So we spent some time talking about warm weather and girls’ knees. Let’s give equal time now to boy’s arms–pitchers’ injuries generally. This is a huge topic, easily filling a textbook or weekend lecture series. Let’s summarize some risk factors identified by researchers from the American Sports Medicine Institute. These can guide us to develop safer training/competition schedules.
Firstly, a negative–number and age of breaking balls thrown had little positive correlation with injury. Injured vs non-injured pitchers all threw on average 60% fastballs, 15%change ups, and 25% breaking balls. There was also no difference in injured vs non-injured in relief appearances or for those who stayed in the game at another position after being relieved.
The 2 groups differed in size, with the injured group tending to be, on average, 4 cm taller and 5 kg heavier. This may reflect the bigger boys throwing harder or having somewhat different mechanics.
The injured group threw more warm ups. Possibly this may reflect a tendency of boys who are already “at risk” taking more time–and more throws–to “get loose.”
The injured group, not surprisingly, used ice and anti-inflammatories like ibuprofen more often and in greater amounts. Again, this suggests boys with already stressed arms, and tells us a lot about the folly of “playing through the pain” in kids.
9-14 year olds who lift weights had greater injury risk, possibly due to the strain on skeletally immature bones and joints in younger boys. Probably best to avoid this until the boy has enough beard to shave somewhat regularly.
Competition issues are the big ones. Injured pitchers competed at least 8 months/year (5x risk of surgery) compared to boys pitching 5.5 months/year. The Institute recommends refrain from all throwing activities(not all sports) for minimum 3 months/year. Inured pitchers threw 6 innings/game and 88 pitches (2.8x risk of surgery) compared to non-injured at 4 innings, 66 pitches. One study demonstrated a clear risk of a specific overuse shoulder injury with >100 pitches/week. Velocity played a role–injuries were more frequent at 88 mph compared to 85 mph. “Arm fatigue” is key. 67% of injured pitchers admitted to throwing with a “tired arm”–52% regularly– with 36x greater risk of needing surgery. The non-injured group numbers were 42% and 11% respectively. I’m sorry, but “toughing it out” in this age group is just crazy.
Finally “showcase” competitions caused greater risk of pitcher injury. Injured players participated in an average of 4 of these events compared to just one in the non-injured group. Showcases tend to be held in the off season when boys are not at peak conditioning and places added physical(and MENTAL) strain on young pitchers. I recommend limiting the number of times boys participate here (if they cannot be avoided entirely) and closely monitor when throwing in this type of competition.
As always, I end by urging parents and coaches to remember the priorities for all youth sports: firstly–have fun and make friends; secondly–fitness, competition, and learning valuable lessons like persistence and commitment; and lastly–win games and glory. College scholarships, should they occur, are icing on the cake. Making the majors??–go buy a lottery ticket.
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Dr. Charles Geneslaw 