May 4, 2021
Protecting the Adolescent Arm, Part II — What Can You Do?
P.J. Gardner, MS, LAT, ATC, CSCS, PES

Last March I wrote an article on protecting the adolescent arm just before COVID-19 invaded our lives. High school baseball as-well-as just about everything else shut down for the next two to three months because of the coronavirus outbreak and young athletes everywhere were left with few options to play. Some club baseball programs were allowed to continue on through the summer months. Many high schools canceled spring sports and life, in general, came to a standstill. Fast-forward one year.

As with all sports, COVID-19 disrupted all sport-training programs — at least temporarily. Almost everything went virtual very quickly. This continued through the summer, fall — although some fall sports were able to get through shortened seasons — and now the repercussions of the restrictions are working into the winter sports schedules across the nation. Already winter and spring sports and practice schedules have been scaled back to an abbreviated version of a full season in most states. At least some sports can play and it is different in every state.

Photo: Wesley Sykes / Great American Media Services

Now we are looking at many sports programs and athletes that have lost valuable training and preparation. The purpose of this article is to review and reiterate the importance of the first article’s points now that baseball season is only a few months away. The opening statement in the first article by Jeff Passan’s book – The Arm still applies: “Baseball knows little on how to protect arms.” This is one of the most informative books on how young arms are pushed in the various levels of baseball described well by the subtitle — Inside the Billion-Dollar Mystery of the Most Valuable Commodity in Sports

Let’s see why.

The Continuing Concerns

Nothing has changed. The rotator cuff and the ulnar collateral ligament are the two most susceptible areas to injury for the young pitcher. The physical demands of throwing harder require physical maturation that the younger pitchers don’t have yet (think open growth plates) and parents, coaches, and athletes themselves need to understand that velocity comes with proper physical training, maturation, and good coaching. This cannot be understated!

The first article included more detail on specific structures and conditions of the shoulder and elbow. This article is also meant to directly address ways to decrease shoulder and elbow injuries to the young pitcher.

Here are the ongoing concerns:

  • The major concern is still overuse of the throwing shoulder and elbow in the younger pitchers and now with less time to prepare, it is even more important to address current issues.

  • Some pitchers that play year-round are not getting adequate rest.

  • Too many 13- to 17-year-old pitchers suffer elbow and shoulder injuries that are preventable.

  • Specific guidelines from professional organizations such as the American Sports Medicine Institute (ASMI) and the American Academy of Pediatrics (AAP) as well as local and state sports organizations are not being followed or enforced properly.

  • Pitch counts may not always be enforced.

  • A maximum number of innings pitched per season and year has to be established for each age group.

  • Showcases, personal pitching coaches – (and their programs) need to be documented and included in overall pitch counts.

  • Subjective pain has to be addressed.

  • Objective signs of fatigue can be subtle and difficult to see.

What Can We Do?

Photo: Wesley Sykes / Great American Media Services

I urge all coaches, athletic trainers, parents, athletes, and other healthcare professionals to make every effort to enforce pitch counts. I think this is the most important action anyone can take.

Don’t be hesitant to remove a pitcher in the middle of a close game because he has reached his maximum pitch count. Protect his arm now!

Parents must inform/discuss with coaches any upcoming showcases or if an athlete is working with an outside pitching coach. This helps the pitch count continuum for the season/year. Communication is the key!

Communicate with summer league and club coaches pitch counts of the previous season to ensure adequate rest between seasons and total rest for a given year. This is where a disconnect usually happens.

» ALSO SEE: Protecting the Adolescent Arm

All parents, coaches, and athletic trainers must require young pitchers to rest from throwing a baseball two to three months each year — as recommended by the ASMI and the AAP. This is where some parents feel more (training and throwing) is better. Not so.

Listen to an athlete’s subject complaints of shoulder or elbow pain and take them seriously and get them evaluated by a healthcare professional as soon as possible.

Look for physical signs of fatigue when pitching and take action to relieve the pitcher.

Final Thoughts

I know these are hard rules (guidelines are too vague) to follow because I see and hear the challenges every year from all parties involved. It comes down to protecting the arms of young athletes so — as they develop and go to the next level, they will be mentally and physically prepared to excel without having suffered a major injury. This is the ultimate goal (or at least it should be) and will prolong their athletic career.

My hope is that through continuing education and communication with baseball coaches, parents and athletes we can convince young pitchers and all who work with them to take all the necessary precautions to reduce arm injuries and protect their future. The question I have for you is: What can you do to make this happen?

P.J. Gardner, MS, ATC, CSCS, PES has been the Athletic Trainer at Liberty High School in Colorado Springs since 2001. He has written sports training-related articles in various publications over the years. He can be reached at [email protected].

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