Protecting Young Athletes' Arms

This guest blog is from Glenn S. Fleisig, Ph.D., research director of the American Sports Medicine Institute.

You can hardly look at the sports headlines today without seeing that another star pitcher has blown out his elbow and is heading for the dreaded "Tommy John surgery," which will sideline him for at least a year and perhaps curtail his career. Roughly 25 to 30 major league pitchers have the surgery every year, and one out of four has had it during his career.

This may naturally lead parents to wonder whether baseball is a dangerous sport—not just for pros, but for our kids.

The answer: Absolutely not. Baseball is a great sport and generally a safe one, especially when the proper guidelines are followed. Based upon nearly 30 years of research at the American Sports Medicine Institute, my colleagues and I have identified key factors for pitchers to minimize their risk of injury.

Last year Major League Baseball (MLB) formed a task force of medical and scientific experts, including me, to look at pitching injuries and take action to make the sport safer. The first thing we found was that Tommy John elbow injuries are indeed on the rise in pro baseball. Our opinion was that these injuries to "the big boys" are directly connected to a sharp rise in elbow and shoulder injuries among adolescent pitchers. Our task force concluded that the best way to prevent pitching was to make recommendations for all levels of baseball—from youth leagues on up to the Majors. MLB then teamed up with USA Baseball to launch a new initiative, including a website of recommendations, called Pitch Smart.

One of its key components is recommended limits for pitch counts and rest between pitching outings. The frequency and amount of pitching has been scientifically proven to be a key factor in determining who gets hurt versus who stays healthy. So kids 8 and under should be limited to a maximum of 50 pitches followed by two full days of rest before pitching again, while 9- to 10-year-olds should max out at 75 pitches, followed by four off days for recovery. (The limits gradually increase as a player gets older.)

Pitch Smart provides a number of other safety recommendations that center on what to do to protect your child's arm: avoid pitching with arm fatigue, avoid pitching on multiple teams (like a traveling and a school team) with overlapping schedules, and avoid playing both pitcher and catcher (since these two positions put the most stress on the arm). Young pitchers should also wait to throw curveballs and sliders and take at least a four-month break each year from competitive pitching.

Prevention of arm overuse is more important now than ever before. When I was a kid many moons ago, my brother Wayne (a current member of Parents board of advisors) and I would play sports with our friends year-round. Sometimes it was organized play, like the school baseball team or the town soccer league. More often than not, though, it was simply free play with friends in the neighborhood.

Clearly times have changed. No longer do most young kids wander out with the simple instructions from Mom and Dad to "Be home by dinnertime" or "Be home by dark." Free play has been replaced by organized, adult-supervised activities including travel teams and private lessons. Although the current system was created with the best intentions, it has significantly increased the risk of overuse injuries.

Besides educating parents about safe baseball practices, Pitch Smart is also engaging the baseball organizations themselves. Major League Baseball and USA Baseball recently announced the development of a program designed to assist the public in identifying organizations that have adopted our guidelines and principles. The list of compliant organizations includes Little League Baseball, Perfect Game, Reviving Baseball in Inner Cities (RBI), and Dixie Baseball Boys and Majors.

It's exciting to see how many organizations, coaches, and parents are turning to Pitch Smart for guidance. The idea behind it is straightforward and logical: Let your kids be kids. Let them play baseball and many other sports, get physical activity, and have fun—while staying healthy, so they can stay on the field.

Glenn S. Fleisig, Ph.D., is the research director of the American Sports Medicine Institute. He is an advisor for Major League Baseball, USA Baseball, Little League Baseball, Motus Global, and MomsTEAM Institute.

Photo of boy pitching via Shutterstock

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