The study in question today comes from the Dr. Andrews lab in the American Sports Medicine Institute in Birmingham, Alabama.
Risk Factors for Shoulder and Elbow Injuries in
Adolescent Baseball Pitchers
By: Samuel J. Olsen II, MD, Glenn S. Fleisig,* PhD, Shouchen Dun, MS, Jeremy Loftice, and James R. Andrews, MD
What did they want to find out?
If the pitching practices of adolescent (14-20yrs) pitchers that DON’T have any history of arm injury are different then adolescent pitchers that DO have a history of arm problems.
The goal here is to identify common factors that most pitchers with injuries have in common and compare to no injured throwers in order to find out which ones may contribute to arm problems which nobody wants.
How did they find out?
They had pitchers both injured and uninjured (90 and 45 respectivly) fill out a detailed questionnaire that asked them questions like:
- How tall and heavy are you?
- How many innings do you pitch?
- How many months out of the year do you pitch?
- Your coach cares most about? the game, the season or your career?
- Do you exercise for baseball?
- Do you ice and/or stretch after you throw?
- If you come out of the game as a pitcher do you stay in and go to another position?
- Out of 10 pitches how many are fastballs, breaking balls, change ups?
- Do you use anti-inflammatory drugs?
- How old were you when you started to shave?
And many, many more questions like this.
What they found out?
The significant differences between the groups were that the injured group pitched more months per year, games each year, innings per game, pitches per game, pitches per year and warm up pitches before game. The injured group was also 4cm taller and 5kg heavier on average – there was no age differences between the groups. The injured group averaged 88mph while the uninjured group threw 83mph.
Let’s look at some of these factors more closely.
1. Height and Weight
While the two groups were very similar in terms of age the injured group was on average 4cm taller and 5kg heavier. At younger ages most pitchers lack the strength needed to handle the forces that come with throwing a baseball as hard as you can so it is no surprise that heavier and taller pitchers have more injuries because they need even more strength.
If you’re tall for your age great!! This height will come in handy when you get older and stronger so make sure that your arm is in good shape to take advantage of your long limbs in the years to come. For coaches and parents out there make sure the taller and heavier pitchers don’t over do it.
As far as weight goes it can be a good thing because it can add to the total amount of force that you generate and deliver to the ball, CC Sabathia maybe?
With added weight comes the need for added strength otherwise the extra mass will work against you. Any weight that you want to add should come in the form of muscle and not junk food.
2. How much, how often and how hard should you throw?
It really comes as no surprise that pitchers who threw more often get hurt but we need to throw in order to get better. We need to find out how much pitching there needs to be.
One factor that jumped out was the members of the injured group that needed surgery (I would classify this injured) pitched competitively for about eight months a year while the non-injured group averaged only five and half months.
Maybe playing on three different teams might not be the greatest idea.
It should be noted that the injured group reported average velocities of 88mph compared to 83mph in the uninjured group. While these numbers may not be completely accurate because I am sure that any adolescent pitcher is going to inflate their velocity numbers but at least both group most likely exaggerated their numbers equally. It’s just like basketball players and their vertical jumps, football player’s and their forty times or men in general with their bench press totals. Take them with a grain of salt until you see them.
Now hard throwers obviously have to deal with the higher forces needed to reach these higher velocities which can place them a higher risk of injury. Think of Joel Zumaya’s arm problems compared to the fact that Jamie Moyer is still throwing in his 40’s.
But hard throwers are more likely to pitch more often since every teams likes to put their hardest throwers up on the bump. Hard throwers are also more likely to go participate in “Showcases” in order to be recruited for higher levels of baseball. While great for exposure these “Showcases” may be doing more harm then good by getting pitchers to max out their arms trying to impress scouts and coaches by throwing as hard as possible in hopes to impress.
These “Showcases” can be especially damaging when they are held during what is typically the off-season. This not only adds more competitive pitching months to the yearly total but has the pitcher going from a state of no throwing to going all out in order to get that scholarship. Trying to go from zero to hero like this is bad news.
If you’re good enough and play organized baseball in the summer scouts will find you so don’t worry about firing up the old pitching arm in winter to go pay someone to go show them what you got.
3. Use of Anti-Inflammatory Drugs
Again this one is not a shocker. If you need to pop a couple of Aleve’s before you pitch to numb the pain that you know is coming you might what to get your arm checked out.
Hopefully you can put this information to good use and help prevent arm injuries from occurring in the first place.
Graeme Lehman, MSc, CSCS