Sports medicine experts in Illinois are leading a preemptive strike against high school overpitching in the U.S. Parents and players envision scholarships, while coaches eye the empty spot in the trophy case.
Concerned that only eight states have pitch count regulations for high school pitchers (Minnesota, Colorado, Alabama, Arizona, Kentucky, Wisconsin, Vermont, Oklahoma), sports medicine physicians at Midwest Orthopaedics at Rush (MOR) are joining forces with athletic trainers and pitching experts calling for all states to regulate pitch count for what they call an "epidemic" of shoulder and elbow injuries of youth pitchers in this country.
‘Improper core and leg strength may be a key component of fatigue and ultimately injury in pitchers, thus, limiting pitches and instituting mandatory rest and cross training is essential for the health of throwing athletes.’
"Elbow and shoulder injuries in throwing athletes have increased greatly in the past decade and there is no sign of them slowing down because young elite pitchers are throwing faster and harder than ever in hopes of playing college ball and making the pros," admits Dr. Greg Nicholson, MOR sports medicine physician. "That's why it's imperative for all high school state associations throughout the country to take action and regulate high school pitch count."
However, MOR sports medicine physicians, who are team physicians for the Chicago White Sox, have their eyes on the long-term effects of shoulder and elbow overuse.
MOR physicians have completed a series of studies investigating the health of young throwing athletes and all reach the same conclusion: high school pitchers are throwing too much without proper recovery time. They also believe they should play more than one sport, rest between seasons and do appropriate warm ups and strength training.
"Our most recent study found that improper core and leg strength may be a key component of fatigue and ultimately injury in pitchers," explains Dr. Charles Bush-Joseph, head team physician for the Chicago White Sox and sports medicine specialist at Midwest Orthopaedics at Rush." As pitchers became fatigued, trunk rotation timing begins to falter and shoulder and elbow pain may increase."
Additional authors on the study were Midwest Orthopaedics at Rush sports medicine physicians Drs. Anthony Romeo and Nikhil Verma.
MOR researchers and physicians have also conducted several studies about the rising number of Tommy John surgeries to repair the ulnar collateral ligament in the elbow. Tommy John surgery is a procedure in which a healthy tendon extracted from an arm (or sometimes a leg) is used to replace a torn ligament in the elbow. Perhaps the most notable study found that teenage athletes make up the fastest-growing segment of patients undergoing Tommy John surgery. The research was headed by Dr. Anthony Romeo with co-authors Drs. Bernard Bach, Bush-Joseph and several others.
"Ten years ago, Tommy John surgery was considered a treatment option used primarily for Major League Baseball (MLB) players," says Dr. Romeo. "Today, more than half of all Tommy John surgeries are for patients between the ages of 15 and 19. That''s because young athletes are throwing harder, faster, and perhaps most importantly, playing all year round."
Dr. Bush-Joseph, who reviews the medical records of all players eligible for the MLB draft, says in the past 10 years, he has seen a dramatic increase in potential pro ball players who report having had Tommy John surgery. Dr. Bush-Joseph believes the number of Tommy John surgeries in pro baseball players is slightly decreasing, most likely because of the greater awareness at the highest levels of baseball. That compares to the numbers of Tommy John surgeries for high school athletes, which continue to rise.
Dr. Bach, founder of the MOR sports medicine program, notes, "On average, less than one percent of high school baseball players will be drafted into the MLB. Since shoulder and elbow injuries may lead to chronic injuries later in life, we educate ball players and parents that the risks sometimes outweigh the benefits."
Making Sure Overhead Athletes Aren't in Over Their Heads
To help educate coaches, parents, players and high school association members, MOR physicians, along with members of the Illinois Athletic Trainers Association (IATA) and the National Pitching Association are participating in a program called Shoulders for Life, which encourages limiting pitches and instituting mandatory rest and cross training is essential for the health of throwing athletes.