There is concern among sports medicine practitioners that the number of youth baseball pitchers with arm injuries is increasing rapidly.
Research points to overuse as the principle risk factor. Overuse is pitching when fatigued.
Overuse may be the result of throwing too many pitches during one outing, not having enough recovery time, or not having a maintenance program between pitching assignments.
But elbow and other pitching injuries aren't only caused by overuse. There are other factors, too, such as improper mechanics.
Coaches and parents should be aware of these factors, and realize that pitchers will vary in arm stamina and need for recovery time.
That's why it's so important to make certain pitchers are following good in-season arm care and recovery exercises such as those included in my TUFFCUFF strength and conditioning program for pitchers.
The number of pitches a pitcher should be allowed to throw depends on physical development, age, prior rest and recovery time, pitcher experience and the pitchers’s arm stamina.
I believe pitch count as a measure is more effective and reliable than the number of innings pitched.
In a competitive situation, often a pitcher will not admit that he is fatigued, overly sore, or has a minor arm injury. It is therefore very important that a coach is able to recognize changes in a pitcher’s normal motion.
Identifing risk factors
Poor pitching mechanics also appear to contribute to injury risk.
This includes not only a pitcher's regular mechanics but also mechanical changes that may occur during a game.
Besides a loss in some velocity and usually control, a pitcher will often change his mechanics to compensate for the loss of arm strength or to protect his arm from further pain.
Look for pitching mechanics changes such as:
- The pitcher rushes his motion trying to generate more force with his body and reduce the stress on his arm. It will look like the pitcher is dragging his arm and he’ll have a loss of hand speed because he has disrupted his normal throwing sequence.
- The pitcher may shorten his follow through (deceleration of the arm) and not use his normal arm extension upon and after ball release.
- The pitcher may not get his hand up into a normal high cocked position. It will appear that he has dropped his elbow during the cocking and acceleration phases.
- Between innings, the pitcher may hold or massage his arm displaying pain. With muscle fatigue, a pitcher’s hand often trembles.
- Between pitching assignments, the pitcher may be reluctant to throw, or throw properly during dill work, since he is attempting to protect his arm from further stress and pain.
I suggest that head coaches work closely and communicate with the assistant coaches, trainers, other players, and even a pitcher's parents, when necessary.
Often times a pitcher will confide in a teammate or an assistant coach but will not tell a coach of the injury because he wants to pitch and contribute to his team. A coach should keep the info the trainer gives him confidential, because coaches will want to players to continue to confide with the medical personnel.
Coaches and trainers should be alert for a pitcher using pain killers. The use of pills and medication does not cure the problem, but only masks the pain which might lead to a more serious or prolonged injury.
Physical indications of an injured arm
In addition to subtle mechanical changes, there are often some noticeable physical signs which indicate tissue damage about the shoulder, elbow or forearm which need to be recognized by a coach, trainer or physician.
These may include the following:
- Redness or discoloration
- Swelling or extreme tightness
- Heat - a burning sensation in the area
- Sharp pain vs a dull ache
- Deformity - could be loss of extension, flexion or range of motion
When the coach or trainer observes these signs, he should stop the pitcher from throwing, apply ice to the area, and allow more recovery time between pitching assignments.
If there is only slight improvement after rest within a given time frame, the player should be seen by a physician.
After proper treatment, the pitcher should be reconditioned via a modified throwing program before pitching.
Steps to prevent pitching arm problems
So what can we do to help prevent arm injuries?
I've outlined a few key steps pitchers and their parents and coaches can take below. Adherence to these recommendations may reduce the incidence of significant injury to pitchers.
- Making certain pitchers are properly conditioned before throwing full velocity or pitching competitively.
- Making certain pitchers have and use a proper stretching and warm ip program before throwing.
- Developing a year round throwing program to maintain arm strength and stamina, flexibility, and normal range of motion. I personally recommend 2-3 week rest period at end of a long season, but then begin a limited and modified off season throwing program.
- Teaching and supervising a proper weight and resistance program. Coaches or medical personnel should be responsible for this program. Many pitchers restrict their flexibility and range of motion by improper use of weights. Other pitchers have actually weakened themselves by over stretching the shoulder joint, causing too much laxity.
- Having the pitcher throw at reduced velocity and shorter distance when learning new techniques or new pitches.
- Making certain a pitcher pitches with proper mechanics. While each pitcher throw somewhat within his own style, through the critical phase of throwing, most successful injury free pitchers use very similar time-proven techniques.
- Limiting the amount of throwing a pitcher does during drills and practices if he plays another position. The positions which would cause the least amount of stress on the arm are first base or outfield.
- Making certain the pitcher dressed properly for warmth during cold temps, or to prevent early heat exhaustion during very hot weather. Also, be aware of proper intake of fluids to prevent early dehydration and muscle fatigue.
Finally, even though I strongly recommend lightweight, full range of motion conditioning and strength work as found in my TUFFCUFF program for pitchers, I sincerely believe that the best method to build throwing arm strength and stamina is to throw a baseball, and throw it mechanically correctly.
And remember, If pitching arm pain develops in the elbow or throwing shoulder, the pitcher should be evaluated by a sports medicine physician.
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What do you think?
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Are there any additional tips for preventing pitching injuries that I missed?
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