An increasing amount of attention is being paid to the continued increase in the number of young pitchers that have to have Tommy John surgery to fix torn elbow ligaments. The MLB Network recently televised a discussion with a panel of experts to discuss the “epidemic” and Commissioner Bud Selig has also addressed his concerns recently as well. The concerns are not just that there is an increase in the number of these injuries, but that there is an increase when people are much more concerned with trying to prevent the injuries. You hear about pitch counts a lot these days, but as the number of pitching performances totaling over 120 pitches by a single pitcher has dropped dramatically over the past 5 years, it has done nothing to slow the injury rate. So what is the formula for actually slowing the rate of these injuries (stopping completely is impossible, but slowing them down would be a huge accomplishment)? Well, I think I have it (compiled from the opinions of a lot of people smarter than me) and one of the most important things to note is that this formula HAS to start when baseball players are just kids. When most of these guys get to the major leagues the damage is already done.
To keep this from being too disjointed, I’ll give you my formula and then come back and site reasons and other opinions afterward:
- Limit the number of pitches that you throw off of a mound. Pitching off of a mound adds to the strain and the torque you put your arm through. Even if you need to practice pitching, do it on flat ground when possible.
- Do NOT throw breaking pitches before high school. If you vary pitch speeds, arm angles and grips you can cause just as much difficulty for opposing hitters as breaking pitches and you do so without adding extra strain to your arm.
- Do not play baseball year-round. Your arm needs a break. Play other sports. It builds other muscles and gives the elbow and shoulder a rest. If you are going to play baseball year-round, then only pitch in one of the seasons. If you pitch year-round you are definitely laying the ground-work for injury.
- Throw MORE. Note… I didn’t say PITCH more. I said THROW more. Throwing more on flat ground helps build up your arm endurance.
- Mechanics matter. Spend time honing your mechanics without worrying about your velocity. The temptation is always to throw really hard to try to make guys miss. If you do that with poor mechanics then you can do more damage with every single pitch.
- Location, location, location. It’s just as easy to make guys miss with good location as it is to make them miss with high velocity. And as you get older, the velocity will improve, and if you already have good location then you are in great shape.
- Do not pitch when your arm feels fatigue. Nobody wants to pull themselves out of a game, but when your arm is fatigued you are inviting more injuries. A 120 pitch outing with no arm fatigue is far safer than an 80 pitch outing with a fatigued arm.
So now let’s go back and hit on a little more about each point:
- Tom House is a former major league pitcher and pitching coach (who also has the distinction of being the player that caught Hank Aaron’s record breaking home run in the Braves’ bullpen). Nolan Ryan credited House’s training methods for helping Ryan be in the best condition of his career when he was with the Rangers. House makes a strong case for not throwing off the mound, “We’re designed to throw on flat ground. … What happens to kids today? They pitch too much year-round and they don’t throw enough. … They only time they throw is in a practice or a game, and the pitcher’s are [throwing] off the mound. … Let them play on flat ground. Let them throw stuff, throw anything. Stay off the mound except for game day, throw as much as you can on flat ground the rest of the time.”
- I vividly remember Tom Browning, former World Champion and All-Star with the Cincinnati Reds, saying that now that he was coaching little leaguers he would pull a kid out of the game immediately if he saw them throwing breaking balls. Doing it too early is just bad for your health. It’s also definitely possible to add pitches throughout your career. Mariano Rivera didn’t add his cutter until he was already in the major leagues and Clayton Kershaw decided to add a slider one offseason even though he already had a devastating curveball. It can be done… don’t be in too big of a rush.
- This is really #3 & #7. Dr. James Andrews is probably the most well known surgeon when it comes to Tommy John surgeries. Here were some of his findings: “The basic thing that parents out there and coaches and players alike need to know is if you throw with fatigue at a young age – in high school, for example, or youth baseball – you have a 36-to-1 chance of injuring your shoulder or elbow. … Fatigue could be event fatigue, seasonal fatigue or year-round fatigue, so it’s a big problem…What we really found out is that [high school patients] only had one week off each year from competitive baseball and that one week was – you could guess what – between Christmas and New Year’s. So they’re playing year-round baseball – that’s the number one risk factor in youth baseball…If you take a coat hanger and you bend it enough times, what happens? It breaks clean, and then of course that injury didn’t begin with that last bend, it began with all of those multiple, multiple bends. It’s a developmental ligament and the stress that it will take is only about 80-miles per hour, so our high-velocity throwers in high school – unless they’ve got great genetics – are really suspect to really injure their ligament along the way.”
Mark Mulder was tweeting about the topic recently as well and he made the point about how each arm only has so many bullets. There are a finite number of pitches each person has. Now you may have really good genetics, like we all assume Nolan Ryan has, and have more bullets than others, but there’s still a limit to the number of times you can put your arm through that. (Tangent… did you know that Nolan Ryan once threw 259 pitches in one game?!) Mulder also took exception with coaches pressuring kids to pitch year-round, “Shame on any coach that tells a kid he prob[ably] won’t make team following year if he doesn’t play on other travel teams or in fall.”
- Tommy John, for whom the then experimental and now commonplace surgery was named, said that one of the things that TJ surgery pioneer Dr. Frank Jobe told him after his surgery was to make sure to throw more. Tommy John added playing catch in the back yard with his wife to his everyday routine.
I grew up in Atlanta and vividly remember watching the Braves when they had the best pitching rotations of my lifetime. I also remember hearing Greg Maddux, John Smoltz, and Tom Glavine all talk about how pitching coach Leo Mazzone would have them throw more often than any other team in baseball was doing at the time. Two of the three will be inducted into the Hall of Fame this year with Smoltz likely to follow suit in the next couple of years.
- In 2012 Lindsay Berra, writer and granddaughter of Yankee Hall of Famer Yogi Berra, did a piece for ESPN the Magazine breaking down the mechanics of Washington Nationals ace Stephen Strasburg compared to those of Greg Maddux to highlight the injury concerns present in poor mechanics. If you could study anyone’s mechanics, please study Maddux’s. He’s probably the only person to have the ability to say, “It’s not hard to throw the ball in the same spot. All you have to do is throw it the same way every time”.
Mark Mulder also tweeted about how the infatuation with hard throwers is putting the wrong emphasis on things for young pitchers. “Feel is missed when Fire is valued”.
- Again with Maddux. You knew he would throw it down and away on the corner of the plate at least once per at bat and likely more than once. It just didn’t matter. There was nothing you could do with it.
Now you will notice that I’m not telling you this as an expert on pitching or anatomy. I am simply compiling what a lot of smart people say into a logical conclusion that could help protect someone from injury. I write this as both a father and a baseball fan. We need to realize that the decisions we make when kids are young can end up hurting them significantly later in life. Parents need to get the stars out of their eyes and do what’s best for the LIFE of their children and the children they coach. (See also: Youth Head Injuries…but we’ll save that for another time).