Pitching Injuries

The issue of arm injuries is one that has garnered significant attention this year, as the media has most definitely latched onto the issue and brought it to the forefront of public attention. And while there seems to be a lot of recent arm injuries in , this is an old issue that is extremely complex. Those that publicly state that there is one reason that are getting hurt are just sensationalizing the issue for personal gain and do not have the education or understanding of this extraordinarily layered topic.

It is important that all the members of Dub Baseball understand our thoughts on the topic and how our views affect the functioning of this program, especially with how we deal with our pitchers. The easiest way for me to present this to all of you is to explain the various reasons for arm injuries, give our perspective on the issue, and detail a counterpoint to each explanation so everyone can understand both sides of the argument. I will then wrap up the explanation with some closing points and hopefully present a conclusion that everyone can comprehend.

Reason #1: Pitchers throw too much/Overuse This is the most common explanation of why pitchers are getting injured more frequently than ever before. With year round baseball more popular than ever, many youth, collegiate, and professional pitchers are throwing year round. On the youth level, travel baseball programs like our own have become more popular and many athletes are specializing in the sport at younger ages. At the collegiate level, most good college players travel to different leagues in the summer and play another 40-50 games over 2 months, on top of the 50+ plus games they are playing for their schools. At the professional level, many players play in Fall or Winter leagues to keep their skills sharp. This can lead to a player playing more than 180 games over the course of a calendar year. Pitchers are often the victims of these strenuous schedules, as they are asked to throw many innings/pitches over the course of the year. Many pitchers, particularly the good ones, are asked to pick up the slack when the schedule gets tough and more innings in an outing or pitch on short rest during crucial stretches in the schedule. Despite the attention on pitch counts at all levels, it is still common place for a pitcher to throw 100+ pitches on a regular basis, some even getting towards 150 pitches in some situations. pitcher injuries accounted for $1 Billion on the Disabled List in 2013.

The New Brand of Baseball Development • Counterpoint - While the overuse argument for pitcher's arm injuries certainly has some validity, it is not the end-all argument for the issue. The fact is that throwing a baseball overhand is unhealthy and that action needs to be monitored closely. There is a reason we have all of the stringent pitching requirements in our program. But the fact of the matter is that pitch counts are more closely looked at now than they ever have been before, and we currently have more injuries than we have ever had before. So if we pay more attention to pitch counts and pitchers are getting hurt more frequently, what is the reason? This is something we will examine in this piece. Up until about 20 years ago, pitch counts were not a big factor at any level of the game. Pitchers regularly went over 100+ pitches at the high school level, 125+ at the collegiate level, and 150+ at the professional level. While this would seem absurd to do on a regular basis these days, it was done regularly back then and there were less injuries.

Reason #2: Pitchers are throwing with more velocity these days This is the reason that is being glossed over or not presented by the media. We are currently in the midst, at the professional level, of the hardest throwing pitchers in baseball history. The average velocity in MLB is the highest it ever has been in history. Science tells us that whenever we throw a baseball as hard as we can overhand, we are at the limit to what the ligaments in the arm can take. For example, the Ulnar Collateral Ligament is the ligament on the inner part of the elbow and it is the ligament in regards to Tommy John Surgery, the surgery that is getting a lot of attention in the media. Tommy John surgery entails a surgeon removing the damaged UCL ligament and replacing it with a healthy ligament from another part of the body (usually the ligament on the outside of the wrist of the non-throwing hand). When throwing a baseball hard overhand, we are putting approximately 44.6 lbs of pressure on the UCL ligament and the ligament will tear at 45.3 lbs. So every single time we throw overhand with max velocity, we are at or near the level the ligament can take before tearing (these numbers are averages from scientific studies, each individual is different). The numbers for shoulder ligaments can be similar. So it is easy to understand why throwing harder can put exponentially more stress on the arm ligaments.

• Counterpoint - There is not much of a counterpoint to this reason, the facts are the facts... pitchers are throwing harder than they ever have in the history of the game, but they are getting injured at a higher rate than ever before. The real issue is our obsession with velocity. Pitchers with higher velocities are the ones that get the college scholarships and get drafted into professional baseball. Pitchers with lower velocities are often overlooked and need to prove themselves much more than pitchers that throw harder. This is not going to change anytime soon. Pitchers that throw harder are much more difficult to hit and they have the most upside when projecting them to the upper levels of the game. So while we work hard to maximize velocity, we need to understand that this increases our risk of injury.

Reason #3: The success rate of surgeries is much higher now There used to be a heavy reluctance to get an arm surgery, particularly Tommy John. The success rate was not high and the recovery was 18-24 months. This was a strong deterrent to not get the surgery and most basically just keep throwing until the arm blew out, then quit the game. That did not get much media attention, but it was a very common occurrence. In the last 10 years they have greatly improved the success The New Brand of Baseball Development rate and recovery time for Tommy John surgery. The surgery has improved with different methods and the standard recovery time is now 8-12 months (I have had a pitcher come back in 8 months with full clearance). The success rate is now 70- 80%. The rehab has also gotten much better and more aggressive, and this is leading to pitchers coming back better than they were before. This is not because the new ligament gives them some bionic arm, but because the pitcher learns proper arm care when going through the rehab process. This whole scenario makes pitchers much more comfortable and confident in getting a surgery done. What once was perceived as a 2- year rehab with little guarantee for a full recovery, now looks to be a solid option for long term health and success. Pitchers are much more willing to get the surgery now because the high chance of success, which has led to many more surgeries being performed. 13 pitchers in the MLB All Star game last year had Tommy John surgery at one point in their career.

• Counterpoint - Surgery is still a risky option and can be negatively viewed by college coaches and professional scouts. Some colleges and professional organizations have an open mind and understand the dynamic of pitcher injuries, while others view a pitcher that has had a surgery as damaged goods. Even at its best, 80%, Tommy John still poses significant risk for a young pitcher. The success rate is lower for shoulder surgeries, the most common being a SLAP (Sub Labrum) tear that has around a 60% success rate.

Reason #4: Poor Mechanics While proper mechanics seems to be something tangible and agreeable for pitchers, there are some very different schools of thoughts out there regarding mechanics, and how those mechanics can affect pitcher's health. We are of the thought that proper mechanics will help a pitcher perform more functionally, and therefore reduce injury risk. Having said that, it is tough to tell how important mechanics are because there are pitchers out there with horrible mechanics that never get hurt and there are some out there with perfect mechanics that get hurt all of the time. Also within the examination of mechanics is the old school vs. new school teaching of pitching mechanics (we are very much on the new school side). There are still many coaches out there that teach the old style of pitching (slow, segmented delivery) and science has shown us that this is not efficient for the body to perform an overhand throw.

• Counterpoint - Like we stated in Reason #4, proper mechanics is an arguable issue and one that does not have a direct transfer to improved health and performance. We see pitchers all the time that are touted to have perfect mechanics get hurt and need surgery ( and Mark Prior are recent examples). So while we strive for perfect mechanics to increase our performance and efficiency, it is not a guarantee for success or health

Reason #5: Lack of Functional Strength Many pitchers, particularly young ones, do not have the functional strength to perform the pitching motion efficiently. They might lack core strength or the flexibility to perform proper mechanics and to be able to repeat their delivery in a healthy manner. This is why pitchers at the upper levels of the game condition their bodies SO MUCH. To be able to minimize injury risk and perform their mechanics effectively, pitchers are usually on a very structured and aggressive conditioning schedule. When I coached in college, The New Brand of Baseball Development our pitchers did heavy weight lifting 3-4 days a week, flexibility sessions 3 days a week, cardiovascular conditioning 3-4 days a week, swimming 1 day a week, and Yoga 1 day a week.

• Counterpoint - Pitchers come in all shapes and sizes, and being strong does not guarantee a minimized injury risk. There are plenty of pitchers out there that are physical specimens that get hurt all the time, while there are plenty of pitchers out there that are not necessarily in good shape that can stay healthy. As coaches, we try to use an individual approach with each pitcher to get their desired fitness level that works for their strengths/weaknesses.

Reason #6: Pitchers Throw Too Many Breaking Balls This is one of the oldest, and most erroneous, reasons for pitcher arm injuries. There is not any scientific evidence that states that breaking balls put more stress on the throwing arm than other pitches, and this is something that has been studied extensively. In fact, several prominent studies have shown that and split fingers put the most stress on arms. Fastballs have the highest speed of throwing hand pronation after release, which puts the most rotational stress on the ligaments. The action of splitting the middle/pointer finger on a split finger pitch causes more tension on the elbow ligaments.

• Counterpoint - Despite the lack of scientific evidence that corroborates that breaking balls put more stress on the arm, we still believe in limiting breaking balls at young ages. We believe this because we feel that pitchers should learn how to first use their fastball effectively, then learn how to use their change-up as a primary off-speed pitch, and then learn how to use breaking balls. We have a way of teaching breaking ball with a progression. This is how we believe it should be done and we have experienced a lot of success using this method.

Closing Points This issues surrounding arm injuries in pitchers are extraordinarily complex. The above presentation of arguments should display that fact. Those that point at one reason for the rise in pitching injuries are oversimplifying the issues and do not have a proper understanding of all of the dynamics of the situation.

The fact of the matter is that throwing a baseball overhand is not healthy and pitchers get hurt. The pitchers in Major League Baseball are some of the best athletes on the planet. They have the best trainers, the best training regimens, and the best coaching. Despite all of these factors, they are still getting hurt at a historic pace. And while the understanding of all of these issues helps us minimize the risk of pitching, the fact is that pitchers get hurt. They always have, they always will.

Having said all of that, we hope that our deep understanding of these complex issues will enable us to keep our pitchers as healthy as possible. We limit pitch counts and give appropriate breaks to our pitchers to ensure we are not using them too much. All of the players in our program perform arm cord exercises before each practice/game to ensure ligament strength. We have a structured throwing and drill program for our pitchers to follow. We use progressive mechanical teachings to maximize body efficiency. When we open a training facility, we will be able to expand our methods for The New Brand of Baseball Development increasing the functional strength and mechanics of our pitchers. With all of this, we are fighting the good fight and doing everything we can to keep our pitchers healthy. But we will not do what others do, sell you a lie that there is one/simple solution to pitcher's health.

* Please feel free to share this with others, but these words are mine and are for reading only. These should not be used by others as their own. Sorry for having to state this, it has happened before.

The New Brand of Baseball Development