Just looking for some advice: My son is a pitcher in 11/12 y/o Little League. He has pitched since he was 8. I have helped coach him for the past 4 years, and have been diligent to not over pitch him. He now has a coach that believes he should throw a full game(85) pitches, followed by practice the following days where he is to throw another 60 pitches(full velocity) during each practice (they practice 3 to 4 days each week). This is the first year he has continually complained of shoulder soreness. I spoke with the "coach" and told him I did not want him pitching until he has had adequate rest. He informed me that he was the coach and he has done this for 27 years. I informed him that I was his father and I did not want my son injured. I left him at practice that day, against my better judgement, and found out later that he pitched him anyway. I plan on keeping him from going to any further practices during this season. Interested if anyone has any other advice they could share.
I think you have an issue with the coach, and that should be worked out before you go any further. As for the pitching, it bothers me that we have all of these "experts" making up these pitching rules. I firmly believe the reason there are so many arm problems with today's major and minor league pitchers is that they don't throw enough. This current generation of pitchers are of the innings restrictions and look at what we have, major league pitchers who can only pitch 5 innings at a time, hardly anyone pitches over 200 innings a season anymore. 25-50 years ago, 200 innings was normal, with some pitchers throwing nearly 300 innings per season. The thing I think people forget is that most little leaguers don't just picth, they play other positions. They pitch, then move to another position and throw. This may cause more harm than continuing to throw.
Post by Glenn Fleisig, Ph.D. on May 16, 2007 12:21:51 GMT -6
pbarkerb, You are completely right. The thing that makes me laugh is the typical statement by your son's coach that he has done this for 27 years, with the implication that in his experience his pitchers haven't been hurt. This is ridiculous, as 11 and 12 year old don't typically get hurt enough to require surgery; however 16-20 years olds do. The boys who throw too much cumulative pitching over the years are the ones who get their elbows or shoulders cut open. If a 11-12 year old coach gave all his players cigarettes , probably none of them would develop lung cancer on his watch but would down the road.
If your son is not feeling soreness, his workload might be okay. However since your son is feeling soreness, he needs to back off. If the soreness does not go away with a reduced pitching/practicing schedule, take him to see a sports medicine specialist. When you are at that point, post here what city you live near and I will recommend a specialist to you.
At the root of my interest in youth elbow injury is my professional belief (I am a emergency and family physician involved with a Michigan based organization that has teams in each age range playing all over the country) that there is an epidemic of elbow injury in youth baseball that is largely unrecognized. I have some random thoughts and questions that I hope will generate dialog and thought and hopefully spur several of you to action to create awareness of this problem.
The threads listed above this illustrate some aspects of the probem. There are no coaching education and certification requirements in youth baseball. Youth hockey is governed by USA Hockey which has five levels of coaching certification. Any coach must pass level one to coach in order to coach. Refer to www.usahockey.com for further information on this program. Clearly, all coaches need to hear from the experts at least one hour of the potential for injury associated with pitching and poor mechanics. Responsible individuals in baseball must bring coaching education requirments to the forefront so that we can all be on the same page.
The second comment I have relates to this notion that kids used to play baseball all the time when 'we were growing up' and we threw a lot more that kids are doing now. Carefully reading the first thread reveals the difference that is current. This youngster has pitched in organized baseball since he was 8. This implies mechanics teaching, pitching work outs, and games. This was not occuring when we were growing up. Dr. Fleisig reminds us that the science teaches us that injury relates to the cumulative effects of pitching. We need to be a strong voice to listen to the science. This could be solved by better education of youth coaches and clear guidelines that will allow the child to prepare to play after their growth plates fuse and they have enough testosterone to build muscle to support the elbow.
Thirdly, Little League has adopted pitch count rules. However, travel or federation, and tournaments have been very inconsistant in adopting pitching rules. I spent a week at Cooperstown Dreams Park and was very surprised to see no pitching rules. I saw many cases of sore medial elbows and some with swelling that were undoubtably related to lack of coach education and lack of pitching rules. All organizations should adopt pitching rules. This will level the playing field and as a result more teams will develop more pitchers.
I also beginning to believe that soreness and pain in the elbow are late symptoms and reflect more underlying inflammation than is generally thought. I think it might be like what we say about hydration and being thirsty. We all know, if you are trying to hydrate and are already thirsty, you are already dehydrated. I think if we wait for the arm to get sore as the first sign that there is overuse or injury then we have waited too long. Clearly, if it hurts it is time to back off. The earlier signs of overuse are not physical, rather they are throwing more than the science suggests. I am curious about what other health professionals think.
drmike, not sure I agree with all of your comments. Certifications? We are innodated in today's world with training and certifications and what do we have to show for it? Kids with sore arms and poor training habits. Look, it's little league baseball. If a kid tells me his arm is sore, I take him out. I don't need a certificate for that. All of this red tape costs money, which youth programs don't have. We barely raise enough money to pay umpires (another subject). Most kids played organized baseball beginning in the 70's. We're not talking about 60-70 years ago. I played, pitched, played sandlot ball 7 days a week and never had any arm problems. I'm not big on pitch counts, some kids are big, some are small, some are fast, some are slow, why establish a number of pitches a kid can throw when you have too many factors to qualify it. Some kids arm is sore when they throw 50 pitches, some can throw 100. I think you now see the effects of pitch counts in the majors and we now have very few starting pitchers that can go more than 5-6 innings because they never get to build up arm strength. This season, the average starting pitcher in the major leagues went 5.2 innings, the lowest in baseball history.
This is just what I want to understand better, so JDEE thanks for your thoughts. There are a couple of things I want to clarify. First, I think there is a difference between 'Little League' and the type of youth baseball that I am concerned with 'Federation or Travel" baseball. Many of the teams I come across from around the country are youth teams playing an extended schedule between 60 and 80 games that have in depth off season programs as well. This seems very different to me than what we did when we were growing up. I think this adds a dimension of injury risk from overuse and/or poor mechanics that did not exist in the recent past. In the 'federation' arena I describe there are little or no pitching rules in tournaments. This is of concern. When I suggest certification, I am mostly interested in required organized education of coaches so that all of us are assured that each coach has heard the latest information on injury prevention.
Keep in mind that our understanding of the effects of overuse on the growth plate is an area currently undergoing research and definition. Unfused growth plates offer unique injury prevention challenges that are currently being defined by the orthopedic community. I am of the opinion that we have never trained these young arms in the past like we are doing now. In fact, we are often teaching the youngsters pitching mechanics, having them do regular pitching workouts, and having them pitch long games without teaching them how to care for their arms.
"Arm Hygiene" is a concept that I am bringing forward as a way of teaching our youngsters how to take care of their arms. I am asking them to care for their arms like they brush their teeth or shower and think of it as personal hygiene. The ASMI has published a book that has a series of simple exercises that I give out to each of our kids. Our trainer teaches them how to do the exercises and we require the kids to do them. This is the type of information that everyone involved in youth baseball should have and would be provided in the forums I suggest.
Finally, I only suggest that we be really careful with these tender young arms. Moderate training, good education, and careful attention to discomfort and pitching history should help give the long careers in baseball.