The number of serious shoulder and elbow injuries in youth baseball and softball players has increased fivefold in the past 10 years, says the American Orthopaedic Society for Sports Medicine.
FORT COLLINS, Colo. — Frank Gonzales is not an orthopedic surgeon, but he knows a shoulder injury when he sees one. After 11 years playing professional baseball and 20-plus coaching, the former pitcher has trained thousands of kids in the mechanics of throwing.
“I can tell just by looking at them. You see grimacing or a change in arm motion and it says right away there’s something wrong,” says Gonzales, varsity baseball coach at Fort Collins High School.
Nationally, the number of serious shoulder and elbow injuries in youth baseball and softball players has increased fivefold in the past 10 years, according to the American Orthopaedic Society for Sports Medicine. At Children’s Hospital in Denver, injury cases as well as surgeries have doubled every year since 2007.
Coaches and doctors blame lack of year-round conditioning, increased competition at younger levels, and simply throwing too many pitches.
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“The problem is people are getting bigger, stronger and faster, and yet our techniques are poorer,” says Gonzales, who gives lessons on proper form to young pitchers, including his two sons, Alex, 12, and Marco, 18, starting pitcher for the 5A state champ Rocky Mountain High School Lobos.
Gonzales emphasizes body control and spatial awareness, teaching the kids to perform the same motion in the correct manner until they can repeat the movement without thinking. “When they have repeatability with their mechanics, then the game becomes a lot simpler,” says Gonzales.
Dr. Eric McCarty, chief of sports medicine and shoulder surgery in the department of orthopedics at the University of Colorado school of medicine, says patients are getting younger and the injuries more serious.
“They often will throw too much without adequate rest to allow their young bodies to recuperate,” says McCarty. Stressing the growth regions in developing joints not only results in that grimace Gonzales knows so well, but it can also fracture or even pull the softer growth plate away from the bone.
“You’ve really got to shut kids down when they have a problem,” says McCarty, who is also the team doc for the University of Colorado and the University of Denver. But the responsibility for shutting a kid down falls on the coach and the parents, who might not fully understand the risks of playing through the pain, says McCarty.
“Some coaches out there will say ‘you’re a little sore — throw through it and it’ll loosen up,’ ” says Gonzales. “But there are ethics involved there.”
This year, the United States Specialty Sports Association, which oversees 55,000 teams ages 6 to 18 across the country, enacted new limits designed to protect young players. The new standards spell out how many innings and days of rest a pitcher must have. For example, 7- to 14-year-olds can pitch a maximum of eight innings in three consecutive days. But if a player pitches more than three innings in one day, he is required to rest the next day.
New national Little League regulations limit the number of pitches per day, rather than innings. Thirteen- to 16-year- olds may throw a maximum of 85 pitches per day. (Yes, someone counts them.)
“When you’re pushing the limit on muscles and tendons, you’re asking for disaster. I would say we’ve seen more strain,” says Tate Shetterly, regional director of the specialty sports association. “We saw a trend that coaches were maximizing the pitching limit — pushing pitchers to the very limit, so as the largest baseball organization, we’re going to tighten the ship a little bit.”
In his job, and as the father of a high school baseball player, Shetterly sees the pressure kids are under. “It is the parents’ responsibility and it is the coaches’ responsibility. But a lot of parents have fallen into thinking ‘my son’s going to play Major League Baseball.’ “
And if neither the coach nor the parents are willing to limit pitches, oversight falls to the sport’s sanctioning body.
“If the parents and coaches don’t see a risk, then we should take an aggressive approach,” says Shetterly. “If a lot of parents weren’t living through their kids, we wouldn’t have to do that.”
In addition to protecting the players from overworking their growing bodies, the new rules aim to encourage coaches to develop more pitchers, rather than relying on a couple of precocious arms.
“In the course of a four- to five-month season there’s gotta be innings in there you can find to develop these kids. It’s forcing coaches and teams to develop more pitching,” says Shetterly.
The latest research shows that a high number of pitches is more likely to lead to injury than the number of innings or what kind of pitch a player throws. Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students, according to the STOP Sports Injuries campaign.
But, throwing curveballs at a young age (under 16, say most experts) can lead to arm fatigue and interfere with mastery of fastball mechanics.
To further complicate the issue, the various baseball leagues — from city-run recreational programs to the ultracompetitive club teams — have different rules on how many pitches and innings an player can throw. So, if a kid plays for a school team and a club team, he could be pitching twice as much as recommended.
Contrary to the single-minded focus of some avid dads, McCarty tells his young patients and his own children to play a variety of sports. “The star throwers in Little League usually aren’t the star throwers in the big leagues,” says the doctor.