Injuries associated with youth baseball pitching pose serious concern for parents, coaches and physicians alike.   The incidence of shoulder and elbow pain has been reported as high as 58 percent in a given season.  This has been coupled with a dramatic rise in the number of youth surgical procedures being performed on these same athletes. In a four year period Dr James Andrews reported performing 9 Tommy John Surgeries on high school pitchers in year one to 201 surgeries in year four.  Our understanding of injuries continues to evolve, but many of these injuries and subsequent surgical procedures may be preventable.

Four significant potential risk factors for injury have been identified for youth baseball:  the number of pitches thrown (during game, season, and year), the types of pitch (i.e. curveball), pitching mechanics and physical condition.

The most current recommendations from the American Sports Medicine Institute and Little League Baseball suggest that youth pitchers avoid the use curve balls.  This recommendation poses challenges to coaches and parents on numerous levels, particularly when opposition pitchers may not adhere to the same rule set. However, there is growing data to suggest that the biomechanics of the curveball may not be fundamentally different than a fastball.  A curveball is associated with greater forearm supination, less wrist extension and a shorter stride than a fastball.  Those differences noted, the load across the shoulder and elbow may not be very different. If proper pitching mechanics can be maintained, and the volume of pitching controlled, it may be safe to allow youth pitchers to throw curveball without the concern of additional, unnecessary injury. Recent data on collegiate pitchers confirms the kinematic similarities of the pitch types.  Furthermore, the most significant data regarding injuries points much more towards the volume of pitching as the leading offender.

The goal of this study is to prospectively decrease the shoulder and elbow injury rates in youth baseball.  This would be the first study of its kind.   The ability to decrease the rate of ACL tears through dynamic strength and balance training has dramatic implications on how youth athletes are trained; it follows that we can do the same for our baseball pitchers.

We propose to take a group of 30 high school pitchers (grade 9 through 12), teach these athletes the proper mechanics of pitching, and follow them out over the course of the season. We will similarly track a group of 30 pitchers who did not go through our program.  The numbers of pitches thrown,  types of pitches thrown, days between outings and the incidence of any injury and days missed will be tracked. This data will be collected throughout the baseball season and continually correlated with injury rate.