Why are there so many youth baseball-throwing injuries?
After three years of research, a multicenter, national research study led by Beaumont orthopedic surgeon and sports medicine specialist, Joseph Guettler, M.D., may have some answers as to why youth baseball pitching injuries continue to rise despite the implementation of nationally recommended pitching limits. In fact, serious pitching injuries requiring surgery have skyrocketed with one estimate reporting serious throwing injuries are occurring 16 times more often today than just 30 years ago.
“Our research team and colleagues from around the country, saw several recurring themes,” says Dr. Guettler. “It became very clear that dangerous pitching behavior is occurring among pitchers as young as little league all the way through their high school years. And, the blame doesn’t usually lie with the leagues or coaches. Most were found to be adhering to nationally recognized guidelines for pitch limits and rest. It seems much of the blame lies with behavior of parents and their kids.”
Some of the findings concluded that contrary to national guidelines limiting pitches thrown, 13.3 percent of pitchers pitched competitively for more than 8 months of the year, 40 percent pitched in a league without pitch counts or limits, 56.6 percent pitched on back-to-back days, and 19 percent pitched more than one game in the same day. Nearly one-third of these pitchers pitched for more than one team during the same season; one-third played only baseball and 10 percent also played catcher on the same team, another high-volume throwing position.
“The most prevalent reasons for arm pain and tiredness can be boiled down to five major issues,” Guettler adds. “The following behaviors can lead to arm pain and tiredness which can then lead to the most significant shoulder and elbow injuries.”
Pitching for more than one team during the same season
Pitching more than one game during the same day
Pitching on back-to-back days
Pitching in a league without pitch counts or playing year-round
Throwing curve balls before high school
A total of 754 pitchers between the ages of 9 and 18 participated in this national youth baseball study where all regions of the United States were represented. The average age of the pitchers was 14.1. The average age of first throwing curve balls was 12.2. The boys pitched on average 5.2 months per year, and when in-season, threw 5.4 innings per week. More than half pitched for a travel club, and 41.9 percent attended a pitching camp. Most importantly, one-third of the pitchers reported having a pitching-related injury in the past 12 months, seven out of 10 reported significant arm tiredness in the past 12 months, and nearly 40 percent reported significant arm pain within the past 12 months.
To date, this is the largest study of its kind. It is also the first study to include all regions of the United States. The American Orthopedic Society for Sports Medicine sponsored the study.
Dr. Guettler says that the first step to bringing down the number of pitching injuries can be remembered with a simple, newly coined “Rule of Ones.”
Orthopedic Experts Examine Baseball Throwing Injuries
“Throwing a baseball is one of the fastest and most violent maneuvers that any joint in the body is subjected to. The violent and rapid motion places numerous structures in the shoulder at risk for injury,” said Dr. Shane Seroyer, lead author of the report and sports medicine fellow at Rush.
Prevention of injury is the key to a long career. Pitchers, especially youth pitchers, should limit the number and types of pitches thrown to minimize the risk of injury.
“For pitchers under 14 years old, we encourage fast ball and change-up pitches and discourage the use of a curveball to prevent injury,” said Dr. Charles Bush-Joseph, sports medicine specialist at Rush and co-author of the report.
It means one game a day, one day of pitching then rest, one position at a time during a pitched game, one team at a time, only one pitch before high school, and at least one season of some other organized sport. And parents, if your young pitcher mentions that his arm is ‘sore’ or ‘tired’ - let him take some time off. One complaint of arm soreness or tiredness equals one week off.
Sprains, muscle pulls, broken bones, and concussions are the most common injuries. Specifically, you should be prepared for the following injuries:
Pitcher’s elbow. Baseball is a game with a lot of throwing action that puts pressure on the upper body. This condition, an inflammation of the bony joint of the elbow, occurs with repeated hard-slamming throws.
Leg sprains and breaks. Baseball doesn’t just involve the top part of an athlete’s body. Every time a person throws a ball, the lower extremities get into the act. And don’t forget those “sliding into base” moves.
Shoulder pull. Another injury of the upper body, shoulder pulls occur from catching high balls, from throwing a ball to base with all you’re worth or from hitting so hard with a bat, it cracks.
Concussion. Even softballs can pack a wallop when they’re thrown at top strength. Unfortunately, baseball players don’t wear headgear (caps don’t count), and sometimes baseballs land where they shouldn’t …on vulnerable heads.
Cracked teeth. Baseball players don’t wear mouthguards either, and the ball that misses the top of the head can get the teeth.
Broken jaw. The jaw, too, is exposed to flying baseballs during a game. A ball might hit a child on the outside of the jaw or face forward. Even a mouthguard can’t protect against that.
Black eye. By now, you know the culprit, a hard thrown ball. But, sometimes, a baseball bat can be the culprit. Maybe an enthusiastic hitter, running off to first, throws his bat—and, unfortunately, it lands on your child, who just happens to be sitting in the bleachers or waiting for his turn at bat.
Heat Prostration. When an inning lasts forever in the hot sun, the pitcher can begin to look like Gatorade.
Foot Injury. Sneakers are not always the best shoe to protect toes from getting stubbed or broken. Making a run to a base or getting hit in the foot from a bat or a ball is all it takes.
Back Injury. Picking up foul balls, bending to catch a low-flying ball, jumping at an angle to get a curving ball—all of these cause back injury.
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Beaumont Health System