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quote:
Originally posted by grateful:
Normally I restrain from getting into these discussions with salesmen, lawyers, pipe fitters, engineers, etc. It is similar to me arguing about courtroom procedures with trial attorneys.


Perhaps that is what orthos specializing in sports say about pitching coaches.

Gosh, I guess only pitching coaches can comprehend what the sports docs discuss. Only pitching coaches can read and comprehend things about physiology and biomechanics.

Or maybe they are just born with that knowledge and no one else can obtain it. Because I haven't met a pitching coach yet with a medical degree and specialization in ortho. Not to say there aren't any, but I haven't seen one yet.

{And BTW, as previously noted I do believe that some downtime is both needed and beneficial.}
Last edited by Texan
It is being said that you should only rest the arm when it is sore. Pain is a sign that there has already been too much tissue damage for the body to reasonably adapt to. The key is to properly care for (including rest) the arm before there is pain.

The reason that a 16 year old kid can throw forever with little or no pain is that their bodies can adapt to that amount of stress without causing pain, it does not mean that there is no damage, just not enough to elicit a response. I am currently treating 2 14 year old boys with degenerative arthritis in their pitching elbows. Venture to guess how much pain they have when they throw...NONE! These boys already have a chronic condition that will be with them for the rest of their lives, yet they have never had to miss a game due to pain.

I think it is dangerous to let your child decide whether or not they need to rest. They feel great and love to play. I think it is even more dangerous to leave that same decision up to a parent that is living through his child or a pitching coach that is getting money or wins out of a young persons arm. Heck, I should keep my mouth shut, I make a living off of people that make bad decisions with their bodies that I get paid to fix.
quote:
Originally posted by spinedoc:
I think it is dangerous to let your child decide whether or not they need to rest. They feel great and love to play. I think it is even more dangerous to leave that same decision up to a parent that is living through his child or a pitching coach that is getting money or wins out of a young persons arm. Heck, I should keep my mouth shut, I make a living off of people that make bad decisions with their bodies that I get paid to fix.


This is a critical point.

Some people have said that what you should do varies from person to person. The truth is that it doesn't. Everyone's body works basically the same way and follows basically the same rules.

The only thing that varies is whether you choose to follow those rules or not.
quote:
Originally posted by shermanreed:
I will say that I have always paid attention to pitch counts - even the point of informing the coach to put the brakes on if the count is getting too high.


Sherman, maybe you could help some folks understand how to do that without completely alienating the coach. It's a touchy area that some coaches draw a line around, although I have crossed it without regret.
It is true as I have said my son only thyrew 13 innings as a freshman. TPM I took no offense from what you said. That is the 1st time he has thrown under 100 innings in each of the previous 5-6 years. He threw bull pen and LT as would any college pitcher. He has also always been a starter and when he played summer ball he said he was not able to pitch more than 5 innings without tiring . He threw 40 innings in the summer. He like many pitchers feels better when he is pitching lots of innings.
He always had a least 2 checkups during the season specific to arm shoulder and back. I won't mention his credentials again.
Bullpens are not always a full effort. Throwing in the winter is a motion issue with light bullpens. 25-30 pitches and it is about maintaining motory senses and keeping the pitching muscles tuned up. he steps it up just prior to spring season.
I am very aware of the injury issues and that they build up over time. If my son's doctor detected any lig ten tears we would shut him down with no weights or anything that would stress these .
One LHP my son works out with all winter is in the minors and just moved up to AAA ball. In his 1st year in the minors he discovered scar tissue in his shoulder and was operated on. He has just had an amazing year.
I respect the fact that a lot of medical people blame injury on over throwing. When you put on a ball uniform you run risks . It is wise to manage that risk. I think we have done a great job doing that. Yes you can't always listen to all teenage guys but they have to be informed which is what we did with his doctor. Doctor advised no weight training other than light weights before his 2nd to last growth spurt which was around 16. We concentrated on mechanics and now we are trying to get his velocity up.
PS. I realy get tired of people with condescending attitudes towards parents. Living your dream through your kid is old and worn out.
Dad04,
You are right, it can be a bit tricky. What I have found is that if I present myself as a "coach's guy" and develop my relatioship with him, it opens up doors for good communication. I always try to prove to the coach that I support him and reinforce what he is teaching my boy. My son is a hard worker and never misses anything - even things that are "voluntary". I usually hang out around many of the practices, and I am at every game. All of this tends to put me in good standing with the coach - one other thing - I never criticize him, nor do I allow others to do it around me.

Because the coach sees me as "on his team" he allows me to call some of the shots with my son. Not things like where he bats in the line-up or when he pitches, but how many innings and how many pitches are within the relationship I've developed with him. The coach knows that the big deal to me and my son is to play after high school. Of course, we want to help the team win another state championship too. It is all about the relationship and my attitude. It would be no big deal for me to inform the coach that my son's arm is tired and needs rest this week.

This is not rocket science. I've always tried to become an "insider" rather than be looked at as an outsider. My son's health is my responsibility and anything I can do to protect it is also my responsibility. Fortunately, my son's coach believes playing after high school is the big deal and prides himself on his players moving on to play college ball as much as winnig a state championship. Hope this helps.
Once again, throwing light pens and long toss is a lot different than 100+ innings in a short season. Pitchers throwing high velocity also risk injury as some tire easily and don't quite fess up when asked.
I agree with lots of what you have said, we too also kept son's workouts to a minimum while he was growing, in fact, I don't think he did any Roll Eyes other than leg work and rotator cuff. We also made sure that his mechanics were in check. That plays a significant part in having a healthy arm. Also this fall he was taken off most weight training for upper body except to keep shoulders and rotator cuff healthy.
Prevention does include proper training and LT. No qualms about that. But there is a reason why pitchers shut down, I suppose, or they wuldn't be advised to do so.
Very interesting, I was reading over something I received from the cape. It's a book from 2006 summer which included previous statistics and category winners.
Back in the late 70's and early 80's some of the pitchers pitched (in summer) 115-150+ innings while a short time on the cape. I did not recognize any of those names. Interesting this summer I think the most time put in was a little over 50 innings (might be wrong on that).
Seeing that a significant decline over innings pitched between then and now only confirms to me, that lots of people finally sat up and took notice that too much is too much. More awareness which is a good thing, and the amount of time throwers put in is a now a consideration when given rest periods.

Injuries also do occur when long rest periods are taken and then they rush too soon to get back on the hill. Important for those who place their sons on rest, to make sure they have prepared a plan in advance and not rush things.
Last edited by TPM
I went over this thread with our son last night to get a players impressions. These summarize his:
1.)Why would anyone not want to eliminate if they could, but certainly minimize, the risk of arm injuries from the constant throwing of a baseball?
2.)Every player who is a competitor experiences discomfort in their arm at various points. When asked how they feel the answer is "great." Players want to play. They also know that throwing does cause discomfort and they all experience it. No one wants to admit they have an injury. When you are playing, you don't know the difference between discomfort that is normal, discomfort that isn't normal, and injury.
3.) As a player, competing every day, it is very hard to appreciate that what you feel today may be different or slightly worse than what you felt yesterday. You see the trainer, ice, stim., get through the acute phase, feel better and move on.
4.) As he looks back, perhaps his desire to compete, to play, to prove himself clouded his ability to recognize the condition was getting worse over time. Until one acute incident, he had been playing with periodic discomfort and actually performing better than ever.
5.) Since MRI's are rarely taken, how does a parent know if there is damage or not. His MRI and arthoscopy showed changes going back many years, most of which he felt fine.
6.) Baseball is a sport of continous throwing and then there are sudden efforts, which you cannot control, like diving, throwing off balance, from a knee and the like. One such play made his shoulder distinctly worse.
7) If MLB teams, following recommendations of orthopedists who see and treat 1000's of professional athletes, recommend up to 60 days or no throwing, why would a parent/coach of players at a younger age not think that is solid information.
8.) Every player doesn't think they will be injured. You see teammates who have surgery, who are disabled, etc. You cannot allow the concept of injury/vulnerability be a part of your thinking because you learn to play with discomfort.
9) When you play without rest or upwards of 144 games in a year, you cannot imagine how much discomfort a player feels. You cannot imagine how much you battle to get yourself on the field the next day because you do not want to lose the position that you worked so hard to earn. If you have vulnerability in your arm from your years of throwing/playing baseball, playing 144 games will expose it in most players, at one time or another.
quote:
Originally posted by 3up-3down:
Bobblehead, How does the doctor check for any tears?Does your son get a MRI a couple of times a year?Does your doctor approve the MRI so the insurance co. will cover it?


My sons doctors have told us that a standard MRI is not a reliable source to detect micro tears . Also, it does not always reveal a partial UCL tear. However an MRI will almost always reveal a complete rupture of the UCL.

Some informative reading:

For the study, ultrasound exams were performed on both arms of 26 nonsymptomatic major league baseball players, ages 21 to 39, during spring baseball training camp in February 2001.

The ultrasound results also showed micro-tears in the anterior band of the UCL in 18 of the 26 (69 percent) pitching arms. In contrast, only 3 of the 26 (11.5 percent) nonpitching arm ultrasounds revealed micro-tears. Calcifications, which often accompany a ligament injury, appeared in 9 of the 26 (35 percent) pitching arms. None of the nonpitching arm exams showed calcifications.

FULL ARTICLE HERE
Last edited by BackDash
quote:
Originally posted by lafmom:
quote:
5.) Since MRI's are rarely taken, how does a parent know if there is damage or not. His MRI and arthoscopy showed changes going back many years, most of which he felt fine.


Yep!!!!


quote:
The ultrasound results also showed micro-tears in the anterior band of the UCL in 18 of the 26 (69 percent) pitching arms.


We can all safely assume there is damage. Hence, there are only so many bullets in the gun, imvho. They should be used wisely.
Last edited by Dad04
quote:
Originally posted by Texan:
quote:
Originally posted by grateful:
Normally I restrain from getting into these discussions with salesmen, lawyers, pipe fitters, engineers, etc. It is similar to me arguing about courtroom procedures with trial attorneys.


Perhaps that is what orthos specializing in sports say about pitching coaches.

Gosh, I guess only pitching coaches can comprehend what the sports docs discuss. Only pitching coaches can read and comprehend things about physiology and biomechanics.

Or maybe they are just born with that knowledge and no one else can obtain it. Because I haven't met a pitching coach yet with a medical degree and specialization in ortho. Not to say there aren't any, but I haven't seen one yet.

{And BTW, as previously noted I do believe that some downtime is both needed and beneficial.}


Texan.....

I usually agree with what you write, and what you wrote above helps to make my point, so I thank you. As a pitching coach, I listen to the Athletic Trainers and doctors 100% of the time.

My comments that you quoted above are not meant for the parents who listen to the expert opinions of Dr. Andrews, et al, they are meant for those who disagree with the doctors and encourage not only their own kids, but other kids, to throw continuously, with no significant periods of rest.

So Texan, I appreciate the attitudes of parents and coaches who take heed to what the docs are telling us.
Texan, no problem, no apology necessary, but thanks anyway!

Now, Bobblehead:

quote:
Originally posted by BobbleheadDoll:
PS. I realy get tired of people with condescending attitudes towards parents. Living your dream through your kid is old and worn out.


Your first sentence above is probably directed at me, since I might be the only one who has contributed here who could be considered as having a condescending attitude toward parents.

But your second sentence is a contradiction of your first sentence; it sounds pretty condescending toward parents.
I have to admit that most parents do not know how to partner with a coach for the development of their child. As a coach I've seen this many times on my travel team. As a parent of a kid playing on a High School team it is very important that his coach believe I am a help to the team. Most parents get into trouble with the coach over things like playing time. For me, this is more than just a baseball lesson - it is a life lesson. I want my child to learn to persevere, to be faithful, and prepared, while maintaining a great attitude - not even a good attitude will do. Sooner or later an opportunity will come knocking on the door of a kid like this. Sadly, most parents do not see the value of instilling this kind of character in their child.
My son's doctor deals with 100s of pitchers, some the best pitchers in MLB.
He has a series of tests that he runs before going to MRI/Ultra sound. In all examinations which take half an hour or so he has determined that there is no need to go any further. In 10 years my son complained of discomfort once. A stressed ulnar. After physical tests he said it was merely swelled slightly. He also checks for bone chips ans spurs. Tight shoulder and rotator.
I totally dissagree that your arm will feel discomfort and or sore if there is not a problem in your throwing mechanics. I don't care how many pitches you throw your arm will flush with blood and lactic acid but you should feel no soreness. You should of course jog and then ice to reduce the swelling and you will also assits in recovery time. Iceing helps repair the micro tears in the muscles and a few days rest you should be ready. My son likes 4 days rest to regain his arm strength and follows that religiously.
My son's doctor use to evaluate pitcher when the Teaxas Rangers were taking a pitcher in a trade or draft. I tend to listen to him and he has not steered us wrong. He also takes my son outside and puts him through his pitching motion looking for mechanical issues.
Now would you listen to him or not?
He also just turned down a pitching coach job at a major D1 4 yr school in Florida. He offered to put in a good word for my son but my son is happy where he is.
There are a lot of comments here regarding injury, different philosophies...

What we do.

As posted, we rest starting with the end of our summer season be it legion or travel. That all ended, with the exception of two of our players by the second week of September. We've taken off until now. Our kids are now starting to throw again with this coming week since football is over. Note - I'm not real happy that some started earlier. However, their parents are their parents and so, they do what they want. We will have our kids, including Just_Learning's son throw and most of them will start with a former MLB Player who has agreed to teach "our stuff." This isn't a problem since we think so much alike and he is a great guy. His name is Pat Perry and he gives lesson throughout the St. Louis area. As important is our plyometric and weightlifting programs. They will also start this week. We are getting a late start in that regard since I was assigned early bird class and so, we have had to wait for my assistant to be able to take over. He just finished coaching a fall sport. We will start on flat ground and do mostly flat ground for some time now. Not only throwing, but long toss, form or mechanics drills and bandwork. We will gear up for a point in February where they will get an opportunity to again have a week off. Then, we will begin our season. Thats what we do. JMHO!
Bobblehead
I dont think anyone has or would suggest that you not listen to your sons doctor.

Whats clear is the majority of information available dictates rest as a premptive tool to minimize the chance of serious injury. Rest in addition to specific pitching conditioning (throwers 10, etc.)and over all conditioning is now being called PRE-habilitation. Pre-hab is being used to reduce the growing number of arms that need RE-habiltation.

Does that mean everybody who doesnt get enough rest will get injured? No, it doesnt.

Does that mean everyone who rests their arms will never get injured? Again, no it doesnt.

In the end we each choose for ourselves.



quote:
Originally posted by BobbleheadDoll:
I totally dissagree that your arm will feel discomfort and or sore if there is not a problem in your throwing mechanics. I don't care how many pitches you throw your arm will flush with blood and lactic acid but you should feel no soreness.

Then there are way to many pitchers at every level with problem mechanics.
quote:
Originally posted by BobbleheadDoll:
quote:
Then there are way to many pitchers at every level with problem mechanics


This is what the doctor says. Too many pitching coaches at all level that don't know enough about pitching mechanics and arm health.


What makes you think a doctor knows anything about what constitutes good throwing mechanics?

This doesn't make much sense to me. Just because someone is a doctor, doesn't mean they know jack about pitching mechanics.

They know how to fix peoples bodies and how to treat injuries sure, but I don't think I would ask one what should I do to increase my velocity, or how I could generate and tranfer momentum better. Roll Eyes

After reading this thread, there are many good points for and against. Obviously everyones situation is unique and should be treated as such. Especially when it comes to a players conditioning, and what their "tolerance" to throwing is. I think this is key.

My .02 is that kids don't throw enough. For me and my son, we usually error on the side of throwing more rather than less (since he seems to do better when he throws on a regular basis...not max effort all the time mind you, just "regular" throwing).

Another unique situtation.
TPM forgive me !

quote:
What makes you think a doctor knows anything about what constitutes good throwing mechanics?


RobV if you read my posts I explained that my son's doctor was a Texas Ranger pitching coach. He hooked up with Nolan Ryan and Tom House while he was there. He also eveluated pitchers for the rangers. He has and still does have paragraphs that he wrote in the Pitchers Edge series and other books written by TH.
Recently offered a pitching coach job at a Florida D1 4 year college. He turned it down because he makes more money by far doing what he does. He still has several top MLB pitchers come to see him for help.
He is very qualified.
Sorry TOM.
infielddad,
Going back a ways, I advocate limiting younger players amount of throwing to a level where they don't do serious enough damage to their arms to need a long rest. I'd rather see multiple short breaks throughout the year than one long break. BTW, if you get the chance I'd appreciate a PM with some info about being scoped since my son will probably be having his arm scoped pretty soon due to an injury he suffered soon after taking 2 months off from throwing.

quote:
How are they not doing a commensurate amount of damage to a younger arm by competing and throwing at maximum intensity on a year round basis. Remember, the intial post had to do with shutting down or throwing bullpens and the like over a 2 month time for a 16 year old in Fla. To my way of thinking, throwing a bullpen is max effort to mirror game situations.


I think the difference is in our interpretation of throwing year round. To me throwing year round includes several 1 or 2 week breaks plus a fairly extended period where there's only light throwing that is nowhere near max effort.

MLB players can't take that much time off during the season so they need a significant amount of time off to allow for healing. Once the damage has healed enough they need to do something to start putting limited stress on the arm. That may be tubing work, light throwing or whatever works for that individual.

Stress injuries can happen in more than one way. They can build up over a long period of time or they can occur relatively quickly due to a significant increase in activity level. Tissues, including tendons and ligaments need to be introduced to higher levels of stress gradually so that they can adapt (get stronger).

Young players who are in or have just gone through their growth spurt and whose tendons and ligaments are getting tighter are especially vulnerable to sudden increases in activity level.

Pre-teen players, young teens, old teens and adults are all vulnerable to different injuries and you can't apply a blanket policy to them.
Last edited by CADad
quote:
Appropriate strengthening should focus on eccentric strength (muscular activity during a lengthening contraction or deceleration). Eccentric strength training seems to stimulate mechanoreceptors in the tendons to produce collagen. Animal studies have shown that loading the tendon improves collagen alignment and stimulates collagen cross-linkage formation, increasing the strength of the tendon.


While this clearly shows that tendons can be strengthened despite lafmom's claims, one still has to be quite careful not to overdo it.

quote:
Strength training has been effective in increasing bone density and strengthening tendons and ligaments.


Painguy,
This one comes from the Pennsylvania dept. of Health

In addition ASMI states that pitchers have stronger UCLs. Wonder how they got that way?

Trying to strengthen tendons and ligaments is a risky business and no one knows exactly the right way to do it.

Unfortunately, medicine is a mixture of art and science and even the experts don't always agree in this area.

The reality is that most injuries are incurred at the beginning of the season due to a sudden increase in activity after a long break or near the end of the season due to cumulative damage buildup. Taking a long break and coming back gradually enough is a viable approach but given HS coaches and players it doesn't always happen that way despite the best of intentions. That is why I say it is risky.
Last edited by CADad
Ypu guys are right when you say that the experts don't always agree on things.

Regarding getting the arm back in pitching shape after a long break from throwing, in my experience it takes a college pitcher six weeks to start a throwing program and be able to throw 90 pitches in a game situation. As a coach, it is important to control the throwing of each pitcher during that six week period.......all the time knowing that some guys may need to back off a bit during that six weeks, and thus may not be prepared to throw 90 game pitches until after 7 or 8 weeks.
quote:
Originally posted by CADad:
quote:
Strength training has been effective in increasing bone density and strengthening tendons and ligaments.


Painguy,
This one comes from the Pennsylvania dept. of Health. In addition ASMI states that pitchers have stronger UCLs. Wonder how they got that way?


This goes against most mainstream thinking with respect to ligaments.

I'd love to see the ASMI quote in context.
A few thoughts… FWIW

Most old timers think kids these days “just don’t throw enough”. I’d like to have a dime for every time I’ve heard that.

I do often wonder how doctors could possibly know more about throwing mechanics than pitching coaches know. I do think doctors would know what throwing mechanics would be the safest. They will always error on the side of caution. The very safest way to protect the arm… Don’t Pitch!!!! We know there has to be a blend between production and safety. To my knowledge, no one has come up with the perfect plan to blend success and safety! The best surgeons would tell the best pole vaulter that doing that is dangerous to your health. But I would guess that the best pole vaulter, pole vaults more than most of the not so great pole vaulters. Risk vs Reward, we hear that a lot!

We have noticed that one of the world’s foremost surgeons has stated that showcases are a problem. Not because of our involvement, but I can’t understand this. There is nowhere else a pitcher throws that is more protective of his arm than a showcase. They have plenty of time to warm up and they don’t throw very many pitches. In addition most showcases have rules that make long innings impossible. I know this is not the topic here, but that same surgeon I’ve never seen at one of our showcases. I’m fairly sure he doesn’t know what takes place. In 14 years we have had zero arm injuries at the showcases. At our tournaments, teams have had some arm injuries.

Regarding professional pitchers. #1 they are most often used correctly. At the Minor League level winning is NOT more important than developing players. That said, who does anyone think is now pitching in all the professional Fall and Winter leagues? There are professional pitchers who are not only throwing year round, they are throwing in games for 10 months.

No one can dispute the fact that years ago pitchers threw many more innings and pitches than they do now days. Yet there seem to be more injuries these days. Maybe it’s just that the old timers who were injured had it end there career. (out of sight… out of mind) Or maybe… All that extra throwing actually did strengthen the arm and prevent injuries.

I’ve mentioned this before… There is one old time pitching coach who strongly believes in over working his pitchers. I don’t mean innings pitched or pitches thrown… he just wants them (when working out) to throw every pitch with as much effort as possible and as hard as they can. His theory is that this is the best way to increase velocity and end up throwing with what appears to be less effort. He has a good track record, but I’ve never completely bought into his thinking. Always seemed a bit dangerous to me. He said, It’s long odds being a Major League pitcher… You can’t get there taking it easy! Who knows, maybe he is smarter than the rest of us… Maybe not!

One thing seems clear to me… No one has figured it all out yet! Maybe they never will! Whenever I read all these posts, I think, any one of these posts could be giving the best advice. Then I wonder… Which one? I truly DON’T KNOW! I’m just pretty sure that the answer isn’t likely to come from one of the surgeons. We can all protect our arms by not throwing baseballs, but that will not lead to any success throwing a baseball!

Reminds me of the three bears… This one is too big… This one is too small… This one is just right! Only, when it comes to pitching it is much harder to determine which is just right for your arm and body!
quote:
"There's no question that you can strengthen a tendon or ligament by exposing it to stress and strain," says ElAttrache.


Painguy,
That quote is from Dr. Neal ElAttrache one of the most highly respected orthopedic surgeons, teachers and researchers in the world. One of the places he has taught at is ASMI. Is that specific enough for you? Did you understand the part about "no question"?

You have been and continue to be dangerous and it scares me that people may pay attention to some of the unfounded misinformation you spew.
Last edited by CADad
PG,
Agree with the three bears theory.

Disagree with the old time pitching coach because I don't think the throwing all out has to be all the time to result in improved performance.

There's a new guy who has some beliefs similar to the old time pitching coach, although he's a bit more scientific in the approach and specifically builds rest time for tendons into his program. I believe (and this is just speculation from here) that his prize pupil was very successful following the new guy's approach, although he may have taken it a bit further even and did possibly have to take some time off due what may have been rotator cuff problems. Please note all the possibly's and may's in what I've written because I am just speculating based on very limited information. I doubt very much the same approach will work for everyone because it is so difficult to figure just what level and frequency of stress you can expose tendons and ligaments to without causing long term damage.
Last edited by CADad
To throw, or not to throw: that is the question:
Whether 'tis nobler in the mind to subject
The tendons and ligaments to outrageous throwing,
Or to take arms against a sea of throwing,
And by opposing end the pain? To rest: to atrophy;
No more; and by a rest to say we end
The tendon-ache and the thousand natural tears
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd. To rest, to heal;
To rest: perchance to atrophy: ay, there's the rub;
For in that sleep of rest what dreams may come
When we have fired off this mortal pitch...,
Last edited by CADad
I know I'm atrophying (battered verb) just by reading all this "don't throw" stuff. I think PG is telling you just the opposite.

Protect the arm? Maybe you're right. But if you don't long toss in the off-season I guarantee you there's others that will and at least most of them will have gained more in velocity than the ones that did not. All I know is my own son long-tossed all last winter and he's 8-9 MPH ahead of then, and gained way more speed than his teammates that did not throw.

I agree with shutting down the bullpens for 60 days, however. And perhaps going 60-70% speed for 30 days wouldn't hurt.
Last edited by Bum

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