Over use of young pitchers fueling Tommy John surgery

If a 45 year old Plumber is diagnosed with a Inguinal Hernia, his present employer will usually be the one paying the bill. Did he receive this injury fixing a leak?, or lifting boxes at his previous job, perhaps the damage happened while lifting weights and playing football 4 years at OU. The truth is the abdominal wall is an area of the body that can easily be weakened by use and overuse.(sounds familiar huh?) When and where this becomes an issue is anyone"s guess.

The good news is God has put some guy's down here that can get our boy's back on the field if this were to happen.

JBB, I want to send out my prayers to your son as well.  My son also went through a similar situation a couple of years ago, with the exception of the surgery.  He was able to rehab only and by a minor (or major) miracle his UCL healed itself.  In my conversation with Dr. Andrews, he told me the same things that he mentioned in the article ie: overuse, too much baseball year round, etc.  The one thing that he said to me that stuck was that the harder throwers are the ones at highest risk for injury.  We can debate the fact the harder throwers are used more and that is probably true to some point, but not just the hardest throwers are used to pitch.  I truly believe that it is a combination of things, with genetics playing a large role.  Rather that be a genetically weaker ligament or a genetically gifted arm that puts more stress on the ligament with each throw.  I can see both sides of the "take time off" argument, and I do agree that kids certainly should take time off from the mound, but I can't seem to make myself understand why throwing in a controlled program year round is a bad idea.  Maybe I am just an uneducated idiot on this subject.  I'm not sure we well ever really understand because there are just too many variables and the injuries seem to be from a cross section of kids.  Again, I want to send you my sincerest condolences and I wish for your son a complete and speedy recovery to return to what he loves most.

Thanks younggun - I echo all that you said.  Good stuff!

too.tall....my son is almost 13 and we focus on strengthening his core...yoga, light squats, crunches, push ups, play basketball.  jaegersports (google them) has a baseball yoga video to watch under strength and condition.  Just don't wear the capri yoga shorts, people will laugh.  Trust me, I know.

 My point being, trying to pin point where the majority of the damage took place is anybody's guess.

One more opinion to throw into the mix.  Blewett advocates most of the usual precautions, but adds the detail of cutting down on "max-effort throws". I tend to agree. (Not sure if he determined this before or after his 2nd TJ surgery.)

http://www.warbirdacademy.com/...the-injury-epidemic/

It also occurred to me while watching some very talented 14U position players in Florida one day... The position players really benefit from year-round play, but unfortunately someone also has to pitch. What's good for the one group is not good for the other.

I played ice hockey as a kid. The kids who played/skated year-round were much better players than those who didn't. The kids from Canada played on an entirely different level. No one worried about fatigue, burn-out, or injury.

too tall Google "throwers 10" exercises as a start.

Get some bands from Jaeger sports and their thrive on throwing CD and the combination of the bands, throwers 10 and following the program he will be fine. (just don't let him pitch too much!)

I have also heard the suggestion that harder throwers are at higher risk, which is pretty basic conclusion, anyone with a technical background will know that loads on a system are a "velocity squared function" which means that stresses go up exponentially with velocity. In some systems torque is a cubed function so loads really go up non linear with velocity/torque. 

Since PG seems to be getting thrown into the mix, I guess I'll ask a silly question.

Jaeger bands?  I'll bet 90% of these pitchers having the surgery began using them as teenagers.  Should we be questioning whether or not they're a contributing cause?

Ok, I'm not really serious, but why are they immune to the discussion when others aren't?

To me, blaming PG is almost as pointless as blaming Wilson and Spalding for making the baseballs.  The system that has developed for getting exposure may well be part of the problem, but PG is just a part of that system... along with the recruiters and scouts who rely on these camps and showcases, along with their own camps and try outs.  Next level teams are looking for the best players, the best players are looking for exposure to next level teams.  PG and others are simply meeting a marketing demand.  The key take  away for me is that parents and players are responsible for proper training, conditioning and scheduling. JMO

Many pitchers (before they become PO) play other positions where as the position guys do not pitch.  How many pitchers also played SS and caught or because of their strong arm played 3B?

I see this as part of the problem.

JMO

PG, I'm only trying to be helpful here, but this type of article is probably not helpful.

http://perfectgame.org/Article...ew.aspx?article=9748 "Sky-high velos, sky-high interest"

Bukauskas threw fastballs that registered, first, at 98 mph and finally at 99 mph. That was up from his previous high of 93 mph recorded at the 2013 Perfect Game Junior National Showcase in June.
And then it happened. This past Monday (April 14) while pitching against West Potomac High School (Va.), Bukauskas not only threw a seven-inning one-hitter with 18 strikeouts but according to reports had his fastball touch 100 mph on at least two occasions on several scouts’ radar guns. The social media floodgates officially flew open.

I blame it on the cleats, 100% of all TJ surgery players wore them!

I do get the point, but most of the band exercises (Jaeger included) are just variations on the "throwers 10" which have a medical history of success. 

If I had a hard throwing son I can guarantee I would limit how many innings I would allow him to pitch. These kids don't need travel ball, just a few PG events and a limited HS experience and that would be it. 

SultanofSwat,

I understand what you mean, but this is a kid with a very interesting story.  Like any kid that pitches, he is at risk, maybe more so due to the velocity.  Any suggestions?  Don't do a story on a young kid throwing 100 mph?  Don't mention the 100 mph?  We are involved deeply in draft coverage right now.  The kid is draft eligible.  Regarding potential TJ candidates... That would be pretty much every pitcher that will be drafted.

On another note, we have started doing our own study, based on nothing more than the facts.  Even in the early stages it is very interesting to say the least.  The only list we can find has about 250 MLB and Minor League players that have had TJ since 2008.

Of those 250 about 35 participated in PG showcases or tournaments.  Most of those appearances were short, most one or two events, most all were in what would be consider the actual baseball season rather than the winter.

Now here is the most revealing thing!  Since 2008 PG participants that pitched in the Major Leagues - Nearly 300!  That is not counting an extremely large number that pitched in the minor leagues During those years, probably more than 2,000, I'm just guessing for now.

Think about those numbers.  35 TJ cases out of thousands that participated in PG events.  We all know the risks involved in pitching, I hate it every time I see someone we know having the surgery.  I even understand that all of baseball has to share in any blame.  But they claim one third of all MLB pitchers have had TJ.  Why would anyone mention PG as the culprit when the numbers/percentages show the complete opposite.

One more thing... Does anyone ever keep track of when these TJ surgeries take place?  I get it that these injuries are caused by overuse, improper rest, poor conditioning, etc., sometimes over a long period of time.  But why do so many of these,the majority in fact, happen during the spring rather than the summer or fall?

The truth is we have seen the abuse.  We never see abuse at our showcases, but it stands out like sore thumb when it happens in a tournament.  Most of the top travel programs have more pitching than they need.  Most of them are very protective of the young arms.  Nobody wants to be the reason a young kid needs surgery. Same thing is true in high school and college. The good coaches don't abuse pitchers!  

So why not place the blame where it belongs.  With the people out there that continually put these kids health at risk.  Problem is, what do you do about that?  Educate the parents?  Sometimes they are the problem!  Most of us have heard it... "Why did they take Johnny out."  "He gets stronger late in the game", "He has a rubber arm"!

All our rules for pitching in Showcase events are geared toward protecting the pitcher.  5 hitters and the inning ends.  No walks, after 4 balls the strike count stays and the pitcher must throw nothing but fastballs.  No taking the mound without sufficient warm up.  Everything possible to protect the pitcher and yet some parents complain that their son didn't get to pitch enough.  Endurance is important at some point, but not at a showcase.  Any baseball person can accurately evaluate a pitchers skills in 20-30 pitches.  Actually I could argue it might take 10 or less pitches.  Sure there are more things to find out, endurance is one of those!  But can you imagine the number of injuries that would result from testing how long a pitcher can throw effectively?  These endurance tests are happening all over baseball.  The 191 pitches discussed in a different thread is an endurance test!  In fact over the years there have been many topics on this site about extremely high pitch counts in games.  Where is that kind of stuff happening?  It's not at PG events!

I don't have all the answers.  So far I don't think anyone does!  I only know that the statistics show those that have TJ surgery are actually LOWER than the average for those that have participated in PG events. So why are we mentioned as the problem? Why do the abusers out there get by without mention?  I know Boyd used to keep track of the highest pitch counts in college!  I know we track pitch counts at every event we do.  But there is no way to track every pitcher that is in summer or high school baseball. Also, I will add this, hope it doesn't offend anyone here... The dumbest people of all are involved in the most important phase of development... Youth baseball!  The younger they are the dumber the coach.  I apologize to those many youth coaches that do a great job. But I think they would agree with me anyway!

In all this argument about the evils of "year round" travel, one thing has always interested me. For the most part, that is limited to warm weather states like Florida, California, and Texas who also, by far, produce the most higher level players.

My kids started the travel ball at 9.  I helped coach and took this issue very seriously.  We read everything we could get our hands on to understand the best thinking available and we lost games because we wouldn't bring a kid back after he reached our predetermined limits. 

Saw a 9 year old throw 129 pitches against us.  Next year had elbow surgery and never pitched again.  We played that team off and on for another 4 years.  It was sad.  His grandfather approached our Head coach once and had a conversation with him and was stunned to hear we remembered his grandson and shared our approach.  The old man cried and said that he wished his grandson had played for people trying to act that responsibly.

I don't know if we were lucky or did the right thing but every player we ever had got to HS with their arms intact and to my knowledge has never had a serious arm injury.  I do believe if you are going to get involved with coaching a travel team...and let's face it about 90+ are run by well meaning fathers up to HS, I do believe that getting up to speed in this area is a must and then making a plan and sticking to it.

I always said that no one will remember who won the 10U Easter one day Tourney in any town USA but they might remember a player in the game if he stays healthy to play ball long enough to find how good they might be.

Luv baseball,

I agree that in the younger age groups more often than not a parent will be coaching.  

However, in the level we are most involved in, you very seldom see a parent coaching.  In most cases the better organizations have very good baseball people in charge.  This does not eliminate The potential for arm injury, but it does lower the risk.

hmmm...

Little Johnny's pitch count is subject to being abused in youth, travel, HS, showcases, and college.

There are statistics indicating that the prevalence of TJ in MLB is far, far higher for U.S.-born pitchers than for Carribbean pitchers.

If this were a teenage question, you might attribute that to the inability of Latin players to pay for the surgery.  But in MLB, cost is equal for both groups, i.e.., covered by the CBA plan.

I think if you were to visit, e.g., the Dominican Republic, you would not see all this concern about year-round baseball or the amount of throwing.  In the past, I read stories about Andruw Jones, who grew up in Curacao, where young children don't go to school and basically hang around a sandlot playing all day without shoes and using re-formed milk cartons for gloves.

What I would respectfully suggest that this shows is that, far from being over used, American pitchers are not throwing enough at a young age.  Or, perhaps there is too much emphasis on pitching and not enough on just throwing, that is, working on the basic mechanics and developing strength, stamina and endurance.

When I was a kid you used to be able to get rubber-coated baseballs -- not like the "squooshy" molded rubber things you get now, but practice balls that were hard but coated for durability.  I used to go in my backyard and throw it against the brick wall of my house just to pass the time.  I usually threw 500 times on any day when it wasn't pouring down rain or frozen outside.  On occasion I would test myself to see how many throws I could get in.  I threw 2,000 times on numerous occasions.  And I never once in my life had any sort of arm injury.

It's just one man's opinion, but I think there is too much, too soon in terms of working on high velocity throwing, and not enough emphasis on just throwing for mechanics and durability these days.  It seems to me the best approach is to build the foundation first and then move on to the higher performance levels.  So if travel ball is to be blamed, perhaps the problem is at the pre-HS age levels where the strong kid is throwing off a mound once a week for 100 pitches, resting his arm the rest of the week, and not doing enough just plain THROWING.

I used to hunt squirrels with hard green walnuts in the off season. Skip rocks all day long, go to my practice, and to my brother's, every pick up game I could find. I would play with guy's I didn't know. Shag balls all day long and just to swing the bat a few times. it was different back then that's for sure.

 I forgot to mention spitting off the dock and killing perch with a baseball or golf ball when they surfaced. But that was all before cable TV and Nintendo.

Midlo, 

My son's pitching coach is Dominican, ex MLB'er and works for a very well known agency.  He says exactly what you say on the difference b/w latin American players and US born players and the amount of throwing they do and arm health.