February 2011 Newsletter

Archived Newsletters

"Calling all Pitchers and Catchers!"
By Dr. Stephen A. Hunt

Now that the Superbowl has passed, it is time for those familiar words to announce the start of one of America’s favorite pastimes, baseball. I know it is hard for some to think about this with eight inches of snow and ice covering our lawns, but spring is around the corner. Spring training for professional and amateur (including youth) athletes is already starting up. Almost 500,000 male high school students played baseball for their high school during the 2008-2009 academic year. Because of its popularity, baseball has been a focus for injury prevention by many sports medicine specialists because of the propensity for young athletes to develop shoulder and elbow problems. Initially these problems may just result in lost playing time, but sometimes they can lead to prolonged disability and even surgical interventions. There are reports of “Tommy John” surgery being performed in younger athletes, which is a surgical procedure to reconstruct the ulnar collateral ligament (UCL) using a tendon from another part of the body. These reports raise a concern that some of these athletes may be pushing too hard.

Recently, there has been research looking into risk factors for youth injuries. A current study published in the American Journal of Sports Medicine evaluated a group of youth pitchers over a 10-year period for “serious” shoulder and elbow injuries. In this study, a “serious injury” was classified as surgery for the shoulder or elbow, or retirement from the sport due to a throwing injury. They found that 5% of youth pitchers would sustain a serious injury. Keep in mind, that this statistic does not necessarily include less serious injuries that are not career ending or do not require surgery. The greatest risk factor for injury was pitching more than 100 innings per year. Throwing curveballs before the age of 13 was not a risk for injury in this study, although other studies have suggested that this may be a risk factor for youth pitching injuries. Additionally, while it is recommended that youth pitchers rotate into other positions, catcher may not be the best position for a pitcher to play. While not conclusive, this study suggested that youth pitchers who also played catcher were at increased risk for injury. This last part makes sense in that a catcher makes many more throws per inning than the field players.

There’s some good news for us in the northeast! Another study, also in the American Journal of Sports Medicine, analyzed differences in high-school pitchers in warm-versus cold-weather climates. Their data suggests that warm-weather pitchers are at an increased risk of injury, because of motion and strength deficits as compared to their cold-weather counterparts. Warm-weather athletes also played many more innings per year than their cold-weather counterparts, which also contributes to their risk factor for injury.

Pitching mechanics are well understood, and it is important that young pitchers are coached to use proper form and take adequate rest to prevent injury.

REFERENCES:

1. Fleisig et al. Risk of serious injury for young baseball pitchers. Amer J Sports Med 39 (2):253-257.
2. Kaplan et al. Comparison of shoulder range of motion, strength, and playing time in uninjured high school baseball pitchers who reside in warm- and cold-weather climates. Amer J Sports Med 39 (2):320-328.