Wednesday, September 22, 2010

What's Causing the Arm Injuries?

This guy on the left is not the only one having significant arm trouble these days. He's just the most prominent. Stephen Strasburg of the Washington Nationals was the #1 overall pick in the 2009 MLB Draft. His college and pro coaches were careful with him because he was widely considered to be the best pitching prospect in years, if not decades. But apparently it was too late. Perhaps the damage was done before he even got to college.

Strasburg is one of many elite pitchers having to undergo surgery and take months off these days due to UCL or shoulder injuries. But the trend is not limited to the best in the world. Youth pitchers are blowing out their arms at a high rate too. But why? Is it flawed mechanics? Curveballs? High pitch counts? According to the doctors and the studies, there are several factors.

Gregg Doyel of CBS Sports blames it on youth coaches and parents. His article from August 26, 2010 may be on to something. Doyel is no expert when it comes to arm care, but he can connect the dots based on what the experts say. Among the primary experts are Dr. James Andrews and Dr. Glenn Fleisig of the American Sports Medicine Institute (ASMI), among other credits.

ASMI conducted a study with some important conclusions - mainly that while arm injuries often do not rear their ugly heads until high school or college (or later), they can begin in youth leagues. How do they begin in youth leagues? Overuse at a young age. Not a new term - that's why we have pitch counts. The study says that arm fatigue is the primary factor involved: "When regularly pitching despite arm fatigue, the risk for injury requiring surgery increased 3600%." That's almost a guarantee.

But more specifically, the study points to year-round baseball. Whether a player is in a warm climate or not, he can find an indoor training facility any time of the year. The study found that players pitching more than 8 months per year were 5 times more likely to need surgery. The USA Baseball Medical & Safety Advisory Committee recommends that pitchers not play any baseball or participate in any "overhead activity" at all for at least 3 months each year. That means "football quarterback, competitive swimming, javelin throwing." What? No javelin?!

At Myers Park Trinity, I think we do a relatively good job of protecting the arms. Little League pitch count guidelines have mandated that for the most part. And we haven't had many known cases of arm trouble in recent years. But let's be honest - the MPTLL regular season is no longer the only baseball that many of our players are involved with. Dozens of them participated on more than one team last spring. Then you've got All-Stars in the summer for many of those same players. Next up is Fall Ball. For some, it nearly blends into one long season. Pretty soon that "overhead activity" guideline doesn't sound all that crazy.

There are other factors involved when you're talking about pitching injuries that begin at the youth level. Certainly proper mechanics are important. Some have suggested the cause of Strasburg's injury is rooted in the placement of his elbow in the picture above. Probably a factor, but I would guess it also stems from his ridiculous velocity - another finding of the ASMI study - or perhaps the possibility that his youth teams depended heavily on him to dominate and win tournaments.

Or is the problem a result of his wicked curveball - who knows how many he threw as a youth pitcher. Youth curveballs are actually a debatable cause of arm injuries. As you can read in a NY Times article by Mark Hyman, while Dr. Andrews and USA Baseball say for young pitchers not to throw curveballs, studies have shown that curves stress the arm less than fastballs. Dr. Fleisig says that "Uncle Charlie" is not the problem.

So what is the problem? There is more than one answer. But I think it's clear that we should follow our pitch count regulations strictly - not just for one of a player's teams, but for all, whether it's Little League or not. We should make it a priority to build in some rest periods for our players after each season. And we should stay informed. I encourage coaches and parents to read the articles and read the ASMI study - it's only 3 pages. And lay off the javelin.

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