The Impact of Throwing Injuries in Youth Baseball
Baseball season is under way - be aware of and take precautions against throwing injuries. Part One of a Two Part Analysis by Tim McCullough, PT, Athletic Trainer
Baseball season is in full swing, and throwing injuries have reached epidemic proportions in young athletes across the country. Orthopedic surgeons are seeing increased numbers of injuries in younger and younger players.
A recent study found that more than half of all players between the ages of 11-18 years old experience elbow pain or injury during or after games. The type and number of pitches influences the risk of pain. Pitchers who threw sliders were 86% more likely to experience elbow pain; those who threw curveballs were 56% more likely to experience shoulder pain. Those who threw between 75-99 pitches in a game were 52% more likely to have shoulder pain and 39% more likely to have elbow pain.
Risk Factors of Throwing Injuries
The number one risk factor is year round throwing. Pitching over eight months per year increases the risk by 500%. Another problem is seasonal overuse. Pitching over eighty pitches in a game increased the risk by 400% in one study. Pitching with arm fatigue increases the risk of injury 3600%.
The type of pitch thrown can influence injury rates. Despite studies that show the curveball does not create the most biomechanical strain on the arm, evidence suggest pitchers under 14 have an increased risk of injury if they throw a curveball. The change up is the safest pitch on the arm. The speed of the pitch has been shown to increase risk. Pitcher’s who throw over 80 mph are approaching elbow forces that increase their chance of injury, especially at the elbow. Inadequate warm-ups, muscle imbalances, and tightness in the posterior capsule of the shoulder joint are also risk factors.
When Overuse Leads to Elbow Surgery
In a 2004 study, high school baseball players who had already had elbow surgery were surveyed. They noted that pitch speeds over 80 mph, throwing ten or more months a year, using curveballs before 14 years of age, and violating recommended pitch counts were common in this injury group. In the surgery group, more than half regularly pitched despite arm fatigue. Pitching with arm fatigue has been shown to increase injury risk by an astonishing 3600%.
In ten years (1994-2004), there was a four-fold increase in college pitchers and a six-fold increase in high school pitchers who received “Tommy John” elbow surgery, in which a tendon from the wrist or leg is used to replace the elbow ligament.
When should a parent worry about arm pain? What actions are recommended? See the final installment next week for more detail on the specific injuries players sustain and how we should treat them.
Any baseball organization interested in hosting a 90 minute presentation on throwing biomechanics and injuries, please contact Tim at tmccullough@cioffredi.com
