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In Part 1 of this series we noted that The American Sports Medicine Institute (ASMI) suggested the top 3 primary risk factors that contribute to overuse injuries in youth baseball pitchers were:

Overbearing dad's who want their kid to get a scholarship and play pro ball???

1. Total number of pitches during a game, season, and a year.

• Injuries are the result of the cumulative stress (microtraumatic trauma) of the repetitive act of throwing.  This stress accumulates over multiple games, seasons and years in young players 

The Pitch Count Rules:

There is a small, yet vast difference in the bylaws for Little League Baseball and USA Baseball as pertaining to pitch limits and mandatory rest periods.

The Little League pitch limits are mandatory and must be strictly followed. Each league now requires a designated scorekeeper or official to track the pitch counts, and to notify umpires when pitchers reach mandatory limits.  Any   violation of the Little League pitch limit and mandatory rest rules may result in a forfeit.

By contrast, the USA Baseball pitch limits are recommendations.  Because they are voluntary, there is no scorekeeper, and a team does not incur a penalty if the guidelines are not followed. 

**However, while Little League Baseball, unlike USA Baseball, does not set mandatory limits on the number of pitches per week, it does require mandatory rest between pitching appearances.  That mandatory rest effectively limits the number of pitches which can be thrown over the course of a week. 

Independent Travel Baseball

A note of extreme caution to parents of youth baseball pitchers on independent travel and all-star teams competing in independently-operated tournaments: they may have NO rules at all on pitch limits and rest.

Another thing parents also need to be aware of is that if your child competes for multiple teams, it is up to you and your child to keep track of his pitch count.  This is because when a child is on numerous teams, there often is little to no communication between the different coaches.  With no communication, each coach only has the numbers down for his own team, not what your child did elsewhere, and not how much rest they need.  Failure to keep track of this may put your child at a significant risk of an overuse injury to their elbow or shoulder that may require surgery.

Limit pitches per season and year

When it comes to a pitch count throughout the season, Little League Baseball does not set limits on that. Although USA Baseball does not either, it does have some recommendations*:

* Pitch count limits include only pitches thrown during games and don't include:

• Throws from other positions (Note: Little League bans pitchers from going behind the plate as catchers because of the amount of throwing involved in that position).  The American Sports Medicine Institute seems to provide some preliminary support for that ban, finding, based on limited data, that playing catcher appeared to double or triple a pitcher's risk of injury, although the small number of injured players studied prevented a finding that the risk was significantly significant).
• Instructional pitching during practice pitching; and
• Throwing drills, which are important for developing proper mechanics - since poor throwing mechanics have been linked to increased risk of injury - and strength - since poor conditioning also increases the risk of arm injuries.

The Conditioning Of Young Pitchers

We've covered some of the important topics on the conditioning components for youth baseball players in previous posts.  If they neglect the proper conditioning elements in the off-season then their chances for success and avoiding injury is limited.  Proper off-season programming can be referenced here:

Baseball off Season Part 1

Baseball Off Season Part 2

But what happens during the season for many young throwers?  They are often told by un-informed dads and coaches that lifting weights during the season will make them "tight" or hurt their performance.  This can't be further from the truth.  We addressed this in a previous post. The kids are maxed out because they are playing for 2 & 3 different teams so this leaves no time to maintain their strength and mobility.  They are told to go out and "run long distance" to keep their legs strong.  This could possibly be the worst thing a young pitcher can do!  More on these topics coming in our next post.  

For our in-season guys (and softball girls) the total volume of work is reduced by 30-50% depending on a number of variables such as the athlete's training experience, physical maturity, are they a pitcher, or strictly a position player.   Medicine ball work is cut in half and more emphasis is spent on countering the repetitive rotational forces that have to do with throwing and hitting.  Extra attention is spent on soft tissue work, hip mobility and posterior cuff strength.  

Check out one of the in-season shoulder stabilization exercises 

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Last week was a big week here at Conca Performance as we anticipated the start of the high school softball and baseball season all winter.  We were fortunate to have 9 of the regions top pitchers training with us, putting in the extra time with the strength program, getting stronger and more powerful and preparing to dominate their opponents.  If the first week is any indication of what the season holds for these athletes, it will be exciting to watch!

In their opening deputes these 9 pitchers combined for a 9-0 record 6 shut-outs and 112 strikeouts!  

Congratulations to:

Annie Pitkin - Suffield Academy

Jack Patterson - Suffield Academy

Kenny Potts - The Masters School - West Simsbury, CT

Matt O'Neil - East Longmeadow

Steve Moyers - East Longmeadow

Madison Grande - East Longmeadow

Megan Logan - Holyoke Catholic 

Lee Albertson - Westfield

Sara McNerney - Westfield 

What makes the difference with these athletes?  Is it their physical ability, their work ethic? Is it their commitment to come in and workout after practice, is it a strong desire to become the best they can be, or all of the above?

It doesn't matter where you are in your athletic / scholastic career, the thought process should remain the same:  "You have to be willing to work for it, it's going to be a long tough road, but you need to take action, not just talk about it."

It would be very easy to do what the other 97% do.  Make excuses.  With so many social pressures from friends, overbearing parents and coaches, to poor personal assessments of where they need to improve, or simply being lazy, many athletes lose focus, desire and get derailed well short of their original goals.

So what's the big difference in these 9 pitchers who came out the first week of the season, arms blazing and a mind full of confidence.  I think it's simple.  They hold themselves accountable!  They show up! They have character which stems from setting goals and working towards improvements to make it a reality. They know what it takes to be successful.  They have supportive families with realistic exceptations. They continue to bust their butts even as the season gets under way.  When the 97% leave practice and call it a night, they make one more stop to put in that little extra training that makes a big difference.    

This is a quote from Strength Coach, Eric Cressey (which I will be putting up in our training center) that sums up todays theme.  The difference in those 9 players can be found in Eric's quote below: 

"It isn't about showing up, it's about genuinely caring about what you do, honestly evaluating where your abilities are, having a passion to become a better person and make the world a better place, and act accordingly - while being punctual, diligent, and respectful."    

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In The News:  A complete game shut out with 15 K's to start the season!  Read about it Here! 

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As a high school and collegiate baseball player who dedicated every waking minute to trying to improve my baseball abilities, I can relate to the passion and work ethic required to succeed.  Fast forward 20 plus years and the dynamics on how today's players approach their baseball development is drastically different.  The rising pressure from parents, coaches and travel teams has contributed to increased physical stress on young arms leading to an array of overuse injuries.  

Let's take a closer look at the alarming injury statistics that our youth baseball players are up against:    

In 2001 the Journal of Medicine, Science, Sports & Exercise reported that athletes who pitched with a tired arm were 6 times more likely to suffer from elbow pain and 4 more times likely to have shoulder pain than those who did not have a tired arm.  

A similar study, in 2002, in the American Journal of Sports Medicine reveled the following: 

• Throwing more than 600 pitches per season yielded a 3.5 times greater chance for elbow pain
• Throwing more than 75 pitches in a game yielded a 2.5 times greater chance for shoulder pain
• Pitchers who reported they were tired while pitching had a 6 times greater chance for elbow pain and shoulder pain increased by four-fold. 
• Nearly 50% of the 476 youth pitchers studied, reported elbow or shoulder pain during the season

1. The 50 pitch count:  For every 25 pitches, after the 50 pitch count, the percentage of throwers who reported pain increased.
2. The 75 pitch count:  Throwing over 75 pitches yielded a 2.5 times greater risk for shoulder pain
3. The 600 pitch count:  Throwing more than 600 pitches in a season yielded a 3.5 times greater risk of elbow.  
4. Pitching while fatigued:  Pitchers who reported they were tired while pitching had a 6 times greater chance for elbow pain and shoulder pain increased by four-fold. 
5. Curves & Sliders:  Pitchers who threw these breaking pitches were at an increased risk for shoulder and elbow pain.  

Pitchers experiencing elbow pain had these characteristics in common:

Pitchers experiencing shoulder pain had these characteristics in common:

• increased # of pitches thrown in games
• increased cumulative pitch counts over the season
• throwing with a fatigued arm
  
• decreased perceived self-performance

  THE BIG 3

Researchers at ASMI and other national institutions conclude that there are 3 primary risk factors that contribute to injuries in youth baseball pitchers:

1. Total number of pitches during a game, season, and a year.

• Injuries are the result of the cumulative stress (microtraumatic trauma) of the repetitive act of throwing.  This stress accumulates over multiple games, seasons and years in young players 

Closing Out The Overuse Injuries

The baseball experts seem to agree that of the Big Three, the total number of pitches thrown combined with the lack of rest (in between starts and total through out the season) are the biggest contributors to the increase of arm injuries.

We've closed out this post on the alarming rates of overuse injuries.  In part 2 we will discuss how to combat these injuries with a smarter approach to throwing and how to properly condition the body to handle the increased volume.  

1. Lyman S, Fleisig GS, Waterbor JW, et al. Longitudinal study of elbow and shoulder pain in youth baseball pitchers. Med Sci Sports Exerc.2001;33(11):1803-1810.

2. Lyman S, Fleisig GS, Andrews JR, Osinski ED. Effect of pitchtype, pitch count, and pitching mechanics on risk of elbow and shoulderpain in youth baseball pitchers. Am J. Sports Med 2002;30(4):463-468.

3. Olsen SJ 2nd, Fleisig GS, Dun S, Loftice J, Andrews JR. Risk factors forshoulder and elbow injuries in adolescent baseball pitchers. Am. J Sports Med. 2006;34(6):905-912.

4. Valovich McLeod TC, Decoster LC, Loud KJ, Micheli LJ, Parker JT, SandreyMA, White C.  National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries.  J Ath. Tr. 2011;46(2):206-220.

5. Fleisig G, Andrews J, Cutter G, Weber A, Loftice J, McMichael C, Hassel N, Lyman S. Risk of Serious Injury for Young Baseball Pitchers: A 10-Year Prospective Study. Am. J. Sports Med. 2010;20(10): 1-5.

6. Kaplan KM, Jobe FW, Morrey BF, Kaufman KR, Hurd WJ. Comparison of Shoulder Range of Motion, Strength, and Playing Time in Uninjured High School Baseball Pitchers Who Reside in Warm- and Cold-Weather Climates.Am.J Sports Med. 2011; 39(2): 320-328.

7. Dun S, et. al., A Biomechanical Comparison of Youth Baseball Pitches: Is the Curveball Potentially Harmful? Am.J. Sports Med. 2008;36(4):686-692.

8.  ASMI Position Statement for Youth Baseball Pitchers, August 2009. 

9. Fortenbaugh D, Fleiseg G, Andrews J. Baseball Pitching Biomechanics in Relation to Injury Risk and Performance. Sports Health: A Multidisciplinary Approach 2009;1:314-320.

10. Wolforth, Ron, Observational Fatigue & New Guidelines (accessed May 27, 2010)

11. Davis, J.T., et. al. The Effect of Pitching Biomechanics on the Upper Extremity in Youth and Adolescent Baseball Pitchers. Am. J. Sports Med. 2009;37(8):1484-1491.

12. Hyman, Mark, "StudiesShow That the Curveball Isn't Too Stressful for Young Arms," NewYork Times (July 26, 2009).

13. Fazalare J, Magnussen R, Pedroza A, Kaeding C.  Knowledge of and Compliance With Pitch Count Recommendations: A Survey of Youth Baseball Coaches.  Sports Health: A Multidisciplinary Approach. published online February 6, 2012. DOI:10.1177/1941738111435632 (accessed February 7, 2012).

14. American Academy of Pediatrics Council on Sports Medicine and Fitness, Baseball and Softball Policy Statement (doi 10.1542/peds 2011-3593)(www.pediatrics.org/cgi/doi/10.1542/peds2011-3593 (accessed February 27, 2012).

Additional sources:

Berler, Ron "Arm-Control Breakdown", New York Times (August 9, 2009)

Krajnik, et. al. Shoulder Injuries in US High School Baseball and Softball Athletes, 2005-2008. Pediatrics 2010;125(3):497-501.

The Learning Curve: Little League Seeks to Address Concerns, Answer Questions about Curveballs and Overuse (Little League International 2011).

 

  

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No single athlete has all the answers to athletic success. That’s because what works for one athlete may not work for another. Although knowing what works for you is vital. However, most athletes don’t understand what needs to be done in order to progress and gain an edge on the competition. As said by world-renowned motivational speaker, Tony Robins, “If you do what you’ve always done, you’ll get what you’ve always gotten.”
 

Do it because you want to reach your full potential, or push your boundaries, or never have the feeling of regret, or because you want to push your sport itself to an entire new level. Do the right things on and off the court, field or ice and that is what it truly means to outwork everyone. Outworking everyone is key to reaching your true potential. It’s what you do when no one else is looking that really counts!

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First step: Identify and address inefficient movement patterns. Once we create a solid foundation of movement, the process of acquiring strength and then speed begins. That’s right, you need to acquire strength first before you can become fast.  Athletes simply need to first build a solid strength foundation. As you can see from the video below, many of our athletes arrive with less then adequate movement patterns. These patterns must be fixed before strength can be applied!

No so fast!!  The repetitive pounding of high volume running and jumping (plyometrics) can be very dangerous to the long-term health of a young athlete. When an athlete is sprinting, the ground reaction forces that travel through the body is approximately 4-6 times the athlete’s bodyweight. An untrained 135lb athlete is now sending forces of 540-810lbs of force into a single leg (ankle, knee and hip joint) during each stride (let alone how much these forces are increased when jumping is included!).

Eccentric strength training (the ability to lower a weight under control) leads to a more dramatic increase in strength while learning movement patterns. It is much harder to handle a load while decelerating it, as opposed to pushing it back or moving fast. This given load can begin as bodyweight and progressively increase with external resistance until the athlete is ready to move the load at a faster pace. Single leg eccentric strength is the key!! From our junior athletes to the advanced collegiate athletes, the philosophy remains the same. Single leg strength first.  Speed second.  

An athlete’s speed will increase as they get stronger. I have parents and coaches tell me their kid's feet are moving so fast but they aren’t going anywhere. This example indicates that the athlete does not have enough relative strength. This is a very simple concept that is often been made all too complicated by a “have to have it now” population looking for a “magic drill.” Here it is in simple terms:

It all comes down to force production. The best solution to slow feet is to get stronger legs (one leg at a time!). Single leg strength to be specific.

In order to propel yourself forward, you need to be able to push back into the ground. The harder you push, the farther you go; the stronger you are, the harder you’ll push; the stronger you are, the faster you will be. Notice the pattern here? In every sport (except track) the athlete needs to be able to decelerate, change direction on a dime and repeat this for an extended period of time.

So why do some facilities advertise “Speed and Agilty Camps? And why do some programs spend so much time on “Speed and Agility”? The simple answer is money. You can cram a lot more kids into a group and run them around some cones, hurdles, ladders and “perform speed drills.” This is much less coaching intensive. Less staff, more kids equals more profit. The process of getting a kid strong, safely takes not only time, but a variety of exercises, individualized cues, progressions and more individual coach-to-athlete interaction. “Speed camps and clinics” just won’t get the job done. At Conca Performance, I will not let the business model dictate how we train our athletes. 

A great example of how to spend your time and $$ and

NOT get faster!

Depending where the athlete is in their stage of development and physical maturity, they may or may not need much movement training. Athletes can increase his/her speed without even performing any wild plyometrics or spending time on the agility ladder. Don’t get me wrong, the agility ladder is a great tool for developing the brain to muscle connection which is a piece of the neural puzzle. But don’t waste your time using the ladder as “the tool” to increase speed.  Pushing a sled is much more effective!

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In Part 1 or our two part series we discussed some of the top 5 components you need to be a successful player.  In Part 2 we will focus in on some of the solutions to get your body game ready.  

Part 2: 

The Benefits of Off-season Baseball Training - Fixing your Asymmetries and Stiffness

Once the season comes to an end, players will notice certain areas of their body feeling stiff, sore, loose and even painful. Recognizing and screening these specific areas will be the first step is finding movement patterns that have become asymmetrical and or stiff.  Addressing these areas should be a priority before they lead to injury.  

Thoracic extension and rotation 

Without these two areas of mobility, the velocity of the ball with not only be less then it was in the beginning of the season, but a greater risk of (stress) injury is placed on the cuff and elbow. Having enough extension and rotation through the upper back not only results in a healthier shoulder, but will also increase performance. The thoracic spine keeps the shoulder from over reaching and allows a longer and greater cocking phase when throwing the ball, resulting in higher arm velocity speeds and a more efficient throwing motion. If these forms of mobility become limited, the stress on the shoulder and elbow increases. 

 
Below are some clips on how to gain thoracic extension and rotational mobility.

Many of the athletes we see come to us with poor mobility in the foot and ankle, baseball players are not the exception. A quick way of checking an athlete’s ankle range of motion is to simply look at how he/she stands. If the athlete’s toes are pointing outward, and the arch of the foot is relatively flat can be an indicator of a lack of ankle dorsiflexion (how far the foot can pull up). Deep body weight squatting is another way to assessment how a lack of ankle mobility can effect gross movement patterns as seen here. Poor mobility around the ankle joint can contribute to poor running mechanics, poor body positioning and overall mobility in the field and can even effect throwing mechanics. 

 
All movement and ground reaction forces begin with your feet, so paying close attention to taking care of your feet (ankles) will give you a big advantage on the field and in the Gym. 

One of the ways to keep the ankle mobile is starting in a half kneeling position and performing the following movements: Keeping the front heel completely flat and toes remaining forward, drive the knee as far as possible straight ahead before the heel lifts off the ground, then return to starting position. Repeat this move five times, and then drive your knee to the right and left of the dowel to turn this exercise multi-planar. 

Glenohumeral Internal Rotation Deficit

This can be one of the biggest issues players, especially pitchers, run into during the season. Glenohumeral internal rotation deficit (GIRD) is known as having a measurement of 19 degrees or more of internal rotation deficit between the dominant throwing arm and non dominant arm. When being assessed, coaches and trainers must find the total range of motion (ROM) of each shoulder. The total range of motion is found by measuring the external and internal rotation of the shoulder, then adding the two numbers together. A calculation of a total range of motion of approximately 170 degrees on both shoulders is ideal. 

DO THIS:

Dynamic stabilizations – These exercises can be done either with a partner or by yourself. Perturbation can be one of the lowest technical exercises with the biggest outcome. Since the main function of the cuff is to stabilize that joint why train it in any other way? Having the trainee stabilize their shoulder in the packed position (down and back) while partners or coaches perform perturbations at different ranges of motion gives the shoulder the functional training it needs to stabilize the glenohumeral joint. 

Recovery

Nutrition is the final piece to the puzzle. Beginning with a diet log 3-4x a week can help you assess how well you are nourishing your body. Once you see that cereal, bagels and pizza aren’t going to cut it, begin with going back to what your parents told you when you were a kid...

Breakfast is the most important meal of the day (and no it's not PopTarts or Cereals!)

We'll save the more detailed nutrition information for a separate post, so for now remember these quick tips for every time you eat.  

Eat protein at every meal
Eat fruits and vegetables at every meal
Eat fiber at every meal
Make sure you have enough omega-6 and omega-3 everyday (Krill Oil)

There are no secrets in the recovery process or becoming a better athlete. Work hard, eat right, get enough sleep and you will become a much improved player from last season.

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If you want to be a successful baseball player you need:

1. ACCELERATION when sprinting to first base or getting a jump on a ball in the gap

2. STRENGTH when swinging the bat, throwing "gas," or firing a ball from deep in the hole

3. POWER when driving a ball in the gap and exploding off the mound in the late innings  

4. STABILITY to control ALL of these movements

 ** You need even more STABILITY in the shoulder if you’re a pitcher.

Aside from the obvious ones I stated above, listed below are my top five reasons why it is a necessity that baseball players become involved with an off-season strength training program. 

1. Weaknesses

"What’s your bench bro???"  This is probably one of the most frequently asked questions with athletes when they step into a "gym" or training facility. Sad to say, how much someone can bench press has very little carry over to sport performance other than powerlifting. Walk into any gym in town and watch who spends the most time on their back pressing weight.  You guessed it!  The middle and high school boys!  

Take a step back and identify your weaknesses or areas that need improvement. Is it your bat speed? Is it the time it takes you to sprint to first base? Or is it that you have been dealing with specific painful areas such as the shoulder, elbow or hip while in season? 

Figuring out where you can make the biggest improvement for next season will only make you that much better and keep you off the injured reserved list. Remember, you’re only as strong as your weakest link.  Having an intervention with yourself, your coach and/or your strength coach is one of the most important first steps before beginning an offseason program.

2. Your Core

When you hear everyone talk about training your core, what’s the first exercise that comes to mind? A million sit-ups? That’s typically the #1 answer received. Unless you’re looking for increased disc pressure and zero improvement in rotational core strength and stability, then go ahead and do your million sit-ups.

Believe it or not, your core muscles are built to transfer energy from your lower body to your upper body.  Coming up in a future post we will go into greater detail on the importance your core development has on throwing and hitting power.  Understand this concept for now. When looking at baseball players, their entire sport is built around generating power through rotation. Hitting and throwing are both major repetitive rotational movements. All the energy generated in these motions begins at the ground.  The more stable your core the more energy gets transferred to the upper extremities, which equals more power (velocity in arm and bat speed).

The key when looking at the best baseball players is that they are all in sync from the ground through their legs, their core and all the way to their upper extremities. 

Plank and bridge variations along with anti-rotation holds and presses are among the top core activation exercises.  

3. Strengthening and Maintaining a Healthy Rotator Cuff

The words baseball throwing and rotator cuff (RC) go hand in hand.  However, many players and coaches lack understanding of RC function let alone how to optimally train it. We will cover this topic in greater detail in another post but for now here are the basics:   

Envision this:  A pitcher begins his wind up and starts his controlled fall to the mound. As the front foot hits the ground, the throwing arm makes it's approach to the release point and in a fraction of a second a 98mph fast ball explodes out of his hand.  The arm didn't create the power.  It was simply the end of the bull-whip. As a result the shoulder has to internally rotate at approximately 7,000°/s during the acceleration phase (just prior to ball release). This is not only one of the most biomechanicaly dangerous movements in sports, it's the fastest motion in all of sports.   

The rotator cuff muscles are too small to be responsible to decelerate the arm (slowing down the arm after ball release) by themselves. Other physical components such as hip internal rotation thoracic rotation play a roll in assisting the deceleration phase. Aside from these other components, keeping the rotator cuff strong, stable and maintaing consistent ranges of internal and external rotation throughout a season can be very complex.  We will discuss what to look for and how to manage this in an upcoming post.     

4.  Soft Tissue Restoration 

Soft tissue is recognized as tissue that connects, supports or surrounds other structures and organs of the body. These tissues include muscle, fascia, tendons and ligaments. When a muscle becomes damaged it also becomes dense or thick with inflammation. To relieve the density of these damaged tissues, certain forms of self-myofascial release are necessary including foam rolling and massage. Performing these techniques daily will help players recover faster, maintain better overall muscle tissue quality and decrease the risk of injury.

Some soft tissue restoration techniques we use at CSF are below:

5.  Be A Better Athlete

With the days of youth sport specialization upon us, younger athletes are focusing on just one sport at too early of an age.  The result is a decrease in overall athleticism and overuse injuries.  The danger with baseball is that it's primarily a static sport.  With the focus on repetitive, single-direction, rotational patterns that involve throwing and hitting, asymmetrical muscular imbalances can develop. Several other athletic attributes such as foot speed and agility can be suppressed.  

If you look at the rosters of most collegiate and pro teams, many of the players were multi-sport athletes throughout high school.  Don't kid your self, college and pro-scouts are looking for good baseball talent.  But what they're really focusing on is your overall athleticism.  They want athletes!!  Can you run fast, be agile, can you move, are you strong, etc. If you can do all the above and bring some baseball talent, you will be a complete player, reduce your chances for injury and attract some attention.  

Start your preparation now and get involved in a structured and supervised off-season strength and conditioning program.  Combine this with continued refinement of your baseball skills and this will not only help you with your baseball development but with your overall athletic development as well. This could be one of the most important decisions you will make in your career. 

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Here is part 2 of Eric Cressey's guest post here at the Conca Sport and Fitness blog.


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Part 2:

This article was originally featured at EricCressey.com.


Three weeks ago, this article on pitching injuries became the single-most popular piece in EricCressey.com history:

Your Arm hurts?  Thank Your Little League, Fall Ball, and AAU Coaches

In that feature, I made the following statement:

We can do all the strength training, mobility work, and soft tissue treatments in the world and it won’t matter if they’re overused – because I’m just not smart enough to have figured out how to go back in time and change history. Worried about whether they’re throwing curveballs, or if their mechanics are perfect?  It won’t matter if they’ve already accumulated too many innings.

While athletes might be playing with fire each time they throw, the pain presentation pattern is different.  You burn your hand, and you know instantly.  Pitching injuries take time to come about. Maybe you do microscopic damage to your ulnar collateral ligament each time you throw – and then come back and pitch again before it’s had time to fully regenerate.  Or, maybe you ignore the shoulder internal rotation deficit and scapular dyskinesis you’ve got and it gets worse and worse for years – until you’re finally on the surgeon’s table for a labral and/or rotator cuff repair.  These issues might be managed conservatively if painful during the teenage years (or go undetected if no pain is present) – but once a kid hits age 18 or 19, it seems to automatically become “socially acceptable” to do an elbow or shoulder surgery.

Sure enough, just yesterday, reader Paul Vajdic sent me this article from the Shreveport Times. The author interviews world-renowned orthopedic surgeon Dr. James Andrews about the crazy increase in the number of Tommy John surgeries he’d performed over the past decade.

A comment he made really jumped out at me, in light of my point from above:

“”I had a kid come in, a 15-year-old from Boca Raton, (Fla.), who tore his ligament completely in two,’ Andrews said. ‘The interesting thing is when I X-rayed his elbow with good magnification, he has a little calcification right where the ligament attaches to the bone. We’re seeing more of that now. He actually got hurt with a minor pull of the ligament when he was 10, 11, 12 years of age. That little calcification gets bigger and, initially, it won’t look like anything but a sore elbow. As that matures, it becomes more prominent. It turns into an English pea-size bone piece and pulls part of the ligament off when they’re young.’”

In other words, it takes repeated bouts of microtrauma over the course of many years to bring an athlete to threshold – even if they have little to no symptoms along the way.  Injury prevention starts at the youngest ages; otherwise, you’re just playing from behind the 8-ball when you start training high school and college players.

In addition to walking away with the perspective that young kids need to be strictly managed with their pitch counts, I hope this makes you appreciate the value of strength and conditioning programs at young ages, too.  For more information, check out my post, The Truth About Strength Training for Kids.

We can’t prevent them all, but I do think that initiatives like the IYCA High School Strength Coach Certification in conjunction with pitch count implementation and coaching education are a step in the right direction.

Eric Cressey, MA, CSCS is the President of Cressey Performance, just west of Boston, MA.  He publishes a free daily blog and weekly newsletter at www.EricCressey.com.


Over the years we have adopted the same philosophies that Eric uses with his baseball clients.  Baseball players in the Pioneer Valley who are looking to take your game to the next level, while reducing your chances of developing a shoulder or elbow problem, give us a call at 413-304-2350.  Let the Conca Strength and Conditioning team provide you with a comprehensive plan to make this your best season yet.

 

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