybe five or six runs in the four innings he pitched but he walked a lot of guys and several errors behind him that kept innings going and so forth. He still was throwing ok velocity wise so the coach didn't think about pulling him. It didn't look like he threw that much to be honest.

I went over the the assistant and asked him what my son't pitch count was (now my son was 11 or 12 at this point) and he nonchalantly told me, '105'.

I about had a fit right then and there. I violated my cardinal rule about disturbing the coach in mid game and went directly into the dugout and told him to get my son out of there, now. He didn't realize the pitch count either and after the last batter he promptly trotted out there to get Danny. Of course Danny said he felt fine and all that stuff.

The problem is that a lot of leagues regulate by inning number and not by pitch count so parents have to be diligent to prevent injury.
ECSAINTS-this amount happened over two games in one day. I wasn't there for the first but parents from our team were. He pitched the last two innings which apparently took some time to complete. Even at 15_20 pitches an inning that is 30-40 and from what I was told, that is generous.

Fast forward to our game. Kid throw HARD for 10. Doesn't need anything but strikes. We had one ball hit fair and a small handful of foul balls (we aren't that great so no surprise there). After 2nd inning, he starts to fatigue and we stop swining. Walk after walk and your total goes up. Now, we end up playing 6 as our pitcher has done his job. The other pitcher ends up with 111 in our game alone. Add that to the unknown amount from previous game, and it is easy 150.

Criminal for sure. In obvious discomfort, they let him go. As the parent of pitchers, you would have heard me yelling across county lines to take him out. A close game in a national championship I did just that. My son was obviously out of gas, it was our 4th game of the day in hot weather, and the count went over 100. Yep, this mama echoed through the mountains.
A few questions:

Why do you participate in Super Series?

Besides the pitch count, what did you observe that led you to think he needed removed from the mound? Describe in more detail "obvious discomfort."

For example, physical cues such as lack of control, reduction in velocity, breakdown of pitching mechanics or form, gazing into the dugout between pitches, leaving the ball high, rubbing his elbow or shoulder, appearing tired......etc.

Working your way back from the number 100, what number of pitches would you deem acceptable? For instance, ECSAINTS is at 90 for 16U.
Good points.

I also look at the kid and the time of the season as well. Some kids work on throwing all offseason so they are much closer to midseason form than other kids that need to work on their arms.

Some clues that I tended to look for with younger kids is an increasing lack of control. This seems to be the first sign of a tiring young man. The kid may still be able to throw hard but the muscles that control the fine motor aspects of throwing seem to tire out more quickly and that is when I worry.

When I was coaching I had an absolute pitch count of 80 on the kids, at mid season. Some boys had less but none, even the ones that were horses, had more. Early on, 60 tops. This is pre high school level, remember this. The goal to me was always to teach the kids and let them have a good time and winning was secondary, especially at the 12U level.
Pitch limits have been around for a few years, now. There's more information now about arm care than ever before. Yet, I still read these Tommy John stories about such young kids. Why is it happening?

Sure, 150 pitches is too much for anyone, except Roy Halladay. Forget that, for a minute. With pitching rules in place, and care-vigilant coaches and parents, how are these young children still suffering traumatic arm injuries?
There are the stories about the kid who threw 150+ and is still going strong (Austin Wood for example) and some dads or coaches think their kid can do it. I think a lot of these guys think that since others can do it and they think their kid is elite, that the kid can do it too.
Their mistake is often in the age difference / conditioning and the fact that they are against long odds and choose to ignore it. Get down to it, seems to be about coach or dad not having the discipline to pull a kid that seems to be (perhaps is) still going strong. Postponing gratification. When you are riding a winner, it is hard to put him in the stable.
PA Dino-
We participate in Super Series because that is where the coach tells us to go. I am a parent and my job is to get my son to practices and games. I show up to support the kids. Period.

I could tell he was tired as he was holding his arm and looking to the dugout with a "get me outta here" look on his face. At 10 years old I certainly wouldn't want to see kids pitch more than once a day and honestly no more than 60-70 pitches a weekend. Did my older sons pitch more? Yes, but knowing what I know now, I might have "encouraged" the coaches to throw them less. Just my opinion.

I have been to many, many travel ball games. I have seen plenty of pitchers I thought had thrown too many pitches. But, I have never seen it this bad. 10 years old? Come on. Not necessary. For what? A plastic trophy that will be lucky to make it to the shelf? Not worth it.
From your description it was obvious that this pitcher was fatigued to the point of risking injury. Any parent or coach should be able to observe the onset of fatigue and take the appropriate action. It's also obvious that continued injuries will happen despite pitch count rules. The same attitude that allows youth pitchers to throw fatigued allows players year round participation with multiple leagues, showcases and skill camps. I'm thinking that living in the snow belt is not all that bad for baseball players. It almost forces you to take a couple months off.
Its not uncommon for 10 year olds to throw 30+ pitches an inning. I have personally kept pitch counts in rec ball and travel at this age. Pitch count adds up fast. I held my son to 60 maybe 70 to get out of an inning but that was max.


I kept count for one kid and once he reached 100 pitches for the day, I personally went in the dugout and through a fit and didn't care what his coach and dad had to say about it.
quote:
Originally posted by AntzDad:
Do you guys think it's simply overuse, or, in some cases, are they being taught too much, too soon? In other words, trying be textbook perfect at 10, rather building upon, or enhancing, their natural motion?


Overuse... yes...whether it is private lessons, playing another position (typically the best pitchers at the younger ages are also asked to go play SS or C before/after they have pitched their game that day/weekend), and too many pitches while they are on the mound.

I think it is important for parents to realize that a private lesson on Wednesday, where little Johnny may throw 35-40 pitches at max velocity (and that is after going through some drills working on mechanics) is not always beneficial when he is then asked to throw 80-90 pitches on a Saturday/Sunday. This isn't even taking into account that he is probably playing another position full-time when he's not on the mound, or heading to practices/league games during the week.

I don't think it has to do with being taught too much, too soon, though. One reason (besides the obvious of having a younger player who is just not physically developed) for the pitch counts being lower for younger kids is b/c their mechanics are not polished, they haven't been taught much, and even if they have been taught, it just takes time. It's a catch-22... to develop proper mechanics (certainly there are natural arm angles for a given player, I'm not talking about that), you have to throw, and develop muscle memory, strength and stamina. The problem is that at younger ages (winning national championships at 8-10 is nice, but I'm not sure at that age playing 70-80 games a year is paramount) these guys are having to learn their mechanics in games, and there is often not enough time spent in dedicated practice in a controlled environment (meaning emotions of coaches, parents, players are not part of the equation). Bottom line... if little Johnny has 100 pitches in him a week, understanding how to divide that up b/w a regimented practice/work-out/training program and game-action is a challenge.

As much of a crime as the original post indicates regarding pitch-count, throwing a curveball at 10-12 is absurd as well, no matter how physically developed the player is.
You guys need to change your math. Assume this:
Game 1 = 20 pitches to warm-up (I hope he didn't come in cold) + 8 from the mound + 15 in one inning plus 5 more warm-ups (in between innings) + 15 more puts me at 63 in the first game.

Game 2 = 20 pitches to warm-up + 8 from the mound + 25 more from the mound (5 innings times 5 warm-up pitches) + 111 actual pitches for a total 164 in the second game.

So, by my math, the real number of "taxing" throws for the day (not counting him playing another position) was 227.

In my book that moves it into the FELONY category!! I wouldn't let my slow pitch softball pitcher throw 227 pitches, much less a 10u player. But, "there is no limit to stupidity"!!
Let me guess. The dad said the kid is being, strong and can handle it. I hear that from three dads whose kids arms were toast by age twelve. Two had surgery. The third his arm in a sling for six months. No one remembers the preteen studs except the ones whose parents ruined them.
I would say most people would want to blame the coach in this circumstance. However the blame falls on the parent. Any parent who would allow this should be reported to child services. If this child was to blow out his arm it will affect more than just his baseball playing days later in life. Now on to the coach. This person should be ban from any and all youth baseball organizations.

My son plays SS and has a good arm but I wont allow him to pitch hardly at all. I would say in the last year he has pitched less than 10 innings. This was only allowed 1 to 2 innings at a time. The last time was a few weeks ago and I allowed the coaches to use him for 2 innings the whole tournament where he threw 33 pitches and 27 of those were strikes.

I personally figure if a kid is meant to pitch they can find that out once they reach high school. Too many parents and coaches today allow a chiild to be ABUSED as a pitcher.
This is really sad. Like someone else said, the kid is the one who will suffer. How proud will daddy be when little Johnny is sitting on the bleacher with his arm in a sling watching his friends play Fresh/JV ball?

My son in law was like this when his son was nine. I let him read an article on how it can damage a young kids arm by pitching too much at a younger age. He has backed off and now monitors how many pitches he throws in a game/weekly.
I remember bringing a pitch counter one year to the games and started tracking just how many pitches the kids were throwing. There were a lot of times I saw pitchers, including my own son, throw 50+ pitches in an inning. There were also a lot of times I saw kids who were throwing more than 80 in a game including my own son.

I know that certain leagues have pitch count/ inning limits which is good. But realistically we should be watching for the warning signs in pitchers and let that be the true gauge. I know kids who can't throw more than 1-2 innings before their elbow or shoulder are just killing them. On the other hand I know kids who can throw 7 complete innings and have no soreness at all in their arm after the game. In warm-ups I see kids who throw maybe for 5 minutes and are already complaining and want to stop while others are just reaching a point at that time when they just begin to warm up their arm to throw.

I am not sure what exactly it is- where the mechanics break down or why but some kids can throw very little and others can throw almost endlessly. I am not sure I buy the whole "not pitching at a yound age" thing. My son started throwing a baseball and tennis ball against the stairs of our house when he was about 5 years old and has been doint it ever since. There are days when he will go out and throw a couple hundred balls into those stairs, come in and watch TV and then in the evening he asks me to come and catch for him while he throws another 50-100 throws. Now I will admit that most of these throws are not at game speed velocity but he knows the difference between throwing and pitching. Both of us have come to believe that his throwing a lot has led him to have a good conditioned arm for pitching when he does.

Yes, we should limit young arms on the mound in games, but at the same time we really need to look deeper at the warning signs and let that be the real judge. For the longest time everyone was on this kick about how "curveballs" were damaging arms. Then we came to find out that throwing fastballs is actually more damaging to the elbow. What i see where we fail is seeing kids have soreness in the elbow or shoulder joint and just prescribe ice and a few days off and move on. I read a study once where like 90% of teenagers requiring TJ surgery complained of chronic elbow soreness leading up to the injury.

I do believe in strict pitch counts in games, but even moreso I believe in completely shutting kids arms down when they begin to have any kind of chronic pain and let it properly heal and perhaps help them change mechanics, strengthen the arm and body and be more conditioned overall to play the game.
quote:
Originally posted by Gingerbread Man:
I read a study once where like 90% of teenagers requiring TJ surgery complained of chronic elbow soreness leading up to the injury.

I do believe in strict pitch counts in games, but even more so I believe in completely shutting kids arms down when they begin to have any kind of chronic pain and let it properly heal and perhaps help them change mechanics, strengthen the arm and body and be more conditioned overall to play the game.


Actually many pro pitchers have ulnar ligament and nerve issues then shut down to rehab, hoping to avoid surgery, most will pitch with bad ligaments unless it becomes too painful and grouchy. Same way with college pitchers, it's really a bummer to have to take time off after you have worked so hard to get where you wanted. Yes the operation is successful but it still takes a pitcher a while to come back. Major (notice I said major) shoulder surgery usually signals an end to a pitchers career. There are so many issues that can occur with the shoulder for pitchers it's incredible.

But you bring up a good point, if a young pitcher or any player is experiencing pain, they should shut down and immediately seek a doctors advice, this may avoid future issues (like TJS or shoulder surgery). The problem is I think is that parents are afraid their players will lose "time". The same way that milb and pro pitchers hide injuries, they don't want to lose time.

MOST pitchers will experience issues that will sideline them at some point, if one disregards the warning signs (elbow pain for sure) those small issues become larger ones later on.

As far as good mechanics and conditioning preventing injuries if that were always the case pro pitchers wouldn't have all the breakdowns as they are the best conditioned, right? Wonder why they would have these issues? They certainly have controlled pitch counts and certain excercises to strengthen, and poeple know much more than they did years ago. Hmmm, maybe it was, when they were younger they pitched too much, too soon, they threw 150 in an outing, they played multiple sports, they threw too hard too soon, they threw CB with sore elbows, they threw sliders, they threw the ball too much against the side of the barn. No one REALLY knows how or when something will happen.

The best thing is to not do stupid stuff and if this is true it's just plain stupid.
quote:

As far as good mechanics and conditioning preventing injuries if that were always the case pro pitchers wouldn't have all the breakdowns as they are the best conditioned, right? Wonder why they would have these issues? They certainly have controlled pitch counts and certain excercises to strengthen, and poeple know much more than they did years ago. Hmmm, maybe it was, when they were younger they pitched too much, too soon, they threw 150 in an outing, they played multiple sports, they threw too hard too soon, they threw CB with sore elbows, they threw sliders, they threw the ball too much against the side of the barn. No one REALLY knows how or when something will happen.

The best thing is to not do stupid stuff and if this is true it's just plain stupid.


It is true that no one really knows exactly when an injury can occur all the time. But, as we learn more we are beginning to see a trend in TJ surgery plateuing at the pre HS ages. Injuries tot he elbow and shoulder almost always occur due to overuse. But overuse can varry from one player to the next, especially at the youth age.

Pain is the number one sign that the arm is getting injured. Pitchers have been conditioned from a young age to learn to pitch through the pain. They have also learned that somehow ice and ibuprofen is the end-all cure between pitch outings. I honestly believe the problems with later surgeries begin on the little league fields when they are just learning to throw and pitch. I think however it may be somewhat unfair for columnists, writers, etc to just label it as "starting too young" when in fact they do not know. There is a school of thought that starting too young with pitching is somehow bad for the overall health of a pitchers arm. In reality I think the blame needs to be placed directly on improper conditioning, not taking proper precaustions in trouble cases with youth age players experiencing joint pain, improper time off to heal etc.

I read an article last night about several teenage pitchers who had TJ surgery and the article made it out to be that the problem was that they started pitching at too young of an age. And yet, each one of them said they had been complaining of severe elbow pain for a while leading up to the rupture of their UCL. One even stated he knew he had a problem when he couldn't pick up a carton of milk the pain was so severe. This is not a case of pitching at too young of an age but merely the fact of overuse and pitching while injured. I constantly ask my son how he feels and he always tells me the truth and points where he has pain. Only once in the past 5 years has he complained of actual elbow joint pain. In that game he was immediately removed after he pointed to his arm and said he was done. But how many other pitchers are taught this way and know what warning sigens to watch and look for?

I agree with you about parents and players worried about losing time especially if it means the difference between getting drafted or recruited by a good college.

All we can do is work to strengthen and condition those who throw and help them to avoid injury as much as possible. Teaching youth age pitchers the correct ways to condition their bodies and teaching them the correct ways to warm up to throw and also teaching them about what factors play in with injuries and what to watch for will do more than anything for preventing arm injuries. I do like what LL organizations have done with limiting pitch counts and innings pitched. This will do a lot to help protect those players who are not properly conditioned, have bad mechanics, or are just plain to stubborn to know when to shut the ol arm down and give it a rest. I know of one specific kid who will pitch through massive shoulder pain just for a win and he does it game after game after game. I have warned both him, his coach and his parents of this and they pretty much just look the other way. It drives me absolutely crazy. I tell them no amount of ice is going to fix their issues besides completely shutting the arm down and giving it a rest. This is the stereotypical kid having an arm blowout leading to surgery later on.
You are seeing that trend because that is when most are more vulnerable due to development in growth plates, etc. That was the time that most kids either switched position or stopped playing when son was younger.

The whole idea should be to prevent children from having major surgery at a young age, period.

My son began pitching at 8, if I could go back it would be more like 14,15 and technically mine has never had any major injury just little annoying ones that has kind of been a set back to him. Instead of kid pitch we would have stayed in coach pitch, it didn't matter, he had the ability for sure, it didn't have to begin at 8. That's just my opinion, and he didn't even pitch that much, or all year, had good mechanics, etc. It's meaningless. I have seen kids who began serious pitching in HS or college and done very well, they had the ability all along. Never had an injury.

GBM, sometimes its not even about any warning signs, sometimes it's not even about doing anything wrong, stuff happens. Some may not agree with me, I beleive the less you do anything the better off you will be.
Last edited by TPM
quote:
Originally posted by TPM:
You are seeing that trend because that is when most are more vulnerable due to development in growth plates, etc. That was the time that most kids either switched position or stopped playing when son was younger.

The whole idea should be to prevent children from having major surgery at a young age, period.

My son began pitching at 8, if I could go back it would be more like 14,15 and technically mine has never had any major injury just little annoying ones that has kind of been a set back to him. Instead of kid pitch we would have stayed in coach pitch, it didn't matter, he had the ability for sure, it didn't have to begin at 8. That's just my opinion, and he didn't even pitch that much, or all year, had good mechanics, etc. It's meaningless. I have seen kids who began serious pitching in HS or college and done very well, they had the ability all along. Never had an injury.

GBN, sometimes its not even about any warning signs, sometimes it's not even about doing anything wrong, stuff happens. Some may not agree with me, I beleive the less you do anything the better off you will be.


I agree that we should try to prevent any youth from having a major surgery at a young age. Limiting pitch counts in youth is a great start. I don't believe pitching at a young age- starting at a young age is bad for arms. I actually think getting started earlier rather than later is better for kids if they can throw without pain and injury. Little league elbow needs a lot more research to find the root cause because like it or not, youth are going to continue to throw and play the game of baseball.

Personally I have done a lot of my own research over the years because I was told constantly that my sons mechanics would blow his arm out. What I found out was that 99% of the talk on the LL fields are myths from Dads and coaches who are misinformed.

I have heard over the years things like- "your son needs to throw over the top instead of side-armed" (he actually throws low 3/4) and "he should be icing after every outing" (son has only iced once in 5 years) and "your son needs to retard his timing of his arm action" (retarding the artm action is actually what leads to over torquing of the elbow joint)
. I have heard it all and researched it out properly over the years. What I have come to find is that throwing a baseball generally doesn't do anything but help the arm. It's when it comes to maximal effort like "pitching" that arms begin to come under threat of breaking down and getting injured. And, this generally only happens when a pitcher is throwing with some type of "velocity". The velocity we see generally up until about 12-13 years old is not the velocity that will cause serious injury or cause long term problems leading to surgery down the road. The statistics show that injury leading to surgery occurs generally after a young pitcher exceeds 80 mph coupled with throwing through pain and fatigue both due to overuse. What I therefore see is not anything that happens specifically while they are young other than they begin to learn it is somehow ok to pitch through joint pain and fatigue and prodded constantly to win and win and win (basically to show off).

It would be interesting to see stats of players starting at different ages for sure. I would bet that the age at which they start has no bearing on if or when injury occurs.
Your research may or may not be right, usually a lot of abuse occurs at the youth age, so in order to avoid it, with parents and coaches still pushing kids (as per above), don't pitch until the arm is maire mature

I still remain with with my opinion as to beginning later in pitching (delaying throwing off of the mound actually), tossing has nothing to do with it, we'll see how your theories holds up as your son gets older. That's the only way you will know if what you did or didn't do was the right thing or not. I am not talking about the obvious signals, because you have no idea what is actually going on inside.
Last edited by TPM
GBM,
You are dead wrong. Younger arms simply "break" in a different place. The UCL is stronger than the bone and they get an avulsion fracture of the medial epicondyle at velocities far less than 80 mph. The 80 mph is simply where UCL injuries typically begin to come into play for the older kids whose bones are more mature.

When I was coaching the freshman winter team we had a 14yo sent down from the JVs to pitch for us one weekend. It took all of about 5 warmup throws to see that something was wrong. We asked him how long it had been hurting (weeks) and shut him down. He had been throwing in the mid 70s. We sent him to a doctor figuring it was medial epicondylitis but he had an avulsion fracture (LL'ers elbow) and effectively never pitched again although he tried to come back a few times. He was out of the game by his junior year.
quote:
Originally posted by CADad:
GBM,
You are dead wrong. Younger arms simply "break" in a different place. The UCL is stronger than the bone and they get an avulsion fracture of the medial epicondyle at velocities far less than 80 mph. The 80 mph is simply where UCL injuries typically begin to come into play for the older kids whose bones are more mature.

When I was coaching the freshman winter team we had a 14yo sent down from the JVs to pitch for us one weekend. It took all of about 5 warmup throws to see that something was wrong. We asked him how long it had been hurting (weeks) and shut him down. He had been throwing in the mid 70s. We sent him to a doctor figuring it was medial epicondylitis but he had an avulsion fracture (LL'ers elbow) and effectively never pitched again although he tried to come back a few times. He was out of the game by his junior year.


I realize that injuries occur in younger players. My concern was with "major injuries leading to surgery. I realize that this happens sometimes in young players. I was generally referring to older players. Here is what I said- "The statistics show that injury leading to surgery occurs generally after a young pitcher exceeds 80 mph coupled with throwing through pain and fatigue both due to overuse". Now of course everything has it's exception and yes it does occur sometimes before this or without those warning signs. But, generally speaking, those warning signs are in place.

Even in the case you mentioned the player had been playing through pain for some time.
quote:
Originally posted by TPM:
Your research may or may not be right, usually a lot of abuse occurs at the youth age, so in order to avoid it, with parents and coaches still pushing kids (as per above), don't pitch until the arm is maire mature

I still remain with with my opinion as to beginning later in pitching (delaying throwing off of the mound actually), tossing has nothing to do with it, we'll see how your theories holds up as your son gets older. That's the only way you will know if what you did or didn't do was the right thing or not. I am not talking about the obvious signals, because you have no idea what is actually going on inside.


If


BVut even in your son's case he pitched at a young age. How healthy is your son's arm? From what I have gathered it seems as stable and healthy as any pro pitchers arm is.

My main concern here is that we ignore the main warning signs and do not address them. How much research has really been done on the real causes of LL elbow? I relaize that many studies have been done but generally those studies have focussed around "breaking pitches" and "pitch counts" and not much on other factors where the real cause lies- specifically that of how one conditions and warms up, their mechanics, etc.

What's worse- a pitcher who throws a 125 pitches in a game and comes out feeling good or one who comes out after 30 with elbow pain? I am not saying that too many pitches isn't a bad thing, I am saying that everyone condemns the coach who allows a pitcher to throw 100+ pitches while they say nothing of the kid always pitching through elbow pain.
quote:
Originally posted by smalltownmom:
CA Dad,

What is an avulsion fracture of the medial epicondyle? Also, what other arm injuries are associated with youth pitching, as opposed to high school and older pitchers?

Thanks


Basically it's a fracture of the growth plate on the inside of the elbow. Usually caused by, but doesn't need to be from overuse - can happen on a single throw. The contraction of the muscle causes the growth plate to separate from the bone. Usually this type of injury is less common once players reach HS and the elbow is fully developed.

I've seen it twice - once it was a 10 year old who had been a pitcher. Happened when he made a hard throw from the outfield. Other player is 12, never pitches, and the injury isn't even to his throwing arm. I guess sometimes things just happen.
LL elbow as far as I can tell is a problem that develops becuase of overuse. But, we must explain what "overuse" actually means. Overuse is what happens when the recovery from injury time does not match up with how quickly the arm is being injured. Whenever one feels pain it is usually the sign of injury in one degree or another. The small tears is what is causing the pain. During recovery the muscles build up stronger than before if given the right amount of recovery time. Overuse happens when those tears are not repairing faster than they are creating longer or more tears. Overuse is directly reflected by mechanics and conditioning- those two factors in that order. For instance- some pitchers can throw a 100 pitches every 4-5 days and never have any kind of pain in their elbow. Other pitchers cannot even come close to these numbers without sever pain. This I believe is first and foremost due to some mechanical flaw such as the arm being behind in it's timing. Not being conditioned to throw has it's effect on the arm because the muscles surrounding and supporting the UCL and bones are not developed enough leading to not having the arm protected. this comes from too much time playing video games and not doing chores, lifting small weights, or throwing enough.

Placing pitch limits thus controls the problem but it is not the cure in my opinion. Limiting pitch counts will do nothing to correct mechanical flaws and will do nothing as far as conditioning goes. Conditioning is done away from game situations.

Thus physicians can thus effectively limit overuse injuries by limiting the damaging effects that "some" pitchers have. The school of thought is changing though to find the real reason behind these overuse injuries that some players have. I am sure that what they will find out is that finding the factors that reduce valgus stress will do far more to preventing injuries than anything else. teaching kids the proper way to throw and how to condition their bodies will do far more for solving the problems than some of the other programs in place.
quote:
Originally posted by Gingerbread Man:
BVut even in your son's case he pitched at a young age. How healthy is your son's arm? From what I have gathered it seems as stable and healthy as any pro pitchers arm is.


My son has had 3 surgeries since he became a professional, one was a scope to find where pain was coming from, much fraying of the ligament which can be typical of a pitchers arm and cleaned up. The following year the same thing, found an impingement and they shaved his cortacoid bone, this fall to move the ulnar nerve, was beginning signs of possible damage because of the constant slipping in and out of the groove (elbow) and now sidelined again for sore shoulder (same place as impingement but probably from throwing too hard too soon). I think if we had not been so conservative, his college coach so conservative he would have had these issues earlier.

I agree with all that you state about injuries occuring when not enough recovery time, etc, etc. Pain comes from all different sources not necessarily from small tears, so one much first decide where the source of pain is coming from and determine if it is serious by simple tests the doc does. Because I feel that biologically the pitcher is more physically mature, I say 14,15 is a good age to begin throwing seriously from the mound, and also ready to begin a real conditioning program that will benefit them in maintaining good arm health. You can't do that at 10.

There is no argument that no one should pitch in pain or discomfort. My contention is that biologically some kids may not be ready.
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Originally posted by Gingerbread Man:
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Originally posted by TPM:
You are seeing that trend because that is when most are more vulnerable due to development in growth plates, etc. That was the time that most kids either switched position or stopped playing when son was younger.

The whole idea should be to prevent children from having major surgery at a young age, period.

My son began pitching at 8, if I could go back it would be more like 14,15 and technically mine has never had any major injury just little annoying ones that has kind of been a set back to him. Instead of kid pitch we would have stayed in coach pitch, it didn't matter, he had the ability for sure, it didn't have to begin at 8. That's just my opinion, and he didn't even pitch that much, or all year, had good mechanics, etc. It's meaningless. I have seen kids who began serious pitching in HS or college and done very well, they had the ability all along. Never had an injury.

GBM, sometimes its not even about any warning signs, sometimes it's not even about doing anything wrong, stuff happens. Some may not agree with me, I beleive the less you do anything the better off you will be.


I agree that we should try to prevent any youth from having a major surgery at a young age. Limiting pitch counts in youth is a great start. I don't believe pitching at a young age- starting at a young age is bad for arms. I actually think getting started earlier rather than later is better for kids if they can throw without pain and injury. Little league elbow needs a lot more research to find the root cause because like it or not, youth are going to continue to throw and play the game of baseball.

Personally I have done a lot of my own research over the years because I was told constantly that my sons mechanics would blow his arm out. What I found out was that 99% of the talk on the LL fields are myths from Dads and coaches who are misinformed.

I have heard over the years things like- "your son needs to throw over the top instead of side-armed" (he actually throws low 3/4) and "he should be icing after every outing" (son has only iced once in 5 years) and "your son needs to retard his timing of his arm action" (retarding the artm action is actually what leads to over torquing of the elbow joint)
. I have heard it all and researched it out properly over the years. What I have come to find is that throwing a baseball generally doesn't do anything but help the arm. It's when it comes to maximal effort like "pitching" that arms begin to come under threat of breaking down and getting injured. And, this generally only happens when a pitcher is throwing with some type of "velocity". The velocity we see generally up until about 12-13 years old is not the velocity that will cause serious injury or cause long term problems leading to surgery down the road. The statistics show that injury leading to surgery occurs generally after a young pitcher exceeds 80 mph coupled with throwing through pain and fatigue both due to overuse. What I therefore see is not anything that happens specifically while they are young other than they begin to learn it is somehow ok to pitch through joint pain and fatigue and prodded constantly to win and win and win (basically to show off).

It would be interesting to see stats of players starting at different ages for sure. I would bet that the age at which they start has no bearing on if or when injury occurs.
smalltownmom,
An injury that happens more often with the younger players is an olecranon stress fracture. It can happen with the older ones but is more common with the younger ones since the bones are not yet mature.

There is also osteochondritis dissecans which is an area of damaged bone typically in the elbow. They often have to go in and clean it out. The prognosis is mixed. (OCD)

Another injury more often associated with youth pitching is spondylolysis. This tends to happen during the growth spurt. Spondylolysis is a stress fracture in the back. It is nowhere near as common as arm injuries but it is something to keep an eye out for.
Last edited by CADad

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