There has been much talk in sports medicine about injury concerns on the still-growing arms and shoulders of young baseball pitchers. This issue was highlighted in a recently published study, appearing on the American Journal of Sports Medicine, which followed young baseball pitchers for 10 years, then in the 9- to 14-year age group.
The study revealed a direct link between the number of innings pitched and incidence of serious pitching injuries. Results showed that those who pitched more than 100 innings in a year had a 3.5 times risk of injury. Of the 481 pitchers who were healthy and active youngsters at the start of the study, only 2.2 percent were still pitching by the tenth year. Five percent of the pitchers either had to undergo surgery or went into retirement due to a serious injury. Two of the pitchers had surgery before their 13th birthday.
The study recommended that pitchers in high school and younger should pitch no more than 100 innings in competition in any calendar year. It further stated that no pitcher should continue to pitch when fatigued. It also encouraged pitchers to play other positions but advised against playing catcher as well, as this appears to increase the risk of injury.
A similar earlier study cited a new rule for Little Leagues that limit the number of pitches rather than the number of innings played. The rule requires specific rest periods before a pitcher can throw again when he has reached a certain threshold of pitches in a day. Anyone who throws more than 20 pitches in a day has to rest for one day before he can pitch again. If 85 pitches have been thrown in a day, a rest of at least three days is required.
In this analysis, 32 male baseball players between the ages of 13 and 21 were followed for six years. The study found growth plate changes in all of the kids upon X-ray and changes in strength and range of motion. The researchers, however, averred that although these adaptive changes generally help protect players from injury, playing too much and playing year-round can push the bone and soft tissues to the point of injury.
The study suggested that it is better for growing children to play varying sports that use different muscles and movements than play only baseball all year.
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Arif B. Khan, MD, is the medical director of Texas Interventional Pain Care, an interventional pain center specializing in the treatment of many painful conditions, and located at 2201 N. Central Express Way, Suite 171, Richardson, TX 75080; 4800 North Galloway Ave. Suite 300 Mesquite, Texas 75150. Phone: 972-952-0290 or fax 972-952-0293.
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