shoulder hurts

danocaster,

I'm not a doctor, but do have some experience with what you have described.

It sounds very much like a stress fracture.

The growth plates in the bones are soft and jelly like until growth is complete.

Throwing a baseball causes stress on the joints and tiny fractures can occur, especially with overuse.

From your description, it sounds like your son has thrown a baseball quite a bit for a nine year old.

It can take a long time for a stress fracture to heal completely.

A sports medicine doctor might take an xray, but the stress fractures are usually small and don't show up on the xray.

That is why the doctor would likely tell your son not to throw for 6 to 12 weeks to let the injury heal.

Xrays and MRI's don't always reveal the injury or extent of the damage, so rest is usually the first advice.

It is interesting that these questions seem to come up in July late in the young boys seasons.

It is important to listen to your son.

I didn't listen in July, but when the pain started back up when fall ball started, I finally took him to the doctor.

"Does he play baseball?" Yes.

"Does he play a lot of baseball?" Yes.

"Your son has a stress fracture and needs to not throw for three months to let it heal" is what the doctor said within thirty seconds of entering the exam room.

It is important to listen to your son.

Yes, it's early in the morning, but I intentionally put that sentence just above in twice.............

And, six weeks is probably not enough time.

Thanks for the advice. What seems weird to me is the time line of when it hurt.

season- felt fine through out and when season ended.

summer- played pick up ball once a week and that's about the only throwing he's been doing- felt fine.

missed two weeks of pick up ball- shoulder hurts when he started playing catch.


So it it started to hurt after he hadn't been throwing. That's what I don't understand.


When your son was injured, did it happen when he was active?

Very similar to your circumstances.

He complained of shoulder hurting during playoffs after a couple of weeks off.

He had a bad outing as a pitcher, and, I thought he didn't want to pitch because of that.

I made him play through it. Then the season ended.

When fall ball started back up about six to eight weeks later, he complained again, so I took him to the sports doctor.

I had never heard of a stress fracture...........

He took the entire fall off and was OK the next spring in time for high school freshman year.

The doctor did have some xrays done that confirmed his intial diagnosis.

The Sports doctor is on vacation at the pediatric center where we take the kids, so my wife went ahead and took him to one of the other docs. The doctor said that she thought that it was muscular, due to the fact of where it hurts, and additionally (I think) because it only hurts when he throws. No other movements cause pain. It could be a stress fracture, but she didn't think it was.

She said to rest his arm for a week, and if it still hurts next week, come back and they will take x rays and the sports medicine guy will back and go from there.

Thanks for the advice.

quote:

because it only hurts when he throws.

That's what makes me think it could be a stress fracture.

But, the important thing that you are doing is that you are listening to your son and seeking professional advice.

Good luck to you and your son.

Im just guessing... but one of the problems of just letting the kids play un-supervised is that they will try to throw it hard without warming up. Whether when pitching or just playing catch, they will have a long toss or a hard throw without warming up. Especially on the first throw ... " hey how hard can you throw it?" or something. It only takes One throw to injure the arm....then you just have to rest it. No throwing at all.

As you noted , shoulder was fine during season , because coaches made sure there was proper warm up, or at least no hard throws before warm up. Then I assume he started to just play catch with friends and got injured......

Rather than speculate what this may be, we rather provide a suggestion on the pitch counts you stated your 9 year old son was involved in. We STRONGLY recommend that regardless of what the league rules are, you limit your son's pitch count to much less than 65 pitches. We believe that boys at this age should not be pitching this much. When you add in the warm up pitches before the game, warm up pitches between innings, misc throws, etc a 65 pitch count can easily exceed 100. Dr. James Andrews (famous sports phd) who is on our advisory board has publicly stated that "the seeds of arm/shoulder/elbow injuries that occur in high school, college and the pros were planted during the little league years." Limit your son's (and the same goes for all of you) pitch count to something like 40-ish...or less if possible. Case in point, Rick Peterson (MLB pitching coach and our partner) didn't let his son pitch until he was 15!

quote:

pitch count to something like 40-ish...or less if possible.

This sounds nice, but isnt realistic. I would be difficult to get a 7 inning game in with each kid only being able to pitch 1 inning and change.

I didnt start pitching until I was 14, and my old man wouldnt let me throw a breaking ball until I could do 100 push-ups. Not that his theory was right or wrong, but the concept behind was solid IMO.

Why is the "100" pitch count such a magic number?

Steve,

I was wondering more about you pitch counts/recommendations for kids this age.My league has an inning pitch rule as opposed to pitch count(which I prefer).How much should a child this age pitch say per week? We are talking games on Saturday and Sunday and practices during the week.I monitor how much my son throws during games and practices.I basically follow the 1 pitch 1 hour rest rule and just bacically listen to his body.I can see if he's laboring and if so,he stops right there.

Also how do you fell about the need for complete shut down for this age.We play year around so taking a couple of months off is not really an option unless he doesn't play for a season.I know he wouldn't go for that.

I've read the ASMI pitch count recommendations,I just want to hear yours as well.

Aloha,Sugi.

Sugi,

How old is your son?

The research we (3P Sports - MLB pitching coach Rick Peterson) and ASMI have done state that pitch counts is more important than innings. For example, if a pitcher under 12 pitches 50 pitches an inning in each of two innings, then we feel he has pitched too much.

As I said before, the less pitches the better. For example, my son who has been privately coached by Rick Peterson (former pitching coach for the A's and Mets)did not pitch more than 50 pitches per game all season. In a all star game, he started and pitched 68 pitches...the most all season. At this age, it is best to keep the pitch count low.

Regarding playing all season, most experts agree there should be some months when they don't play. Resting the arm/shoulder is very important. If they play all year, they certainly shouldn't pitch all year.

I'm far from an expert on this, but among distance runners, a generalized rule is that you should not run a distance greater than 3x your average daily mileage. Doing so puts you in the region for overuse injuries.

Exactly how that would translate to baseball is unkown since I've never heard anyone try....they simply come up with some absolute level for pitchcounts in what seems to be a vacuum.

However, I do think that one of the reasons kids are getting injured is that they come out and throw too many pitches from a non-existant throwing base. I don't know why a pitcher wouldn't have an average of say, 20 pitches per day in season. That would be 140 per week, and might mean 10 on easy days alternating with 30 every other day. A start with 60 pitches would leave 80 to be spread over the other 6 days, so about 13-14 per day. Maybe if the kids never throw at all between games they ought to be limited to 25-30 pitches...who knows what the right level is. Its all a function of what your arm has been conditioned to, and that can be expressed by knowing what your last two weeks daily average was.

Maybe in baseball you can safely go to 4 or 5 times your daily average of pitches. I rather doubt it though, and would bet that the safer limits would be 2-3 times your daily average over the preceeding two weeks. All of which means that throwing more often is better for you.

Update:

After a week and a half of rest, his shoulder is feeling great. We eased into it with several test throws, and then the next day warmed up and threw normally. He pitched 10 pitches on the 3rd day and he said he felt great. He practiced with the tournament team with no problems and will probably pitch, play SS and 1B this weekend. After the weekend, we will shut it down to play football.

Thanks again for all of the advice and concerns. I'd like to get more advice on pitch counts, and how to practice pitching effectively during the season without doing too much.