The question of whether or not young pitchers should throw breaking balls has been asked for years, and with the Little League World Series currently taking place the debate about pitch counts, curve balls and arm injuries may be ever more obvious. For years the common wisdom has been not to let young pitchers throw curve balls, although everyone knows they do anyway. A 2012 study that set out to prove that curve balls were bad failed to prove that they were any more dangerous than fast balls to young arms.
The study was conducted by orthopaedic surgeon Dr. James Andrews, founder of the American Sports Medicine Institute, and Glenn Fleisig, the institute’s research director. Andrews performed Tommy John surgery on 17 youth and high school players in 2000. This was 18 percent of all elbow reconstructions they performed that year. In 2010 they did 41 reconstructions on young players, making up 31 percent of the procedures. Most of these were high school age players.
Tommy John surgery was first performed in 1974 on a player named Tommy John by Dr. Frank Jobe. It has become commonplace, but many players having the procedure never fully return to their previous form. In the procedure a tendon is harvested from below the knee or from the forearm and used to replace a torn ulnar collateral ligament in the elbow.
Andrews and Fleisig’s study failed to prove that curve balls thrown with proper mechanics are no more hazardous to young arms than fast balls. But Andrews has challenged his own results, saying that in the reality that occurs on the baseball field most kids are not throwing with proper mechanics, especially when throwing while fatigued. He says “those are the kids I’m seeing every day in my operating room.”
Little League has considered banning all breaking pitches, but with the results of studies failing to show that they are at the root of arm injuries, Stephen D. Keener, chief executive and president of Little League International, said that they felt compelled to leave things as they are. Even advocates of banning breaking pitches at the early level acknowledge the difficulty of enforcing that rule, particularly with volunteer umpires who have all they can do to call balls and strikes.
Dr. Timothy Kremcheck is the physician for the Cincinnati Reds and an orthopaedic surgeon who frequently treats young pitchers. He said that he performs 150 elbow ligament reconstructions per year, and 70 percent of those surgeries are on pitchers who have not yet hit college.
Another common concern today is the number of pitches thrown, even more than the worry about the danger of curve balls. Most of the participants in the debate about curve balls agree that throwing too many pitches of any type is the biggest danger. Both Little League and Pony League have instituted pitch count rules and mandatory rest days to try to reduce the number of arm injuries, but with kids now playing on travel leagues and comp teams in addition to regular team play many are playing year-round, giving tired arms no chance to recover.
Little League pitch limits are 85 pitches per day for 11 to 12-year-old players, with mandatory days off between pitching appearances. Fleisig and Andrews recommend further restrictions, including a break of months from competitive play and overhand throwing, a 100-inning annual limit and not allowing pitchers to play catcher.
Most kids avoid being taken out of the game and throw through pain. Kellen Sillanpaa, a talented player who hoped to go on to pitch at the college level, may be representative of that trend. Sillanpaa says he first noticed a sore pitching arm when he was 9, but since it did not affect him he kept pitching. At 13 it did affect him, and at 16 he had Tommy John surgery. At 18 he had another surgery to repair the nerve near his funny bone, and that was the end of his baseball career. Looking back, he and his father wish they had used a pitch count to help save Sillanpaa’s arm.
Young pitchers have a harder time recovering from elbow surgery than do major league players, who have the advantage of being able to devote their full-time attention to rehab with a full gamut of specialized trainers and physicians. Young players are in a hurry. They want to get back to the game so they can be scouted for college, or play their senior year.
Anyone watching the Little League World Series will see plenty of breaking balls, although the mandatory pitch counts will help protect these young phenoms from arm injuries. Keener says there are 5 million U.S. kids playing baseball. Only around 1,500 will play college ball and only about 100 of those will make it all the way to the major leagues. He asks whether the price of a life-altering injury is too high to pay for finding out if a child is truly a prodigy that can make it all the way.
By Beth A. Balen