Tuesday, August 16, 2022



Thousands of kids play organized baseball through programs like Little League every year. While baseball is a great way to encourage teamwork and physical activity, it's also important to be aware of the potential for injuries. One of the most common baseball injuries is damage to the ulnar collateral ligament (UCL), located in the elbow. This type of injury often requires surgery, repair known as Tommy John surgery, to growth plate fractures are another type of injury that can occur in young athletes. These fractures happen when the bones grow faster than the muscles and tendons, causing stress on the growth plates. Growth plate fractures can lead to long-term problems like deformities or arthritis if not treated appropriately. By understanding the risks and taking proper precautions, parents and coaches can help reduce the risk of arm injuries in Little League baseball players.

Tommy John Surgery and Growth Plate fractures are two of the most common arm injuries in Little League baseball players. Tommy John Surgery is a procedure where the ulnar collateral ligament in the elbow is substituted with a tendon from another body part. The surgery is named after Tommy John, a successful major league pitcher who was the first to have the surgery. Growth Plate fractures occur when the bones in the arm grow faster than the muscles and tendons, resulting in a stress fracture. These injuries can be severe and require extended rest periods and rehabilitation. As a result, coaches and parents must be aware of these injuries' signs and symptoms so they can be treated promptly.

Pitch count is an important factor to consider in Little League baseball. Too many pitches can lead to injuries, and PitchSmart.org reports that "Elbow and shoulder injuries are most common in baseball pitchers. These injuries often require surgery, and some may end a pitcher's career." by monitoring the number of pitches a player throws, coaches can help safeguard against these sorts of injuries. In addition, PitchSmart.org recommends that players take at least four days off between pitching appearances to give their arms time to recover. By following these guidelines, coaches can help their players stay healthy and avoid serious injury.

In recent years, there has been a dramatic increase in young athletes suffering from arm injuries. One potential explanation for this trend is the increased focus on pitching in youth baseball. To reduce the risk of arm injuries, Major League Baseball introduced PitchSmart, a program that tracks pitch counts and mandates rest for pitchers who exceed a certain threshold. However, new research suggests that PitchSmart may not be effective in preventing injuries. Some experts believe that the program may be causing more harm than good.

One of the problems with PitchSmart is that it does not consider the type of pitches being thrown. For example, a fastball puts less stress on the arm than a curveball. As a result, a pitcher could easily exceed the pitch count limit without damaging their arm. Another issue is that PitchSmart does not factor in the age or experience of the pitcher. A teenage pitcher who has just started playing baseball is at a much higher risk of injury than a veteran who has been pitching for years. Finally, some experts believe that the program encourages young pitchers to throw harder and faster, leading to problems.

At this point, it is impossible to say definitively whether or not PitchSmart is working. However, given the evidence, it seems clear that the program has some serious flaws. Until these issues are addressed, arm injuries will likely continue to rise among young baseball players.

According to Dr. James Andrews, one of the most prominent surgeons in sports medicine, "There is no single number that will protect all pitchers from injury." However, he believes that by tracking a pitcher's pitch count, we can help to reduce the risk of arm injuries. Dr. Andrews is not alone in this belief; many other experts have also argued that pitch counts are a valuable tool for preventing injuries.

However, some argue that pitch counts are not enough. They believe we need to combine pitch counts with other tests, such as those used by physical therapists, to get a complete picture of a pitcher's health. While this may be true, it is essential to remember that coaches are often volunteer positions. This means they may not have the time or training to administer these other tests. We can ensure that more coaches can implement this critical safety measure by keeping things simple and using pitch counts.

Here are some thoughts to consider:

1. Mechanics:  Everyone has an opinion, but my experience says the longer the arm path, the more dangerous pitching is to your health. One bad throw can cause catastrophic injury.
2. Training:  The is more "specialized" training now than before. One should train for two reasons: 1. To Stay Healthy. 2. Improve Physical Performance. Indeed, this "training" is not keeping kids healthy. The exact opposite is happening. We can argue for days whether pitching performance has increased or crashed and burned
3. Human Movement:  Most adolescent pre/just post-pubescent kids can barely stand on one foot for 10 seconds, let alone move with precise neurologic precision in fundamental movements like the squat, the lunge, and basic arm path to throw a ball.
4. Strength:  Arm, Core, Posterior Kinetic Chain?

These are just a few factors a pitch count would not assess. They are significant factors that should be evaluated to keep kids healthy.

More needs to be done in terms of in-game testing. We cannot rely on the number of pitches thrown to be the only assessment.

What if there were a formula that included pitch count but also tested the above-noted metric? What if that test and procedure can be assessed after warm-ups and between each inning the pitcher throws?  

What that test, assessment, and formula would take any well-trained coach about 90 seconds to assess?

How many arms can we save from injury? Stay Tuned for MAJOR ANNOUNCEMENTS!

Dr. Kevin J McGovern, PT, CSCS

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