Sports Med Studies... 1/3 will be proved wrong

quote:

Keep in mind that most such studies, in almost any field, are eventually proved baseless.

Keep in mind that 1/3 of medical studies are eventually shown to be incorrect, incomplete or total poppycock.

Speaking of anecdotal statements, could you provide any documented proof that "most such studies, in almost any field, are eventually proved baseless" or "1/3 of medical studies are eventually shown to be incorrect, incomplete or total poppycock"?

The following are the articles I have bookmarked over the years dealing with arm and shoulder injuries in sports, primarily baseball. I am no Doctor, but I did stay in a Holiday Inn express last night. I would take the advise of a Doctor over any advise I found on an internet Bulletin Board.

I see Major Leagues pitching coaches have by and large adopted lower pitch counts for adult pitchers than we see in the Little League World Series. Again, I am not a major League Pitching Coach, but I could take there recommendations over advise I found on an internet Bulletin Board.

As far as your tabloid entertainment statement, you may be correct. are these articles just Doctors jumping on the band wagon? I Don't know.

A Clinical and Roentgenographic Study of Little League Elbow


American Sports Medicine Institute


Doctors see a Big Rise in injuries for Young Atheletes


Risk of Injury From Baseball and Softball in Children

Elbow Injuries in Young Baseball Players

Too Much Too Soon


Armed and Dangerous

USA Baseball Medical And Safety Advisory Committee Reports

I corrected my post in two ways. That 1/3 of medical studies are wrong was quoted in the Wall Street Journal (I believe that's where I saw it) last week. I shouldn't have said "most" studies in any field are wrong. The 1/3 error rate may apply to most. Certainly medical research receives better vetting than most ...ask Merck!

Heck, if you go back far enough, 98% of medical "studies" were probably wrong. George Washington received the best medical care his money and position could buy. But bleeding him for a severe throat infection may have killed him.

quote:

I see Major Leagues pitching coaches have by and large adopted lower pitch counts for adult pitchers than we see in the Little League World Series.

We don't have any $100 million arms to protect in LL...yet. Or million dollar coaching salaries to protect either. No one knows how best to protect arms for certain. The caution is mostly about protecting jobs and avoiding litigation. There are some who advocate more, not less, pitching. Hasn't Leo Mazzone been quoted as doubting whether so much caution is needed?

quote:

Originally posted by micdsguy:

We don't have any $100 million arms to protect in LL...yet. Or million dollar coaching salaries to protect either. No one knows how best to protect arms for certain. The caution is mostly about protecting jobs and avoiding litigation. There are some who advocate more, not less, pitching. Hasn't Leo Mazzone been quoted as doubting whether so much caution is needed?

The question here is that one does NOT know. If I took vitamin E because I felt it was good for me, that was my perogative as an ADULT.
Young players look up to their coaches and trust their parents to make the right decisions for them. If there is ANY doubt, which has come to light lately, according to doctor's studies, well than that should be a consideration as what NOT to do.
How does a LL coach know whether a player will have a million dollar arm or not?
Mazzone's statements and doubts are for grown up men, who are already developed and employed.

Please post for us any articles that negates the above articles. I am always willing to learn something new.

It doesn't really matter if there are more arm injuries today than there were before. What should matter for youth coaches and parents is that we err on the side of caution with kids' arms. Tod disregard medical advice and put our kids at risk for the purpose of winning games is absurd.

If youth coaches would develop MORE pitchers on their teams, then the better pitchers would not be overused. But, if winning youth baseball games is more important than caring for the health of the kids we coach, then by all means youth baseball coaches are the experts (even though they make their living doing something else).

The goal for every youth coach should be to develop several quality pitchers and send them on knowing full well that they have been cared for better than their parents would have cared for them.

Agree many studies are agendized. Those with an agenda will use flawed studies to further their causes. Or to sell - papers, magazines, agendas...

Intelligent people will sift and analyze data and ultimtely come to intelligent conclusions.

The dialogue created has value in and of itself.

And finally got to ask....are the studies that show that 1/3 of medical studies are wrong...are THOSE studies ALSO wrong 33% of the time?

The majority of studies that are later proven wrong have too many generalities, such as the Vitamin E study you mentioned. I was at the conference in Baton Rouge where the study author explained his findings. He did a literature review of all previous Vitamin E studies, but he threw out all studies where at least 10 people didn't die! He totally manipulated the statistics.

It is for the above reason that I believe your statistic that 1/3 of studies are disproved, but I would be amazed if that number would apply when dealing with the physical sciences, because most (if not all) of study particpiants are "in the same boat" so to speak. You aren't comparing a healthy 12 yo pitcher to a diabetic, you are comparing a healthy 12 yo pitcher to other healthy 12 yo pitchers.

All physical rehab studies performed on young athletes (pitchers in particular) have proven 1 of 3 things. Pitchers can be injured by either:

1.Overuse
2. Undertraining
3. Genetic/Physical predisposition

That is what makes it such a guessing game. Where do you draw the line between undertraining and overuse. Then you have to decipher what physical load is best for each individual. Some kids can throw 90 pitches with no problems, others can't even get to the recommended pitch count for there age.

I totally agree with grateful, err on the side of safety. Make sure they are training in a controlled evironment under supervision, and don't put winning above all else, especially at the 12-16 yo levels. A perfect example of this was the LLWS game Friday night. The Iowa pitcher threw over 125 pitches. Not only did they lose because he lost his control walking 2 batters before giving up a 3R HR on a full count fastball, but who knows what he did to his arm.

Sorry to go on, but lastly, if you have a son or daughter that is a pitcher or is involved with any overhead activity, have their shoulders evaluated to establish a baseline. Have someone establish there complete Ranges of motion as well as each indiviual muscle strength. This is the idea behind pre-habilitation. Prehabbiing adult employees for potential weaknesses has saved some companies as much as 6 million dollars in workers compensation in the first year, why wouldn't it work for athletes.

For example, maor league and college pitchers have a maximum of 165 degrees of external rotation in their pitching shoulders, and at least 10 dergees more external rotatrion in their pitching vs non-pitching shoulder. If your son or duaghter has limited shoulder external rotation, it makes sense that they will have diminished performance and increased injury risk by having less range of motion in which force can be generated. Why not work on addressing that issue before they become injured.

All that I know is it could never hurt to get a physical blueprint of where you are as an athlete. Hope that helps some.

Flaws are found in validating medical studies
Many see need to overhaul standards for peer review....from The Boston Globe
By Michael Kranish, Globe Staff | August 15, 2005

WASHINGTON -- They are two of the most widely publicized pieces of medical research in recent years: Reports in prestigious journals declared that women who underwent hormone replacement therapy, and people who ingested large amounts of Vitamin E, had relatively low rates of heart disease.

Each study was vetted by peer review, the basic process for checking medical research, in which other researchers judge whether papers meet scientific standards.

But after research contradicted those studies -- frustrating anyone who had followed their recommendations -- some specialists began looking at whether peer review had failed to identify serious flaws in the research.

But the specialists found that it was almost impossible to discover what had happened in the vetting process, since peer reviewers are unpaid, anonymous, and unaccountable. Moreover, their reviews are kept confidential, making it impossible to know the parameters of the reviews.

Now, after a study that sent reverberations through the medical profession by finding that almost one-third of top research articles have been either contradicted or seriously questioned, some specialists are calling for radical changes in the system.

In advance of a world congress on peer review next month in Chicago, these specialists are suggesting that reviewers drop their anonymity and allow comments to be published. Some are proposing that peer reviewers be paid to ensure a more even quality of review and analysis among all journals.

Dr. Drummond Rennie, who relies on review as deputy editor of JAMA, the Journal of the American Medical Association, said of the process, ''The more we look into it, the harder it is to prove whether it does good or bad."

Rennie has called for greater study of whether peer review improves research, and he has a personal policy of disclosing his name when he reviews articles.

''It would be lovely to start anew and to set up a trial of peer review against no peer review," Rennie said. ''But no journal is willing to risk it."

Rennie's journal published the study, which said that subsequent research had found that almost one-third of the top papers that appeared in top journals over a 13-year period from 1990 to 2003, had been either contradicted or found to have potentially exaggerated results. All the articles had undergone vigorous peer review, leading to questions about whether problems should have been caught by reviewers.

The author of that study, Dr. John Ioannidis, an adjunct professor at the Tufts University School of Medicine, said that flaws in the system were not solely responsible for the problems with the initial studies, but he said that they may be ''part of the puzzle" that should be examined to improve research.

Ioannidis has proposed making peer reviews public so that ''one could see whether someone said, 'This is a great study, publish it,' or whether there was constructive scientific thinking, comment and criticism." He noted that he could not examine any peer reviews, including those for the hormone replacement and Vitamin E studies, because of the confidentiality surrounding peer review.

SOURCE
Boston Globe Article - Medical Studies Flawed

spinedoc,

Great stuff. I am guessing you are a physician and if so what is your specialty? Orthopedic Surgeon? Just curious. I am an Engineer so alot of what you are talking about makes sense to me mechanically speaking.

I started this topic after reading the business best-selling book, Freakanomics The author, a University of Chicago economist distrusts "experts" He details the symbiotic relationship between attention-craving money-driven "experts" and the modern media.

Remember Mitch Snyder an expert on homelessness who was a fixture on talk shows 10-15 years ago. Snyder, himself "homeless," spewed all sorts of stats showing that millions of Americans--including whole families-- lived on the streets. Great talk show fodder! But his stats were mainly his own creation, according to the book's author.

A few years ago, there were two or three killings linked to cults. Sure enough, our local talk shows soon featured a series of "cult experts" who detailed the horrors of thousands of kids engaging in blood lust witch craft or some-such. Has anyone heard of cult killings lately?

How does this affect baseball training? I'm just trying to point out that training experts are ALWAYS biased, to some degree, for financial and ego reasons.

I am not a scientist.

I know I played a lot of baseball as a kid. Pick-up baseball and organized ball. I was throwing constantly and never iced my arm. When my arm hurt, I didn't throw as much or as hard.

I could throw pretty hard (mid 80s) well into my 30s. Then I had something pop in my elbow and I had surgery. I can't throw nearly as hard, but I can throw harder than the average almost 50-year-old.

So, has modern medicine let me down? Hardly. I'm not a freak of nature, either. My arm got strong, and stayed strong, because I played a lot of baseball and used common sense.

How many kids play anywhere near as much baseball as today's parents did growing up?

Look, I've taught my kids how to take care of themselves, just like anyone else. I read the stories, use what makes sense and bag what doesn't.

But the one inescapable fact of athletics today is that we are doing with weights, diet and ice what we used to do on the playground.

Seems to me if we get kids back on the playground, the medical theories will prove themselves in good time.

micds,

You are singing to the choir with me. You can find an expert or study to support just about any position. I am also amused at the homeless problem. Not saying that I am not sympathetic just amused at how it is covered and reported sometimes.

Also, agree with you OldVaman.

By the way, Salem Massachusetts paid "witchcraft experts" in the 1690s to discern who was and who wasn't a witch. There was something of a bounty to pay the "experts" as I recall.

Is anyone surprised that those hired experts found witches...lots of them!

micsdsguy,
Correct me if I am wrong onthis. You are a HS player, junior, senior?
Until you go through some real life experiences, have kids and watch them being over pitched, hurt, etc., you can post all you want about proving 1/3 of medical studies being wrong.
This board is "littered" with articles for reasons you probably don't understand, but you will someday.

Spinedoc, great post! 125 pitches, my son doesn't even throw that in college. Really, really sad.

Old Vaman, also a great post.

quote:

micsdsguy,
Correct me if I am wrong onthis. You are a HS player, junior, senior?

You are WAAAAY wrong. LOL. How many HS kids cite the Wall Street Journal, best-selling business books and the Salem witch trials? My reference to 1990s homeless advocate, Mitch Snyder, is another clue that I'm not in HS.

Micdsguy...you have a PM

luvbb---

Aren't you supposed to be at the Phillies/Pirates game? Or did you forego the tickets because Zach isn't pitching??

HEY PAmom.....only had 4 tickets and 5 family members. Being the good mom that I am...I'm home typing on the computer! It would have been a different story had Zach been pitching tho!

Good post OldVaman. What I would like to see is an injury comparison between now and when the "old timers" like Gibson (on Omaha Native) and walter "Big Train" Johnson would pitch. These guyts would throw a coplete game 60-70% of the times they would pitch, and they may pitch 2 or 3 games in a row, or on 1 days rest on a very regular basis.

The key there is that a mature arm can handle an exponential amount of stress compared to a developing arm with open growth plates. Kids can't be treated as small adults, they have to be treated as kids.

I will say this, if you cornered me and forced me to say the one thing that was causing the most injuries in young pitchers: I would cheat and give you 2.
1.) year round baseball. Not a fan, a pitcher should go at least 3 months a year when they don't pitch. I keep my boy on a pitch count during the year, he goes 6 weeks with NO throwing at all after the fall season, and 3 months with no pitching. He spend that time working on hitting drills and fielding ground balls, so it is still productive time.

2.)Catch!! Kids don't play near enough catch. I think this keeps their arms from getting the conditioning that past generations got. I also think this is why so many players "peeter" out on the 60/90 fields, they never get strong enough to give themselves a chance.

Clevelanddad, I use to be a surgeon (not an ortho surgeon though), but I hated it. I am now a Chiropractor. I believe that enhancing the structure and biomechanics of the human body is the key to improved function (i.e. athletic ability) as well as injury prevention. I think too many athletes were being cut into that should have never been on the table, so now I get to the cause instead of trying to be the solution. Much more rewarding that way.

Great thread guys, keep it up

(Thanks for the nice comments Luvbb.)

On the subject of experts, I'm reminded of the ancient wisdom:

quote:

Never Ask a Barber Whether You Need a Haircut.

LOL

I LOVE the baseball/sports med article links posted here (I shouldn't have used the word "littered."). Like everyone here, I'd like to find a cheap safe vitamin or easy training regimen to make my kids better. But it worries me that kids are apt to overweight the importance of the newest theories in sports medicine.

micdsguy
Member

Back in September I could hit 80-82 with about 20 pitches of a 35 pitch workout with my fastball.
From about October 15th to January 20th I did my weight training, cardio, throwing, stretching and abdominal exercises. The exercises consisted of about 35-50 minutes of Cardio on Mondays, Wednesdays, and Fridays, and only about a mile run on Tuesdays and Thursdays. I would do legs, mostly the core exercises of Leg Press, Extensions, squats, calf raises, lunges etc. on Mondays, Wednesdays, and Fridays. On Tuesdays and Thursdays and sometimes on Saturday, I would do the upper body workout which consisted of Inclined bench press, lat pulldown, bench press(not too much weight), arm rows, etc. Each to every other day I would try to do a lot of the stretches that I later saw on that Pacific Tigers website page. And I would also try to throw, either long toss or catch, about once or twice a week.
I was doing a lot of working out as I'm entering into my Junior season, and I can't be blowing off the offseason.

I took about 5 days off from much of anything this last week(only jogging early in the week) so I could rest my body, and let the muscles repair themselves from the workouts.

On Saturday I threw about 40 fastballs to see what my velocity was, and I sat around 76-78, topping only once over 80 at 81.

Can someone tell me why my velocity hs dropped 3-5 MPH even with a solid workout, which most of which was picked up here, and then a week to rest my body?

I did this also at the end of December, but was at 78-81 then.
I did everything the same the week leading up to both my throwing sessions.

Should I lay off of weight lifting?


micdsguy
Member

Finally got to make a start this year.
However it didn't go as I planned.
My line was 3.2 INN, 6 H, 5 ER, 1 BB, 2 K
Hopefully I do better next time. I just sucked today. I guess I should have made better pitches, although I was pleased with almost all of the pitches I made.

Posts: 306 | Location: midwest | Registered


micdsguy
Member

This was from one of your posts, sent to me by someone, maybe WE re just confused, college maybe?

Wow, you really have a bee in your bonnet over this!

Ever hear of a whole family sharing one alias?

No bee in bonnet (someone else used that expression lately).
Answer to your question is NO.

It is now, finally, obvious to me. The real experts are the parents. While watching games all these years, listening to them in the bleachers (or along the fence)......wish I would have known. I could have been taking notes.

Why would I have thought to consult and listen to people like Dr. Andrews, or Gordie Gillespie, or Pat McMahon, or Brian Shoop, or Jim Farr, etc.,.......when I could have just asked the experts in the stands?

Cong – Thanks for the “litter of links”. It was most informative and better yet kept me from my “honey do list” for the better part of the day.
Micdsguy – Thanks for kickin’ up the dust. Your post reaffirms that you should continually re-evaluate the authority of experts, including the Wall Street Journal (ENRON and WorldCom come to mind as two examples). What is that saying… believe ½ of what you hear and ¼ of what you read or was it the other way around?!?! Regarding your comment regarding pitching injuries, I disagree with your opinion 100%! Don’t confuse medical science with tabloid entertainment… or was that the other way around?!?!

Believe nothing just because a so-called wise person said it. Believe nothing just because a belief is generally held. Believe nothing just because it is said in ancient books. Believe nothing just because it is said to be of divine origin. Believe nothing just because someone else believes it. Believe only what you yourself test and judge to be true. ~ BUDDHA

Sports med research would benefit immensely if we'd develop lab animals who can play sports.

Imagine huge lab colonies of rapidly breeding, inexpensive mice who could throw 90 MPH. Overload some; put others on low pitch counts. Compare the throwing speed. With short lived rodents, the pitcher could go from Tee-ball to Senior softball in months. Scientists could control every aspect of the animals' lives. (which you can't do with human jocks)

Then kill and dissect the mice to really check out their insides.

Heck, we do much of that with multi million dollar human drug tests, and we still end up with Vioxx-type problems.