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I hope many were watching 2013 Urban Invitational this evening on the MLB network while listening to what the broadcasters had to say about Curveballs and Sliders in the youth leagues.

 

 

Staying well-armed

 

 

Young pitchers are increasingly at risk of injury

 

By JEFF BERSCH
Fort Collins Coloradoan

The scar stretches some 6 inches on Kevin Kroneberger's right elbow, a permanent reminder of the pain he felt one April afternoon.
 

The Poudre High School baseball player was warming up to pitch a nonconference game at All-City Field in Denver.
 

"I warmed up pretty good," Kroneberger remembers. "It felt great, actually. Nothing hurt."
 

A few pitches into the first inning, Kroneberger felt a pain in his elbow. Two pitches later ...

"I felt a pop; it was definitely a huge pop," Kroneberger said. "I felt it snap. I threw one more pitch ... (but) I just couldn't take it. It was that painful."
 

Kroneberger, 17 at the time, knew something was wrong. After years of playing baseball, he suddenly couldn't throw anymore.
 

The ulnar collateral ligament, or UCL – the primary elbow stabilizer – had snapped and pulled away from the bone. He needed surgery.
 

Kroneberger is among a growing number of kids needing what is commonly referred to as Tommy John surgery, named for the first pitcher to have the procedure done 30 years ago.
 

Once reserved for professionals or college players, the need for Tommy John surgery has trickled down the age ladder.
 

Doctors couldn't tell Kroneberger why his UCL snapped. The injury usually happens over time, the ligament tearing a bit more with every pitch.
 

Tommy John surgery – known to doctors as UCL reconstruction – usually requires the UCL to be replaced with another ligament, typically the palmaris longus, an otherwise useless or extra ligament in the wrist. Other times, ligaments are taken from the hamstring or other muscles.
 

In Kroneberger's case, the UCL simply was reattached. Still, it didn't make it any easier to take.
 

"I had never had problems with anything," said Kroneberger, adding that he hadn't pitched a whole lot during his baseball career. "I was always a center fielder. I wasn't a starting pitcher. I just pitched when I was needed."
 

Dr. James Andrews, the nation's most recognized name in Tommy John surgery, has operated on some of Major League Baseball's best pitchers, including Chicago Cubs right-hander Kerry Wood and Atlanta Braves ace John Smoltz.
 

Dr. Glenn Fleisig, research director at the American Sports Medicine Institute, or ASMI, in Birmingham, Ala., said that between 1995 and 1999, Andrews performed 184 elbow-replacement surgeries on baseball pitchers; 21 were high-school age or younger.
 

From 2000-04, Andrews performed 624 surgeries, 124 of which were on high-school-age or younger patients.
 

"I know of no (national) database, but I know what Dr. Andrews has done," Fleisig said. "Year by year, it's been a growing trend."
 

The reason: Pitchers are throwing too much too soon, Fleisig said.
 

"Injuries that show up in high school, college or later often can be traced to what happened when players were 9, 10 or 11," according to Fleisig and the ASMI.
 

"When people get hurt, they think they threw too many pitches one day," Fleisig said. "They didn't get hurt that one day. That day was the last straw. ... People are tricking themselves (because) baseball UCL injuries are always overuse injuries."
 

Fleisig said the tension on the elbow is the main cause of the injury. With each pitch, the UCL tears a bit more. Without proper rest, those tears add up at a faster rate than can be repaired. Eventually, the UCL tears.
 

The injury is more apparent now than in the past because youth baseball teams including those in Fort Collins, are playing more games. More games means more pitching is needed.
 

"Of course we are concerned," said Pat Wunsch, director of the Fort Collins Baseball Club, or FCBC. "We're concerned with the competitive teams, teams that travel and play a lot of games. ... But we have limits on the innings pitchers can throw, and it's in place for the safety of the kids."
 

Limits on the number of innings pitched are popular, whether in league play or over the duration of tournaments. In Rookie and Select League teams in the FCBC, the number of innings allowed is divided by age group.
 

The club also encourages coaches to "follow league restrictions for all games (league and nonleague) to ensure the health of all pitchers."
 

The encouragement is needed because many teams in the FCBC play league games, then compete in tournaments on the weekends. The number of games easily can climb into the 60 to 80 range over the summer.
 

"I've never had anyone ask why (we limit innings)," said Phil Ebersole, the competitive chairman for FCBC. "In fact, the feedback we get is that we should track it for tournaments, too.
 

"Logistically, that's just not possible. We can't track how much a kid throws in his backyard, either. But the feedback is that we should be even more careful."
 

The FCBC requires the winning team in each league to report the number of innings pitched by each player. The innings are posted and tracked on the club's Web site.
 

Wayne Flax, a coach for the FCBC's 14-and-under Sandlots, said his teams have played 50 to 60 games a summer the past five seasons. He is aware of the risk of overusing pitchers. Flax, whose team plays only in tournaments, hasn't found it to be a problem.
 

"Most of the tournaments have their own limits," he said. "Nobody abuses it.
 

"Our pitchers are throwing only one game a week, maybe seven or eight innings at the most. ... We're definitely not going to risk it to win a ballgame."
 

Scott Bullock, the coach at Rocky Mountain High School and the school's summer legion team, keeps close tabs on the number of pitches thrown each outing, as well as innings pitched per week and season.
 

The second-year coach said he's removed pitchers who were throwing well because they had reached their pitch limit.
 

Scott Bachman, who just finished his junior season with the Lobos, said he has had some elbow tendinitis during his baseball career. He said rest helps and he hasn't given too much thought to serious elbow injuries.
 

"You try not to let that cross your mind," said Bachman, a left-hander. "It's just not something you think about, and you just have to take care of your arm and do everything you can to keep it from happening.
 

"At Rocky, you're never put in a situation where you're throwing a ridiculous amount of pitches. It's about keeping you safe before winning. They won't leave you out there because they want to win so bad."
 

Bachman estimates that between high school and legion games, he throws about 150 to 160 innings. It's considered a good season by a major-league pitcher if he can pitch 200-plus innings. Still, Bachman said he's not worried about the number of innings he pitches.
 

"At this time," he said, "it's not a huge concern."
 

In addition to the amount of pitches and number of innings, another concern is the type of pitches thrown. Fleisig and Andrews say boys shouldn't throw breaking balls – curves and sliders – until they can shave.
 

More and more, however, younger pitchers are turning to those pitches because they work. Bachman said he didn't start throwing a curveball until he was 13. Even then, he said, he used it about four or five times a game, usually with two strikes on a batter. He began throwing more curves once he was in high school.
 

"I'd see kids in Denver who were 10 throwing curves and striking all these people out," Bachman remembers. "I'd see it and think maybe that's the pitch I need to get. I'm glad I had good coaches. They told me there'd be a time for that."
 

Jake Brunner, 14, a pitcher and shortstop on Flax's Sandlots team, already has had elbow problems, going back two seasons. To be fair, the problems stem from a camping trip when Jake slipped and fell; he broke the growth plate in his elbow.
 

This season, however, two years later, Jake complained again of pain in his elbow. Brunner's father, Dennis, said he and his wife, Jill, took Jake to the Orthopaedic Center of the Rockies, where they learned Jake had fractured the growth plate in his elbow.
 

Dr. Sean Grey of the Orthopaedic Center of the Rockies said that's a major problem with younger pitchers.
 

"The cartilage in there is weaker and what happens with the 11-, 12-, 13-year olds is that it basically irritates the growth plate," Grey said. "It can actually fragment and then it affects the angle the arm grows."
 

Grey said with any elbow injury he recommends rest. Dennis Brunner said Jake did not pitch for six weeks and played only second base, where the throw to first base was much closer than shortstop.
 

"I don't take it too seriously until it hurts too bad," Jake Brunner said. "When it hurts bad enough, I tell someone about it."
 

Said Dennis Brunner: "It's not something you want to mess with. It can be a long-lasting injury."
 

Unlike Bachman, Jake Brunner said he started throwing a curveball when he was 12. He said it was a "football curve," thrown like a football without snapping the wrist. It's supposed to relieve the stress on the elbow.
 

"I heard about (not throwing curves too young) before I started throwing it, but our pitching coach showed us the right ways to do it," Jake said. "I wasn't worried."
 

Fleisig, though, said no curveball is safe. He recommends a pitcher learn a fastball at age 8, a changeup at 10 and a curveball at 14. All other pitches – such as a slider or split-finger fastball – should not be introduced until high school.
 

A study of young pitchers in Alabama showed statistically that kids who threw curveballs had a higher chance to have elbow pain," Fleisig said.
 

He and Grey also emphasized proper mechanics and recommended young pitchers with elbow problems see a pitching coach to make sure there is no mechanical defect.
 

That's also the first recommendation of Brian Niswender, a former strength and conditioning coach with the Arizona Diamondbacks. Niswender is the owner/director of athletic development at Performance Dynamics in the Edge Sports Center in Fort Collins.
 

"I've seen kids as young as 7 or 8," said Niswender, a graduate of Rocky Mountain High. "They are having constant shoulder pain or constant elbow pain. ... They're just throwing too much and not in the right way."
 

Niswender also recommends strengthening the arm and elbow through exercise. With so many things to worry about, Fleisig has some simple advice for players, coaches and parents. Communication is key.
 

Coaches should listen to their players, and parents should listen to their sons. And players should never be afraid to come forward when something doesn't feel right.
 

"The truth is, each kid has different limits," Fleisig said. "We can't have scientists watch every kid, so limits are based on stats about what we believe is right. Limitations are guidelines, but the best way to prevent overuse is communication.
 

"If your kid says his arm is tired of giving the mannerisms – shaking his arm, walking around the mound or is throwing slower and with less control – don't blow it off."

 

• • •

 

You can reach Jeff Bersch via e-mail at jeffbersch@coloradoan.com">jeffbersch@coloradoan.com.



"Hustle, it costs you nothing, but gains you everything"

Last edited by TCWPreps
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Originally Posted by TCWPreps:

 

Fleisig, though, said no curveball is safe. He recommends a pitcher learn a fastball at age 8, a changeup at 10 and a curveball at 14. All other pitches – such as a slider or split-finger fastball – should not be introduced until high school.

This is the best pitching advice I have consistently heard over the years.  I hope parents of all young pitchers abide by this.  If your pitcher learns to change speeds at a young age, he'll get batters out.   Throwing a change up for a younger pitcher is easy to learn and easier to control than a curve and batters just don't expect it. Let the curve ball wait until the kids are older and their body has developed. 

 

I totally disagree. 

 

1) These kids should focus on their fastball first and foremost, not working on a changeup that won't help them at the next level.  The change up thrown in college and beyond is not the same changeup in h.s. 

 

2) The curveball is a safe pitch when thrown properly.

 

3) Sliders and splitters are dangerous pitches for a h.s. pitcher and should not be thrown at all.

 

 

 

Bum,

I agree first work on the fastball.  Then for the second pitch, the change up.  If thrown properly it will help you at the next level, be that HS or college or beyond.  Are you advocating throwing a curveball at ages 8 and 10 as a second pitch because it's safe if thrown properly?  I think the curveball should be unveiled at age 13/14.  Just my opinion.

No, certainly not.  I'm advocating learning to compete with and develop the fastball, through long-toss and sound mechanical training.  The curveball age 13/14 is a good pitch to mix in since it is the equivalent of a changeup anyway.  Go and and use the change just remember you will not master it at the h.s. level.  I don't know any large college coaches that recruit a fastball/change unless the fastball is 90+.  They are looking for a fastball/breaking pitch and be forwarned the slider and especially the splitter are arm killers.

Overuse is definately the main problem, but let's also mention the lack of knowledge of some coaches on how to develop a pitcher. I'm sure we've all seen/heard of conditioning that is being used for baseball players that actually can hurt them more then help. Who has seen baseball teams using drills really for football players? How about youth league coaches or HS for that matter who do not have their pitchers on a pitching program. They usu pitch then go play another position same day. The next several days they do not have a set program to follow they just wait until they get on the mound again. IMO HS coaches need to get special training to work with pitchers, esp when it comes to conditioning.

What it is- its overuse. Trying to push aside the real issue and blame it on something else. Its not throwing breaking balls. They may contribute, but really only in the overall pitch count. Last year on our hs team there were two kids who had elbow pain. Only one was a pitcher, other was a position player. Heres my point- neither one threw a breaking ball! Every arm is different, mechanics change from pitcher to pitcher. Some may be born with greater ligament strength. Some may condition better. Some may have bad luck. Not sure exactly how every case is but I do know that every kid has his threshold. For some it may be one inning while others it may be a complete game. But, its not hard to put two and two together to realize and understand that overusing an arm is not healthy and is definitely the fault in almost every case of throwing injury!

Sliders are not arm killers. Pitching too much- "ARM KILLERS"

Wrong, Skylark. H.S. and college sliders are most definitely arm killers.  I've seen too much of it.  Thank God Bum, Jr. didn't pitch too much at his first college.  They tried to take away his curve and throw a slider that (fortunately) was not a quality pitch.  So he got few innings there.  There were several players on that team that went under the knife.  All slider pitchers.

Skylark, if the fastball is the cause of most arm injuries I guess most kids shouldn't throw fastballs, right?  Perhaps frisbees?  Baseball is a game built around the fastball.  Without it, without a good fastball, it is impossible for any kid to pitch at the "next level", whether that level is travel ball, h.s., college or beyond.

 

Throwing a fastball is by definition "fast".  It is a calculated risk to throw a baseball fast.  But not doing so would seal the fate of most any pitcher.  Hang up the cleats, go bowling or join a choir, because your baseball days are over.  Read all the studies that tell you it is so stressful and make your choice.  Quit the game or take the chance.  Without it you quit the game.  Period.

 

Not so when determining which secondary pitches to throw.  The changeup at the lower levels, while effective, is usually thrown improperly and detracts from the ultimate goal (to develop and learn how to command a good fastball).  Kids slow their delivery, open up, and engage in trickery all of which might work but each time one is thrown it is subtracting from the gain that could be had learning to command a hard fastball. 

 

Get to college, and you will quickly learn that kiddie change is merely a BP fastball that goes yard.  Don't kid yourself, your changeup in h.s. is a meatball.  Have fun with it, throw it, get people out with it, but it's subtracting from your development. Try to sign with a D1 college with an average fastball and a B.P. changeup.  Not going to happen!.

 

So you need a solid FASTball and a secondary (breaking) pitch.  Again, the secondary pitch is NOT a B.P. fastball.  That leaves few other options, so choose: a college slider, which will tell your arm "I'm toast" in a year or two or a curveball, which if thrown properly, is harmless.

 

Skylark, I've seen enough of the college sliders to know they're worthless AND dangerous.    

 

I'm NOT saying changeups are bad.  Just consistently saying the changeup in h.s. and in college and beyond are two different pitches.  Two different pitches!

 

 

 

 

 

Bum,

You sure are on this CU kick, hehe! My son has one of the best cu around, when he can command it, ( not very often). Your opinion may be that sliders are bad for the arm, perhaps bad for your kids arm. Whatever, you have your opinion. Let me ask this- how many professional pitchers throw a breaking ball over 80 mph? How many throw a cutter over 85 mph? The "slider" is a pitch that is thrown with mechanics somewhere between a traditional curve ball and the fastball. The cutter is very similar to the slider but then again, so is the traditional curve ball. So, how many professional pitchers are on the road to ruin because they throw a slider or cutter, or any "hard" breaking ball? You can learn to throw any pitch safely. Like I said before, we had 2 kids on our hs team that had chronic inside elbow pain. Neither one of them pitch a breaking ball. Why is it then that there were also 2 kids on our hs team that threw hard breaking balls that have never had chronic elbow pain?

This reminds me of some of those baseball camps where they go into all these drills supposedly to protect your arm and increase velocity and efficiency saying this or that is bad and yet, you go watch video of long term professional successful pitchers and they do everything opposite of what you learned at camp.

It is amazing how misinformed and naive people can be. Bum, you are absolutely 100% incorrect about a change up not being a secondary pitch that college programs look for.  It absolutely IS.  Yes, command of a curve is necessary too however the fastball and changeup are the top two pitches considered.  How much movement does the FB and changeup have with command.  

 

Sliders are the most harmful to any arm.  Period.  This is the risk pitchers take when they choose to have a slider as one of their pitches.  Many do NOT throw it.  If you have command of various fastballs with movement, a nice changeup that is in the range of 10-12mph off the FB and have a curve that has late break with better velocity in a 12-6 to 1-7 rotation, then you have THE 3 pitches to take you to any level.  ANY level.  I include "cutters" as FB pitches because it is a "cut fastball".  Meaning, fastball thrown with movement, due to a different grip than just a 2 seam or 4 seam.  

 

I have been to the last ASMI seminars.  There is more science out today than ever.  I am not sure about your background but it seems sketchy from the words you speak.  Many things are not done "old school" any more.  Long toss beyond 120' for pitchers is purely harmful, NOT sound conditioning.  That is just one example.  

 

Over usage is a bad thing.  That's why THE programs that are true programs, have a rotation, pitch counts and a full off season/ in season conditioning that is isolated for pitchers deceleration  and acceleration areas.  Come on people.  Get informed.  Get some knowledge before you somehow try to persuade people of your opinion in an attempt to "help" I guess,    

What to throw, how old, etc. all depends on the pitcher.  IE: I did not let my son throw a CB until he could throw his FB for strikes... a lot of strikes.  Then we moved onto the CU - again, for strikes.  Mixed in a CB (slowly) at 13.  To this day (he’s 15 now) I still have to remind him to back off on the CB and rely on his FB/CU.  Pitchers live off their FB and deceive hitters with off speed when the situation dictates.  He loves to throw his CB because he is successful and feels comfortable with it, but throwing it 2-3 times in a row because his CU isn’t working is not a good thing and often results in hard hit balls.  There is no magic rhyme or reason to when or how you teach a young pitcher to throw various pitchers, but one thing is for sure - all pitchers are not created equally and they develop at different rates. 

Fastballs are the most dangerous pitch on the arm. The fastball has been to show having the greatest stress on both the shoulder and elbow. When you couple that fact with kids playing more baseball than they should, you have what is called "overuse". Overuse is the number one leading cause for pitching/throwing injuries. Studies have shown that pitchers who throw breaking balls (including sliders) are no more at risk than those who don't.  Again- Ask yourself these questions on the health of your kids arm-

 

Does my kid pitch while injured or fatigued?

Does my kid play baseball more than 8 months out of the year?

Does my kid play multiple position that require a lot of throwing after he pitches?

Does my kid throw over 80 mph?

 

Answering yes to any of these questions places your kid at an increased risk for injury (yes, even just throwing hard increases risk). This means you should be aware of the main risk factors and learn to stop, limit, or control those situations. No one should be pitch9ing more than 8 months out of the year. No one should pitch while fatigued or injured. Pitchers should rest after pitching. If your kid throws at 80 mph or above he really needs to learn to stretch properly and condition his muscles and ligaments to prevent injury.

Skylark - I’m going to give you the same perspective my surgeon gave me 20 years ago.  Pitching (a baseball) is one of the most unnatural and violent motions to the human body.  The rotator cuff was not meant to throw overhand with any force at all.  Hence the reason fast pitch softball pitcher can throw all day and in some cases two days in a row... it’s really not that uncommon to see a young lady pitch a complete game then throw a few more the next day... but overhand pitching... the human body just wasn’t made for it.  Think about that for a minute. 

 

Now - Ill say this, having been the recipient of reconstructive surgery (RT rotator cuff).  Pitching has its dangers and risks associated.  But they can be mitigated with proper instruction on mechanics, conditioning specific to pitchers, and arm care.  I don’t care what pitch you throw.  If it is thrown with poor mechanics, no strength and conditioning program, the arm is overused whether it is in a bullpen, on the mound or playing a position... you will end up with a 4" scar just like many others. 

bballdad2016,

 I agree, proper mechanics coupled with proper conditioning and rest is a recipe for a long career regardless of what pitches you actually throw.

 

We had one pitcher last year, horrible mechanics, could only go 1-3 innings and then have to have a week off to rehab the sore elbow. He only threw fastballs btw.

Good post Coach Rob.

A lot of this is a matter of opinion and how it is perceived.

My son didn't throw a true CB in HS more like a slurve but did not rely on it for success. He threw a 4 seam, a 2 seam (with different grips) and a CU 9with different grips) and he did just fine in college and at the next level until he began throwing a true slider and developed shoulder then elbow problems (again only after he began relying more on the slider).

So I truely believe that the slider is a very harmful pitch. He began throwing a cutter at the end of last season, now being a reliever, his secondary stuff does not have to be AS important as his 96-99 mph fastball or his 88-89 sinker (both with lots of movement).  Movement becomes more important the higher one goes up the ladder.  If your FB doesn't have that movement, you better have a good secondary pitch to keep them off balance or you are not going anywhere.

 

First and foremost the FB, no matter how "fast" it may be, needs to be THE most important pitch for ANY pitcher.  Not the straight down the middle FB, but the one that moves up, down, inside, outside and this DOES take a long time to command, so yes, do not let your young pitcher give up this pitch for the breaking ball.

I do not agree with everything being said, but I agree that the CU is much different at the pro level.  A HS pitcher with good FB with movement and a decent change will get lots of opportunities at the college level, the velocity being the game changer. 

Yes pitching fast can cause injury, mix that in with CB, slider and overuse WILL cause injury. I leave out CU for reasons discussed.

 

I also believe that for many tossing past 120 feet can be harmful.

 

Coach Rob is definetly got it right. You will not see that many injuries in pitchers in the really good programs because they know how to use their staff, know how to develop good pitching by montoring pitch counts and know how to do specific pitcher conditioning off season as well as in season.

 

He is also correct in the statement that any pro pitcher that throws a slider knows the implications and many abandon the pitch after they develop elbow issues. If this causes issues in mature pitchers why would you want your HS pitcher throwing one?

 

 

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