Pitching and Tommy John Surgery. Is Your Child Next?

From 1996 to ’99, Dr. Andrews performed Tommy John surgery on 164 pitchers, 19 of whom were high school aged or younger. From 2004 to ’07, those numbers had increased to 588 total pitchers and 146 high school or youth league players — a sevenfold increase.

The recent 18 inning battle between Jesuit and Rummel in baseball has gotten a lot of national attention lately, and not just because of how good the game was. Each starting pitcher threw over 150 pitches. And as a result the question of pitch count has come up again.  How many pitches are too many?

The research has found the following results:

  • Pitchers aged 9-14 throwing 75-99 pitches/game have 52% increased risk for shoulder pain
  • There is a 234% increased risk of elbow pain with 600-800 pitches/season
  • 80 pitches/game leads to 4x greater chance of requiring elbow/shoulder surgery
  • Competitive pitching for greater than 8 months/year leads to 5x greater chance of requiring elbow/shoulder surgery
  • Fatigued pitchers have a 36x greater chance of injury

These stats should be alarming, especially if your child is playing travel ball or on multiple baseball teams. Throwers are limited by their throwing mechanics, their  strength, their stability, and their physical maturity. Too much throwing can certainly leave a player at risk for permanent damage.

But like any learned activity pitching improves with practice. And more repetitions can help the athlete to become proficient. Unfortunately with repetition comes the risk of overuse injuries. And so for athletes there is always a balance between doing enough to master their craft, and doing too much causing injury and damage.

For us in the injury prevention and rehabilitation, the question is how can we help protect athletes and make them more suited for their athletic activity. One clear step is to develop more educated parents and players.

The first way for a parent to help their child avoid injury is to get involved in the process. Give your child the tools he needs to succeed and pay close attention to your child’s behavior. Here are 4 ways to help limit your child’s risk of throwing injury:

  1. A physical evaluation: Strength, flexibility, muscle balance, and coordination are all keys for good pitching mechanics. A physical therapist, an orthopedist, or an athletic trainer with experience in sports medicine would be a great start to identify potential weaknesses.
  2. Technical training: Good throwing mechanics are essential. Have a specific throwing/pitching evaluation from a knowledgeable coach.  Someone who has experience at least at the college level is recommended. But do your home work and select your coach wisely.
  3. Regular monitoring– injury checks:  Have your child’s arm assessed regularly throughout the season. More often as soreness and the season goes on. A physical therapist, orthopedist, or athletic trainer who is active with sports medicine and rehabilitation can be very helpful in determining how much your child should be throwing.
  4. Stay engaged: Bottom line is that as a parent you need to be engaged and pay attention. Children want to perform, they want to please, and they want to perform well. Sometimes to their own detriment.  You know your child better than anyone else. Don’t be afraid to step in and get help.

For a FREE consult,  more information on throwing, injures and specific training,  call or stop by our office, like us on Facebook, or follow us on Twitter.

Here are 2 great resources for more information on pitching injuries:



Prevent Running Injuries and Muscle Imbalances

If you could correct for the variables that make you vulnerable to running injuries, would you?

Most runners like to do one thing… Run!

But the act of distance running lends itself to muscle imbalances which can lead to movement dysfunction, overuse, and injury.

Common imbalances for runners include:

  • Hip flexor tightness
  • Lower back tightness
  • Calf tightness

These imbalances can lead to what is called lower crossed syndrome, a movement dysfunction where tightness in one muscle group causes weakness and overstretching in the opposing muscles. So as the hip flexor muscles become tight, the gluteals become weak.  Likewise, as the low back muscles become tight, the lower abdominal muscles become weak. Uncorrected, these imbalances can set you up to be on the sidelines for the next race.

To avoid lower crossed syndrome and the aches and pains that go along with it, add these exercises to your routine:

  1. Hip flexor stretch
  2. Soleus stretch
  3. Bridges
  4. Posterior pelvic tilt
  5. Cat and Camel

1. Hip Flexor Stretch: Hold a arms together overhead. While in tall 1/2 kneeling position, reach arms up and towards the left. Rotate towards the up knee to feel a stretch in the front of the right leg. 15 sec hold, 3 reps.

2. Calf stretch: In 1/2 kneeling position, shift weight forward to feel a stretch in the back of the lower calf. Make sure to keep your heel down. Hold 15 sec, 3 reps.

3. Single leg bridge: While lying on back, perform a 2 legged bridge, then extend one leg. Hold for 30 sec each leg, 3 times each.

4. Posterior pelvic tilt: lie on back, press your lower back to the floor by pulling in your lower abdominal muscles.  Repeat for 10 repetitions holding for 10 seconds.

5. Cat/Camel: while in a hands and knees position, pull lower abdominal muscles in to round out your low back, then allow your back to sag. Repeat 10-15 times.

For more information on running, overuse injuries, and training techniques like us on Facebook, follow us on Twitter, or contact our office.