A hypothesis about youth/hs pitching injuries

Pitching the baseball, of course, is to perform a violent act with several parts of our arm (and other body parts). We all know that more kids are playing more baseball at an earlier age. For young, undeveloped bodies, this is a problem. For older players, the eventual wear and tear is a problem.
I think you bring up a very interesting question regarding mechanics. Absolutely, more physical conditioning will help prevent injuries. I think that the emphasis on "proper mechanics" will always have a heavy slant on performance/velocity with protection of the arm being very important but secondary (whether we will admit it or not). So, I think that the nature of the motion combined with the competitive nature of the game will prevent us from finding a great solution, but age-appropriate conditioning is a big plus.

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Is it possible that learning proper pitching technique at a young age can actually increase the chances of injuries for some kids because their undeveloped bodies are not able to withstand the forces they create with better mechanics?

Yes, it's possible - more force.

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Is is possible that bad mechanics in immature bodies actually protect some kids from injuries because their bodies are naturally compensating for poor strength and range of motion?

Much less likely - most of the kids that have bad mechanics are the first to complain about sore arms. Although, when a pitcher tires late in a game, it seems the body tells him to adjust his mechanics (drop arm slot, etc.), so you have me wondering?


I love the question. I hate that I just opened it further for a certain someone to hijack the thread

Swampboy,
You do know that you have touched upon a subject that many times over the years has produced lots of interesting discussion here.

My son is many years out of youth baseball and the changes in philosophy, the awareness is like night and day. Any parent that does not educate themselves about injuries (all sports, all position) and not take advantage of today's recommendations is IMO, not doing their job, because ultimately, it falls on the parent to protect their players against the dangers involved in youth sports. It is also important to be involved in a strength and conditioning program. At what age to begin, I think depends on the physical maturation of the player. I do beleive that healthy kids involved in all typse of activities don't need to be involved too early in weight training, ans like everything else, youngsters should be monitored in the gym.

Yes, we are hearing a lot more about injuries of younger players because the science for diagnosing and fixing is better.

Not sure about your philosophy, don't know much about your son as a pitcher, but if he is involved in 2 sports it just may be that he hasn't spent as much time on the mound as most, and that is a plus. Not sure of his velocity or his mechanics, so it's hard to say what has worked and what hasn't. Having strong legs and core certainly may be a factor, but that would only factor if he used his whole body not just his arm, which, IMO is the biggest culprit for injury.

As far as conditioning, do know that many that work extrememly hard at conditioning still have injuries.

My son never had any issues until after he left college. Now I could say that it was because we watched carefully how he was used, didn't allow year round pitching, use of cb later, didn't allow him in the weight room too early and never encouraged at a young age to throw his hardest.

Does that mean that it will work for everyone, no.

I will stand behind one thing, the longer you can hold off, the better, not too many agree, but that's the conclusion I have come to.

The increase in pitching injuries is because today's parents won't let the kids play on their own and hover over them as helicopter parents. When I was a kid, I threw all day long, probably did most things wrong based on today's standards and never once had arm trouble. Sure I probably got a sore arm throwing maybe 300 pitches all weekend with a spongeball while playing stickball and real baseball but never more than that. I could throw or pitch all day long because my arm was used to throwing.

Bottom line is that we did it on out own and no parents putting limits on us, telling us we can't throw this or can't throw that.

Kids today are monitored like a lab subject and don't throw enough, then when it comes time you need to stretch them out, they break down down because they're not conditioned to throw or just being kids.

I remember a father of a son's friend once wouldn't let his son play wiffleball with my son & his teammates from a youth league because he was afraid it would ruin his arm. Now how ridiculous and stupid is that?

I'd say letting them be kids, play on their own and them playing multiple sports if the choose to is the answer.

zomby:

Bob Feller agreed completely with you. It worked out well for him. What is right? It's probably different for lots of different players.

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The increase in pitching injuries

I challenge anyone to provide numbers that show a rise in the number of total youth pitching injuries over the years.

The only numbers I have seen are numbers of injuries treated by sports injury clinics. Of course, those have risen. We know why, Little Johnny might make $$$ in the MLB.

Years ago, when I was a kid, I never heard of kids being treated for pitching injuries. You just rested. If it didn't heal, you better be a good hitter. So, there would be no possible way to quantify those injuries.

That is an interesting hypothesis. I do not really agree with it however. The thing that I have witnessed over the years is the increase in out of season training. Any issues that my players have had have been due to over training outside of the regular baseball season or practice day. Don't get me wrong, this is not an attack on personal instruction, but, we cannot train children as if they are grow men. The intense training really used to start the latter years of high school and carry over in to college. Now I see high schoolers training more than they would in a D-I school, and children training year round. Young bodies are not meant for this. Even professionals take time off. These are my observations.

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Originally posted by hsballcoach:
That is an interesting hypothesis. I do not really agree with it however. The thing that I have witnessed over the years is the increase in out of season training. Any issues that my players have had have been due to over training outside of the regular baseball season or practice day. Don't get me wrong, this is not an attack on personal instruction, but, we cannot train children as if they are grow men. The intense training really used to start the latter years of high school and carry over in to college. Now I see high schoolers training more than they would in a D-I school, and children training year round. Young bodies are not meant for this. Even professionals take time off. These are my observations.

Good point.

I am in agreement, too often young players are training like grown men, too often you hear "that's the way professionals do it", guess what, they are not professionals and correct, even they give their bodies rest.

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Originally posted by Swampboy:



I've heard and read (but don't have the data to prove) that there has been an increase in the number of youth pitching injuries (though I don't know if that reflects more hurt kids or better sports medicine diagnosis capability).

The data is out there, and there is no doubt there has been an increase in significant injuries that were once the domain of adults.

quote:

Originally posted by Swampboy:
Is it possible that learning proper pitching technique at a young age can actually increase the chances of injuries for some kids because their undeveloped bodies are not able to withstand the forces they create with better mechanics? Is is possible that bad mechanics in immature bodies actually protect some kids from injuries because their bodies are naturally compensating for poor strength and range of motion?

I do not believe you will find any credible source that would accept your hypothesis. If anything it is just the opposite in that improper mechanics can cause injury over time that will rear its head later. Additionally some kids become pretty good with their quirks, and are unwilling or unable to break their bad habits which again will lead to injuries.



I believe most youth injuries involve two main factors. The first is overuse at a young age. Kids today can play year round and do not have the opportunity to rest their arms. Furthermore they do not get the proper recovery within a given number of days because they play for various teams. You also have coaches who are oblivious to injury potential and ride certain kids arms all in the name of winning.
Second is the throwing of certain pitches which are not age appropriate such as curves, sliders, etc. Those pitches should not be thrown until the kids growth plates are fused, period. Also pitches like a screwball or gyro should be avoided all together.
Many a pitcher from just a decade or so ago say they never threw curves until they reached varsity or college. Now days you see kids throwing curves in LL with their parents being vocal advocates encouraging them to do so.
I always warned my son that even though he knew how to throw certain pitches, if he did so in a game, I would pull him off the mound.

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Originally posted by Swampboy:
Obviously it's not an either/or situation. You have to learn how to pitch properly, and you have to develop your body. But would it make sense from an injury avoidance perspective to develop players by putting physical conditioning a step ahead of their baseball instruction?

I would agree with your reasoning. That is not to say they should not learn proper mechanics before they increase their conditioning. However anyone who instructs pitchers knows that when the conditioning breaks down, so to does the mechanics. So you are right to believe proper conditioning should be part of the foundation of injury prevention for pitchers. I'd say that is a good rule of thumb for any athlete.

Swampboy -- You put forth a very interesting hypothesis. I have a 4" scar on my left shoulder that is due largely to growing up pitching doing almost the direct opposite of what we know to be right today. When SP_son first began Pitching, I saw a carbon copy of me, and I got deeply involved in trying to obtain the best knowledge and practices for preventing (or at least mitigating the risk of) injuries.

Here is what I have come to believe over the past 9 years ...

-- Kids today do not have the same level of skeletal/structural/foundational strength as that of previous generations. Their lifestyle is far more sedentary and less physically demanding than was that of previous generations. Sooo ... they do not "naturally" develop the same level of strangth in the connective tissues around joints (where Pitchers break).

-- When kids begin to "strength train" the focus tends to be on the primary driver muslces; with modest emphasis on the secondary drivers; and virtually no focus on the skeletal/connective tissues. Thus, they can apply more force against weaker joints when they take the field. If you think about it, the emphasis should be in reverse: fisrt build a solid foundation, then build the supporting secondary muscles, then work the primary drivers.

-- Kids today don't throw enough (right TR?). They don't go skip rock on the pond, just throw a ball around at the recess they don't get in school; or just play pick-up ball at the park. Thus, most of their throwing is doen during the time they are at organized baseball, and their arms are not conditioned to throw hard for extended periods of time.

-- Kids today Pitch too much. Add all of this up and you have kids who are under prepared, pitching from a mound too much for what their bodies are prepared to handle. Researchers have documented that the physics of coming down a mound when delivering a pitch give that 5 oz. baseball an effective weight of 45 pounds in the split second before release. The same ball thrown on flat ground has an effective weight of 5 ounces.

-- I am very confident that learning "proper" mechanics helps mitigate the risk of injury, by helping the player learn to transfer as much of the force as possible to and through the baseball, rather than having it leak out at different points in the delivery, and on stress points in the body.

I have spoken with a number of people very deeply involved with doing the most current research, and these are the lessons I/we have taken from them. They tell us how major injuries that were virtually unheard of 30 years ago are epidemic today in kids at all ages groups.

All I know is that when SP_son first started pitching, he complained that his elbow hurt for a few days after he pitched. First we got him started on proper mechanics, and the pain went away. Then we learned what we know today, and we got him started on the foundation up approach to conditioning, paid attention to pitch count guidelines, established sound prehab & rehab routines; and he has been a work horse for his teams ... and has shown no signs of pain or injury due to pitching to date.

My 2 cents.

southpaw,
Very interesting info.. looks like you've done a lot of homework. The 45lb vs. 5 oz. comparison is incredible. Is there a source for more info on this? I feel like I may need to take this into serious consideration with any pitching routines/workouts we put in place.
I would also love to hear more specifics about foundation up conditioning and prehab/rehab routines but I don't want to redirect attention from swamp's thread - perhaps if you are willing to PM me?

-- When kids begin to "strength train" the focus tends to be on the primary driver muslces; with modest emphasis on the secondary drivers; and virtually no focus on the skeletal/connective tissues. Thus, they can apply more force against weaker joints when they take the field. If you think about it, the emphasis should be in reverse: fisrt build a solid foundation, then build the supporting secondary muscles, then work the primary drivers.


Son was just talking about this, how you have to condition the whole body using short intense burst of speed and strength (climbing,jumping,running push ups, core work etc)

I can't think of a negative factor from getting proper instruction for pitching a baseball. I've seen improper mechanics result in injury, much more oftern than the inverse.

Cabbagedad -- I'll PM. Battling deadlines tonight.

I have seen a few youth pitching injuries and I can't remember a single instance where anyone knew exactly what really caused the injury.

Complex issue for sure.

Kids play a lot more organized baseball than they certainly did when most of us were kids. An eight year old that can throw the ball consistantly well is an asset that some youth coaches tend to overuse them.

The proliferation of select teams I think has exacerbated this. I'm not slamming select teams in general but I honestly think that some teams are more interested in winning than in teaching good baseball habits to the kids. When you have a decent throwing 8-10 year old on a hypercompetitive team playing like every tournament is the World Series then you run the risk of overuse. Some coaches are very good about protecting a youth's arm but there are enough of them in the game that are willing to risk injuring a young arm just to get that first place trophy.

Most leagues have rules governing pitch counts and innings allowed but lets be honest, unless someone is really paying attention it is fairly easy for some coaches to cheat their way past these rules. Parents in these groups can be intimidated by the whole things and are often afraid to speak up for fear of a negative result for their kids. So they tend to rationalize the whole thing.

I am not sure it is the entire proper instruction thing to be honest. I suppose it could be indirectly responsible simply because kids that are taught proper mechanics early on tend to be more accurate and at the age of eight that tends to be the most important thing. So I suppose you are right although I honestly don't think being taught a proper way to throw is necessarily a bad thing. A parent that goes and has a kid taught a proper and safe way to throw a ball is fine in my book. But these boys tend to run the risk of being overthrown, especially in the competitive world of select ball. So parents have to be the guardians.

I see now that the way I worded my intro makes it easy to misunderstand my main question.

My question is not whether good mechanics are better than bad mechanics. Of course they are.

I'm wondering whether it might be possible to reduce some injuries by changing the synchronization between learning good mechanics and developing core, posterior chain, and other functional strength.

Right now, a lot of kids have "game" that is way ahead of their bodies.

Would having more kids whose bodies are on par with or ahead of their game change the injury picture?

I'm sure that there may be something to what you say but again, I think that it isn't the emphasis on good mechanics causing kids to get hurt but the overuse that results from those mechanics.

Lets say you are a LL coach and you have an 11 year old that has outstanding mechanics. Even the densest dad-coach out there knows when a kid is throwing the ball properly. Because of it the boy hits the strike zone 75% of the time instead of the maybe 40% of the time.

Who are you going to pitch more often? Who are you going to ride more in the playoffs.

Posted by Swampboy -- Would having more kids whose bodies are on par with or ahead of their game change the injury picture?

YES

Then add in the overuse (by game, week & season), poor mechanics, inadequate pre-hab & re-hab, too much mound work & not enough flat ground throwing, and inadequate nutrition and you have the makings of an epidemic for breaking young (immature) bodies.

My 2 cents condensed.

Wow… this is a great post…

My son, now a HS Freshman, had problems which I believe were related to trying to perform proper mechanics from a young age with a body that wasn’t ready for it. We live in a small community and the baseball program here is limited to a 15 game season. Wanting to provide the best for my son, we travelled to baseball training centres from the time he was 8YO and he was pretty much training year-round from 9YO forward. He was a very heavy-set kid (5’3”/165 Lbs. at 10YO) and if he wanted to play a longer season, he had to make out-of-town teams. He was primarily a pitcher and power-hitter.

This is long because I think it can help others with a hard-to-diagnose problem:

At 12YO he experienced a ZONE OF PAIN in the SIDE OF HIS BICEP to the extent he would only be able to go an inning or so and we shut him down in late June. He did not train for pitching that winter. I started inquiring on this site and others about the problem but, few people seemed to know about it and some said they never solved the problem. After a winter’s rest and a Sports Medicine doctor, he began his 13U summer – and stopped about the second week of July. That winter he played for a highly competitive basketball team and they ran a lot of weight off him. He did a little spring training and he said he could feel it flaring up again. His hitting instructor recommended a physiotherapist who performed acupuncture. This lady actually relieved some symptoms and got very close to the problem. She recommended that he see a specialist and get an MRI to rule out a labral tear or rotator cuff. Our family doctor recommended a Specialist (a doctor for the National Olympic team). In the meantime, two different coaches recommended another sports medicine doctor, who we started seeing. The season began in May as usual, with games that he experienced no pain or random pain. In early June, he had a start where he pulled himself at 18 pitches. We stopped his pitching appearances at that point but, kept on with both doctors.

In July, we had ultrasound and MRI tests done at the best hospital in the province. At the same time, the sports medicine doctor who had spent an hour measuring different aspects of my son’s body from the feet on up, was able to touch on points and was the first medical professional to reproduce the pain. We learned many things that day: my son’s feet did not really pronate as some doctors had said; the tip of his right shoulder blade was nearly 3 cm out from where it should be relative to his spine; his right pec was tight and short. He was correctly diagnosed with Short Head bicep tendonitis. It was lucky that we learned this a day before he went in for the Ultrasound. The doctor conducting that kind of confirmed the short head bicep tendon, while he was looking at other aspects. The MRI and Ultrasound came back clearing him of any labrum or rotator cuff problems and they also said his growth plates had fused. I talked to the specialist about our other findings with the Sports Medicine doctor and she concurred with the diagnosis.

The Sports Medicine doctor began weekly sessions with us in mid-July using a technique called active release. Results started to occur about two weeks later. My son would pitch a couple of innings… then we would try a couple of days low pitch-counts back to back. In late August, he did 93 pitches over two games on a Saturday in a tournament.

What happened?

Essentially, what we believe is that my son who was always big, tried to emulate proper mechanics, but his body started to fail at the weakest link. His shoulder blade moved out and up, his pec tightened, and the forces generated by a heavy/powerful lower half manifested themselves on this tendon. Due to his body the way it was, his muscles had essentially found their place and he had limited degrees of freedom all the way down to his feet. The ripping apart/rebuild (a layman’s attempt at the process?) process of Active Release, allowed him far more movement and a place to start re-building his mechanics.

Another fortunate thing happened to him last summer. He made a powerhouse travel program late in the summer and they are very specific about their training/pitching start-up process. After fall ball, pitchers worked on specific weight routines from November through January with no throwing. This has really toned-up his body (now 6’1”/190 Lbs. and just turned 15). Along with 35 16U to 18U pitchers, his mechanics are under the supervision of four different pitching coaches, one who is an MLB scout.

Bottom line, although I would change some things in the past, I’m not sure he could have broken out of the small town we are in, without all the training that was done at a younger age. I think he would have long been discouraged. I’m just glad we pulled him out when he experienced pain and kept on looking for a solution. Ironically, a lot of guys envy his size and body now at his age.

I agree 100% with everything southpaw_dad has said above. I will add that breaking pitches thrown at a young age are a huge problem too IMHO. I saw it with 9 year old travel teams a few years ago. Also, I had my travel team parents insist on having their young kids throw curve balls in travel games. I had to fight it on my own team, and we ended up winning a state champioinships or finishing near the top almost every year without a curve ball thrown.

Fenway -- Good points. Dr. Andrews and the ASMI did a study that proved that a PROPERLY thrown breaking pitch does not measurably increase the risk of injury. The problem is that most kids don't have the mechanics or the strength to throw them properly.

I think Swampboy has the ordering right. Train the body to be prepared; eat & drink right so the body is properly fueled; learn proper mechanics to optimize efficiency and effecitveness; follow usage guidelines so as not the wear them out ... and pray for the best.

Great discussion.

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Originally posted by SultanofSwat:
I have seen a few youth pitching injuries and I can't remember a single instance where anyone knew exactly what really caused the injury.

I've seen more than one "drag his arm", hurting the shoulder, in the opinion of folks who would know.

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Originally posted by Dad04:
I've seen more than one "drag his arm", hurting the shoulder, in the opinion of folks who would know.

Yea me too. I know a guy that threw like this and I always said "he's gonna hurt that shoulder". Then he did. Now "just as I suspected".

But of course, there's the possibility it was caused by lack of warm up time, lack of conditioning, pitching too many innings, lack of rest between starts, throwing too many sliders/curves/splitters, throwing after fatigued, or any of the other things "we all know".

Dad04 & Sultan - would one of you post info describing or defining arm drag. If there is a video, that would be even more helpful. I have a lot to learn. Thanks

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Originally posted by Texas1836:
Dad04 & Sultan - would one of you post info describing or defining arm drag. If there is a video, that would be even more helpful. I have a lot to learn. Thanks

I can't wait to see what picture GotWood comes up with for this one!

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Researchers have documented that the physics of coming down a mound when delivering a pitch give that 5 oz. baseball an effective weight of 45 pounds in the split second before release. The same ball thrown on flat ground has an effective weight of 5 ounces.

That is so wrong! The loads are only slightly less on flat ground. The "effective weight" might be 40-44 lbs. instead of 45 lbs on flat ground vs the mound but the loads are still significant. Generally players throw a couple mph harder off the mound so that is the main reason why the loads are higher off the mound and it is close to that ratio, i.e., 87/85ish. The landing angle, etc. contributes a tiny amount to how the loads are distributed in particular areas.

In other words, loads tend to be a bit less on flat ground but anyone who thinks that throwing on flat ground completely eliminates any risk or damage is way off base.

TX1836, The only way I can explain is; arm drag: The pitcher is transfering to his plant foot before getting his pitching hand to the top of his motion, leaving his pitching hand to "catch up", causing additional stress on the shoulder muscles. Common result is pulled or torn labrum.

It results in "flying open"

The result is pushing off, while the arm is still getting to the top, causing additional stress

Drill to fix involves standing on mound, balance on back foot, toss ball to pitcher, wind, drive and throw, forcing pitcher to be at the top before driving to the plate.

Here is another explanation, better than mine, I am sure.

The fault of "flying open" occurs when upper body, shoulders, and arms open with the stride leg and front hip. This is a natural tendency biomechanically, but this action decreases rotational forces (angular velocity) and puts the pitching motion out of sequence, negatively effecting control and velocity plus creating unnecessary stress on the shoulder and arm muscles.

"Flying open" causes the arm to drag because the stronger & larger muscles of the legs, hips, and trunk have already fired and are not available to create torque. Because of the lack of torque, most of the pitch velocity has to come from the shoulder and arm muscles, which will cause early fatigue.

http://www.thecompletepitcher....itching_delivery.htm

Sometimes what people call dragging the arm is caused by externally rotating too early and then having to wait for the arm to get lined up in order to throw a strike.

Then of course coaches tell the player to get the arm moving sooner and that just results in being even earlier and more "arm drag".

One needs to look at video to see if there is really arm drag or if it is something else. In other words flying open may be causing the problem and not vice versa. Forcing the pitcher to be at the top before driving to the plate could compound the problem.

Reminds me of hitting when a kid will get the hands out front in response to the "throw your hands at the ball" cue, hit everything to the right side as a result and then be told by a well meaning coach that they have to hit the ball out front more which of course compounds the problem.

That's why good pitching or hitting instructors who can tailor their instruction to the individual are worth their weight in gold.

I don't recall that there was such an overriding emphasis on velocity or emulating major-leaguer pitchers when I was a kid 40 years ago. No radar guns, ESPN, MLB network, top-10 lists, bloopers, highlights, etc. All I knew about Juan Marichal was that he kicked his leg high and once bashed Johnny Roseboro over the head with his bat.

Like everything else these days, it seems that kids are surrounded by yardsticks that they must measure themselves against. If you're 16 and you don't throw mid-80s, you're nothin'.

I doubt there is a 17 year old kid on the planet who has thrown more long toss over the years than my son--I believe the fact that he has never had arm issues is not a coicindence. I know there are those of you who think this is hooey, but not in my experience. That and a strong core help take the load off the elbow and the shoulder. It's remarkable how many pudgy, out of shape pitchers I have seen over the years.

The travel team my son has been on since he was 12 has a strict policy regarding offspeed pitches. The organization teaches a knuckle change-up to all its pitchers that is the best off-speed pitch I have ever seen thown by 12-16 year-olds. At 16-17, they slowly introduce the curve and slider and their pitchers throw no more than 10 a game. Besides, it's remarkable how few 17-18 year olds have a plus change-up.

My son has been in very competitive 12u tournaments in which opposing pitchers have thrown 40 curveballs a game. That coach and/or the parent who allows that should be horsewhipped.

I agree with the one poster that kids today concentrate their throwing within the baseball season and pre-season. They're involved in other sports/activities throughout the off season that preclude them from spreading out their workload over 9-12 months. Too much, too soon, I think.

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Originally posted by slotty:
I don't recall that there was such an overriding emphasis on velocity or emulating major-leaguer pitchers when I was a kid 40 years ago.

Pitchers didn't make millions $$$ back then.

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I doubt there is a 17 year old kid on the planet who has thrown more long toss over the years than my son--I believe the fact that he has never had arm issues is not a coicindence.

I know many that never used long toss and never had injuries. So, that would be hard to draw any conclusions from.