Poor form, overuse lead to pitching injuries, doctors say

If you are going to throw the ball, you need to learn how to throw it right. It's about learning the mechanics. That's a given. But it also might be the solution to a common pitching problem many youth pitchers face: Little League elbow or Little League shoulder.

Tracy Wheeler And Mary Meehan of Knight Ridder write the following article, which appeared in the Lexington Herald-Leader, June 20.

Among pitchers younger than 12, as many as 45 percent complain of chronic elbow pain, according to several published studies. At the high school level, nearly six of every 10 pitchers suffer chronic elbow pain.

Yet another study -- in the May/June 2005 issue of the Journal of the American Academy of Orthopaedic Surgeons -- showed that it might be even worse than that, with 50 percent to 75 percent of all adolescent baseball players -- not just pitchers -- reporting elbow pain.

"It's bad. Many parents -- and coaches -- don't understand how many pitches a kid should throw. They think, 'They're young, they're healthy, they can't get hurt,'" said Dick Schoonover, owner of the Dick Schoonover Academy of Pitching Instruction in Munroe Falls, Ohio.

For most young baseball players with throbbing elbows, the real problem is the never-ending baseball season.

Boys this age are now playing more baseball than ever. Even in cold-weather climates, baseball has become a year-round sport -- and that, more than anything, is leading to the increasing number of elbow injuries.

"There very definitely should be a limit on the number of pitches thrown during a season," said Dr. Ben Kibler, medical director for the Lexington Clinic Sports Medicine Center. From studies "it looks like about 800 pitches is getting to the overload point. You've got to understand that you can't go out and throw all the time."

Plus, he said, players are pushing themselves harder and harder to throw faster. "Everybody is throwing to match the radar gun," he said.

Since the last baseball season, Kibler said, he's had to operate on four patients for baseball-related elbow pain. He's had to tell eight players they had to stop playing to give their arms a rest. Another issue, he said, is the prevalence of young players throwing breaking pitches. Because of the mechanics of the way the ball leaves the player's grasp -- to make the ball spin, the wrist is rotated and the elbow follows -- the breaking pitch, if done incorrectly, can be harmful.

And, he said, to learn how to pitch it properly, kids have to throw hundreds of balls incorrectly. They will try to muscle their way through pitches, he said, but many young players simply don't have the strength in the legs and trunk muscles to do that.

The consequence is elbow and shoulder pain, he said. "They've got to realize that until kids have muscle, the only way they can throw the ball well or efficiently is through good coaching," he said. Combine overuse with inherent physical weaknesses, and you've created a recipe for injury, said Dr. Joe Congeni, director of Akron Children's Hospital's sports medicine center.

Congeni said most young baseball players who come to his office will heal with a combination of rehabilitation and rest -- sometimes two to three months without throwing a baseball. Others will need surgery. They're typically 8 to 15 years old. And they're almost exclusively boys because the roundhouse motion used by female softball pitchers doesn't create stress on the elbow the way pitching a baseball overhand does.

Read what the solution is here.