Dr. Wayne Christie
Question: My son is a young pitcher. How can he avoid injuries from pitching?
Answer: This is a good, timely topic for this time of year. A research study published in the July/August 2011 Sports Medicine Update followed 481 youth baseball pitchers during one sports season. The study showed significant associations between the number of pitches thrown and shoulder and elbow pain, and also found associations between the curveball and slider with increased shoulder and elbow pain, respectively.
This has become more important because aspiring young players can play baseball almost all year now, at indoor baseball centers, baseball camps in the south, fall baseball leagues and, of course, spring training and the summer baseball season. Most people would probably be surprised how many kids we see, even in the winter months.
The study showed that the overall risk of a youth pitcher sustaining a serious throwing injury within 10 years was 5 percent. Those athletes who:
? Pitched more than 100 innings in a year were 3.5 times more likely to be injured
? Threw more than 80 pitches per game had almost four times the increased risk of injury
? Pitched more than eight months per year were five times more likely to be injured
? Threw primarily high velocity fastballs or breaking pitches, or who also played catcher in the same game they had already pitched, also are at somewhat higher risk for injury
Most injuries occur in the shoulders or elbows. Most are not serious, and a large number of them can be prevented by monitoring pitch counts and resting if the athlete feels arm pain or fatigue. In most cases, athletes cannot simply "play through it." The harm will worsen by continuing to pitch.
The biggest thing is just resting the child and not having him throw a ball. Monitoring pitch counts is vital in helping to avoid future problems.
Younger athletes may not even feel pain. But as they get older and want to play in high school or college, they may have "microfracturing" taking place that eventually causes so much pain that they can't use their arms. Over time it can really wear them ,and they essentially throw their arms out.
Surgery is seldom needed for young pitchers, who have not yet developed the strength to cause structural damage. Older youths or young adults using overhand throwing motions may need "Tommy John surgery" to correct a torn medial collateral ligament in the elbow.
Aside from baseball, a frequent injury for young skateboarders and snowboarders is a fracture to the scaphoid bone on the thumb side of the wrist. This is usually caused by a fall on an outstretched hand, with the weight landing on the palm.
Skateboarders and snowboarders can avoid these injuries by wearing splints on their wrists. They fit right on the wrist and they work by keeping the wrist from hyperextending.