In the August 9th issue of The New York Times Magazine, Ron Berler wrote a critically important but disturbing article on the alarming rise of elbow and shoulder surgeries in youth sport pitchers. He cites how parents, coaches and league officials in baseball are turning a blind eye in the face of credible evidence from Dr James Andrews, the foremost sports medicine expert in the world on this topic. Andrews has repaired the joints of many professional athletes including Roger Clemen’s shoulder, John Smoltz’s elbow, Steve Carlton’s shoulder and Chris Carpenter’s shoulder and elbow to name a few.
The issues that Dr. Andrews brings up related to youth sport baseball are relevant to almost every competitive youth sport program today. The adults involved, parents, coaches and league officials are all operating on a penny-wise:pound foolish mentality. They are encouraging young athletes to over-work now, rather than to allow young athletes to gradually build up their strength, skills and endurance over time so that they can remain active and successful in their sports well into college age and beyond. This too much, too soon approach is fueled, as always by an adult over-emphasis on the outcome and winning.
As a result, we have kids simultaneously playing on several teams, nearly year round, dramatically spiking the rise in overuse injuries. For example, in 1996, Dr. Andrews noticed a disturbing trend in the number of teenage patients seeing him for shoulder and elbow injuries. In 2001 and 2002 he performed a total of 13 shoulder operations on adolescents. Over the next 6 years that number went up to 241! The increase in the number of Tommy John elbow operations was similar: 9 from 1995 to 1998, 65 over the next four years and 224 from 2003 to 2008! Andrews described this rise as an “epidemic” and felt that something had to be done about it.
As a consequence he set up a research component to his sports medicine/orthopedic practice to scientifically study the causes of sports injuries and how best to treat them. What he and his researchers initially discovered is what we would expect. The very best pitchers were the ones who were being “abused” by all of this over-use because these were the kids who were pitching all of the innings.
Why would the best kids be asked to pitch the most innings? Duhhhhh! So they could give their teams the very best chance of winning. The supervising adults are making a very dangerous deal with the devil here, trading these kids’ physical and emotional well-being and athletic future for the more immediate fool’s gold glitter of winning an “important” game or a league championship today or tomorrow!
The problem fueling the over-use was that so many parents and their kids were being driven by the lottery-like dream of being a star in high school, getting seen by a D-I college coach and landing a scholarship to ultimately make it into the Majors and sign a multi-million dollar contract. What most parents fail to realize is that kids are NOT pint sized pros and that they need 3 – 4 months of recovery each year from competitive baseball, both physically as well as mentally. Those kids who ended up having serious shoulder and elbow problems requiring surgery all had two things in common: They pitched in pain; and their arms were fatigued from overuse.
In 2002 Dr. Andrews and a biomechanics expert by the name of Glenn Fleisig presented their findings at the annual meeting of USA Baseball, the people in charge of all youth baseball programs in the country. Andrews tried to get the participants to come together about developing a unified set of rules that would ultimately protect the arms and health of these young pitchers. However, no one was really interested in what Dr. Andrews had to say, claiming that ” their own systems were working just fine.” In other words, vague to no guidelines that have been responsible for this dramatic rise in overuse injuries in these kids is working just fine!
Of the group, the only ones who paid any kind of attention to Dr. Andrews and Glenn Fleisig was Little League Baseball. In the Spring of 2005 Little League became the first youth league to implement a pilot pitch-count program. Fifty of its’ member leagues took part and adopted a limit of 75 pitches per game for 11 & 12 year olds as well as a mandatory four days of rest for any kid throwing 61 pitches or more.
Unfortunately, right from the start Little League began to water down Dr. Andrews recommendations. Two years into the pilot program they increased the pitch count to 85 without consulting Andrews! The irony of that is that Dr. Andrews is listed on the Little League website as “the world’s foremost authority on pitching injuries.” Little League’s explanation for the move:
So, let me get this straight. “Responding to our membership so that a pitcher has a chance to throw a complete game” means that it is much more important for a kid to have a chance at throwing a complete game than it is to protect that child’s physical well-being! What’s that about? Winning and outcome are more important to “the membership” than the safety of these young kids!
The very next year when Little League rolled out the program to its’ entire membership, they cut the four day rest period in between games to three, once again without consulting Dr. Andrews! Why? Because the member leagues and volunteer coaches wanted to make it easier for pitchers to pitch more than one game a week! And who would know better about the welfare of these young kids’ arms than the volunteer coaches! Give me a break!
At the most recent Little League World Series, a 12 year old pitcher from Hawaii pitched four games in a space of 10 days, throwing 288 pitches, all within league rules. To put this in perspective, author Berler cited Red Sox ace Josh Beckett pitching two games and throwing 201 pitches over that same 10 day time period!
When asked to comment about the workload of these young pitchers, the head athletic trainer for the LA Dodgers, Stan Conte said,”We wouldn’t do that! A manager or coach would lose his job if he did. We look at a starting pitcher every five days – an older guy whose mechanics are good and, when everything’s right, is throwing 100 – 110 pitches per week. And this is with years of training!”
To be fair to Little League Baseball, at least they have partially adopted Dr. Andrews recommendations. That’s more than can be said for the other organizations under the USA Baseball umbrella. To me, the issue is quite clear. We are placing far too much emphasis on winning and meaningless statistics at the risk of our kids’ emotional and physical health. If the adults involved in youth sports can’t use their own common sense and the available research of world renown experts to guide their sports specific treatment of our kids, then who can we turn to to help us protect our children?
