Deciding to rest superstar pitcher Stephen Strasburg after elbow surgery was unprecedented.
Yet, the Washington Nationals’ move – albeit unpopular – sent a clear and meaningful message to all baseball players: Your health and the longevity of your career are more important than any games.
Even the playoffs.
Pitching places more stress on the shoulder and elbow than almost any other athletic activity. As a result, thousands of unnecessary injuries occur to these joints at every level of play.
The causative factors can be described as the terrible triad: too much time pitching, poor technique, and tough luck. That last factor refers to the unfortunate circumstance of learning from an overzealous coach who does not understand the principles of injury prevention.
Youngsters’ shoulders and elbows are not the same as adults’. In children, growth plates near each joint are sensitive to stresses incurred with repetitive throwing.
Likewise, ligaments surround the joint and stabilize it, and are frequently injured in the same way. In fact, injury to the ulnar collateral ligament (UCL) of the elbow is most common. Overuse injuries to the growth plates and ligaments create pain, dysfunction and instability.
The extent of injury runs the gamut from mild sprain to complete tear. The result is often less playing time during the season but, if severe, could be career-ending.
Most shoulder and elbow injuries can be treated without surgery. If pain develops, consult a doctor with experience in sports injuries. The treatment plan will include rest, ice and medication for pain.
Critical to the recovery process is an assessment of the principles outlined in this article. Correction of any deficiency is an important part of avoiding recurrent injury.
Returning to play requires not only the resolution of symptoms, but also rehabilitation, as rest leads to loss of muscle, flexibility and endurance. Regaining peak physical fitness is essential before returning to the field.
Keys to injury prevention
• Warmup: stretch, run and gradually increase intensity of throwing
• Proper technique: Learn age-appropriate skills, good mechanics, control and accuracy
• Communication: Explain how the throwing arm is feeling; stop pitching if pain develops
• Rest: Adhere to pitch counts, rotate to other positions, avoid pitching on multiple teams, don’t pitch on consecutive days and don’t play year-round
• Never use a radar gun
Maximum pitch counts established by Little League Baseball
(Age dependent and based on single-game performance)
7-8 years – 50
9-10 – 75
11-12 – 85
13-16 – 95
17-18 – 105
Age recommendations for learning:
• Fastball – 8 ± 2 years
• Change-up – 10 ± 3 years
• Curveball – 14 ± 2 years
• Knuckleball – 15 ± 3 years
• Slider – 16 ± 2 years
• Forkball 16 ± 2 years
• Screwball – 17 ± 2 years.