Wanna know what’s even more disheartening? Being super careful with your kid’s arm each season, never letting him throw a curveball and strictly adhering to pitch count limits…only to have an orthopedist tell you that he’s injured his growth plate…from pitching!!!
In baseball over the last 4 years, we have seen an epidemic of throwing arm injuries and it’s NOT just affecting pitchers.
Most of us are familiar with Tommy John surgery and that it’s an injury to the UCL ligament in the elbow. It’s been ending seasons for MLB pitchers at a rate that has never been seen before. But in my opinion, we have an even bigger elbow problem affecting our players at the youth level (8-15 yrs old) called “Little League Elbow.” This is an injury to the growth plate on the inside of the elbow. There are varying degrees of this injury and it’s not always a season-ending situation but it very well could be!
Most coaches and parents aren’t even aware of this growth plate injury until it happens to them or someone they know. Other coaches and parents that are aware take every precaution to prevent it, almost to a fault at times. I’ve seen many situations where players are super careful with their arm, only throwing 50 pitches max per outing. They allow for multiple days rest per week and stay as far away from curveballs as possible. In the off season they don’t touch a ball for the often-recommended 3 months off from throwing. So how is it that these players are sustaining these growth plate injuries, when they took every precaution possible?
Let’s first start with nature. In my experience, the more serious growth plate injuries are happening to kids who just went through, or are in the middle of a growth spurt. The growth plates are still open and the players’ bodies are changing and growing, therefore altering the way their body moves. This clearly makes it much more difficult to maintain consistent throwing efficiency, adding additional stress to an already vulnerable area for throwers.
Secondly, as I feel with most arm injuries, more often than not, most players that were injured were not properly conditioned prior to the season. And I’m talking about throwing conditioning. I see kids adhering to strict pitch count guidelines, asking what their pitch count is after every inning. In their mind, their vigilance and discipline will protect them. The reality is most pitchers are NOT conditioned to meet those guidelines.
For example, a 12 year-old kid can typically throw 85 pitches in a spring season game. My question is, how many times prior to the start of that season did that pitcher throw a high intensity bullpen near 85 pitches? In my experience most bullpens are 20-50 pitches and often not high intensity.
Now clearly, these high-intensity bullpens should be introduced after the arm and body are properly conditioned, through a progressive throwing program, low/medium intensity bullpens and a full understanding of recovery. The point I’m making is that if you’re not conditioned for the workload, you’re going to break down. And the most vulnerable areas will typically be affected first. If we are going to stress the arm in games, we need to create gradual, comparable stress leading up to the season. If players are creating more stress than their bodies are trained to handle, adverse reactions are inevitable. The great thing about the arm is that it’s very adaptable. For instance, many baseball players have extraordinary external rotation in the shoulder, far greater than non-throwers. The body can adapt to the movements required for each sport. So as a thrower, we need to gradually train our arm to be able to handle the stresses created by pitching a baseball.
With a combination of proper conditioning and vigilance, we can keep our players on the field and performing at their best.
Steve’s answer perfectly explains why the injuries I mentioned above all happened in early spring rather than in the summer or during fall ball. These kids’ arms, having been in off-season rest mode, weren’t quite ready for the work that lay ahead of them. But how do you strike the right balance between off-season rest and increasing intensity conditioning? Looks like another question for Steve.