Minimizing the Risk of Injury in Little League Players

It’s that special time of the summer again when young players flock to Williamsport, Pennsylvania in search of the Little League World Series Championship. Watching the games on television, you can’t help but notice the young pitchers and pay attention to how many pitches they throw and the types of pitches they throw. At the youth level, it seems that the pitchers who excel are the ones who are able to learn to throw a breaking ball. At that age, it is difficult for the hitter to recognize and hit that pitch. So, often the pitcher uses the curveball or slider frequently. Recently, in the media, there has been a lot of discussion regarding overuse injuries of the youth pitcher. The conventional wisdom was that throwing the curveball at too early an age would lead to injury in the young pitcher. However, research done by several authors in the past couple of years contradicts that idea.

A couple of studies done by The American Sports Medicine Institute (Birmingham, AL) and Connecticut Children’s Medical Center (Farmington, CT) were done to evaluate and compare the biomechanical differences between the fastball, curveball, and change-up pitches. Both studies demonstrated that the stresses to the shoulder and elbow joint were greatest when throwing a fastball as compared to the other types of pitches. The authors concluded that throwing the curveball may not be responsible for the rising injury toll in young pitchers.

So, if it’s not the type of pitch, then what is responsible for what seems like an epidemic of shoulder and elbow injuries in the young baseball athlete? The answer, yet again, may come from research done at ASMI in Birmingham, Alabama. Three main risk factors seem to be more responsible for contributing to a young pitcher’s development of pain and injury: Improper Mechanics, Fatigue, and Overuse.

Improper Mechanics

I’ve wrote about this area in many of my articles and blogs, but it bears repeating again. The overhead pitching motion is a fine-tuned sequence of movements in body segments originating from the lower extremities and pelvis, progressing through the trunk, and culminating in the smaller, less powerful upper extremity structures. The better and more efficient the thrower’s mechanics, the better the chances of reducing stresses on the shoulder and elbow. Mechanical faults that alter the timing of the sequencing of events or place the body in an improper position can result in increased upper extremity forces and torques. These increases in joint stresses can lead to an increase in subsequent risk of injury. Even though the curveball, by evidence of research, is less stress full on the elbow and shoulder than the fastball, the pitch should still be taught by a qualified pitching instructor. Too often, a volunteer coach or parent attempts to introduce the breaking ball to a young pitcher. Without proper knowledge of the pitching motion and the specific grips and key teaching points, the athlete may learn incorrect technique which may surely elevate his risk of potential problems.

Fatigue

The ASMI study notes that young athletes who pitch with arm fatigue or throw more than 85 pitches per game are more likely to require elbow surgery. Younger, less experienced pitchers are unable to maintain their accuracy or level of performance as they become fatigued. The fine-tuned chain of events necessary to execute the throwing motion is altered and creates timing delays and compensations in movement and muscle activation patterns which may ultimately result in an increased risk of injury. Fortunately, many youth baseball programs have adopted limits on pitch counts per outing and mandated specific lengths of rest prior to returning to the mound.

Overuse

Along with the number of pitches per outing, the length of a young player’s “season” also impacts his risk of potential shoulder or elbow injury. Adolescents who pitch more than 8 months out of the year are also several more times likely to require arm surgery. 8 months out of the year?! This seems absurd to me. The Major League Regular Season is only 7 months long and these are mature, seasoned, developed, and conditioned pitchers. If you enjoy playing baseball, that is fantastic! It is a great game. But as a youngster, go out and play other sports too. Learn how to move, run, cut, jump. Develop your overall athleticism. As you get older, then you can begin to focus on a sport that best suits your talents. If it’s baseball and pitching, then having a better foundation of athleticism can only help you.

The moral of the story is that if your son is going to throw the curveball, he should learn how to throw it correctly. It is important to learn how to identify when he is beginning to tire and be sure to allow for adequate rest and recovery between outings. Finally, avoid overuse by allowing your young player to become a multi-sport athlete. This will allow the body physically and mentally rest from the repetitive stresses of baseball and help to develop a better physical foundation for athletic performance.

David Yeager, ATC, CSCS
Co-Founder
BaseballStrengthCoaching.com

Testing Athleticism

February marks another rite of passage for aspiring athletes. Every year, sports performance “gurus” prepare their athletes for the National Football League’s combine. Professional football prospects and team representatives descend upon Indianapolis, Indiana. There the athletes are put through a battery of physical drills and psychological tests attempting to identify elite players, determine their draft status, and predict eventual success on the field. Yet, according to a study in the Journal of Strength and Conditioning Research (Kuzmits and Adams, 2008), there is no consistent statistical relationship between combine tests and professional football performance. This is consistent with studies in other sports, such as handball (Lidor et al, 2005), rugby (Gabbett et al, 2007), and ice hockey (Vescovi et al, 2006). These studies noted that only the players’ skills, not their physiological characteristics were predictors of their playing ability. In other words, the only true measurement of an athlete’s performance on the field… is his performance on the field.

This is not to say that testing of athleticism does not have its’ place. Vern Gambetta defines athleticism as the ability to execute athletic movements at optimum speed with precision, style, and grace in the context of the sport or activity. These characteristics are all related to movement efficiency. Therefore, athleticism, by its’ very nature, aids and fine-tunes the performance of sports skills.

Analyzing athletic properties can provide a profile of an individual’s strengths and weaknesses. This is particularly true if the results are compared to the player’s performance. For example, let’s say that a right-handed pitcher is tested in the “5-10-5 Agility”. His score is rated as average when compared to other players of his performance level. However, further investigation notes that this pitcher is 0.1 seconds slower when moving to his left compared to the right. In terms of performance, the pitcher’s coach routinely works with him on locating his fastball to the far corner of the plate. One explanation of the pitcher’s poor performance on this task may be a lack of hip mobility when rotating his pelvis and trunk to the left. Decreased hip rotation can disrupt the sequential timing of events needed to place the throwing arm in the correct position to execute the throw. This ultimately results in poor efficiency of the movement and limited precision of the outcome (i.e. the inability to hit the outside corner of the plate).

Although athleticism may not predict future success in sports, it can be a useful tool in the enhancement of the skills needed for successful sports performance.

Warm-Up to Throw! (Don't Throw to Warm-Up)

It is not uncommon for a coach to call down to the bullpen for a relief pitcher to “get loose”. The pitcher immediately jumps up and begins throwing to the catcher. After a few “warm-up” throws, he tells the catcher to get down and proceeds to pump out a series of pitches at high effort and intensity. Without being aware the coach and the player are inhibiting the player’s performance and potentially increasing his risk for breakdown and injury. While it sometimes may be necessary to perform this routine due to the pace of the game or the slow situational reactions of the coach, the best approach is to perform a dynamic warm-up to prepare the body for the upcoming stresses of pitching.

Current research indicates that carrying out a sport-specific dynamic warm-up, will enhance overall strength and power while performing on the field. An active warm-up prepares the muscles and joints for performance by “turning-on” the neuromuscular (brain-to-muscle) connections that will be utilized during the sports skills.

Muscular stiffness and lack of joint mobility result in greater muscle damage after exercise. A dynamic warm-up increases the body’s global core temperature, as well as, the localized tissue temperature for the specific muscles that will be active during sports movements. When the muscle tissue is “warm”, it becomes more elastic, more flexible, and less stiff. This greater elasticity means less tissue damage and less potential for injury.

Rather than waiting for the coach to react, the pitcher should be paying attention to the game. As the game progresses to the middle innings, the bullpen pitchers should begin preparing for the time that they may be called upon. The following is a sample dynamic warm-up that can be performed in the bullpen during the game. The warm-up progresses from general to more sport-specific activities.

Relief Pitcher Dynamic Warm-Up

Jogging Down and Back in Foul Territory
High Knee Run x 10yd
Side Shuffle x 10yd
Carioca x 10yd
Walking Knee-To-Chest x 3 each
Walking Quad and Reach x 3 each
Walking Shin Grab-Hip Rotation x 3 each
Russian March x 3 each
Lunge and Twist x 3 each
Lunge and Instep Touch x 3 each
Medicine Circle Chops (6lbs) x 5 clockwise / x 5 counterclockwise
Medicine Ball Trunk Twist (6lbs) x 10
Medicine Ball Lunge and Throwers Chop (6lbs) x 5 each
Throwing Arm Tubing – Rows x 10 (stride stance)
Throwing Arm Tubing – External Rotation at the Side x 10 (stride stance)
Throwing Arm Tubing – External Rotation at 90deg Abduction x 10 (stride stance)
Throwing Arm Tubing – Diagonal x 10 (stride stance)

David Yeager, ATC, CSCS

Co-Founder, BaseballStrengthCoaching.com