By By Mitch Freeman Madison County Record
Prevention is the best medicine when it comes to baseball pitching injuries, according to orthopaedic surgeon Dr. Stanton B. Davis, M.D.
The number of pitches per game, getting enough rest between pitching appearances, and not throwing breaking pitches until a young pitcher's arm is mature enough are key points, Davis said.
Most of the injuries Davis and his colleagues see are strains and sprains, which usually are the result of overuse (too much pitching without adequate rest).
A strain is a stretching or tearing injury to a muscle or a tendon. Muscles make body movements possible and tendons connect muscles to bone. A strain occurs when a muscle or tendon is stretched too far or when a muscle is stretched when it is contracting.
A sprain is a stretching or tearing injury to a ligament. Ligaments hold our skeletal structure together and prevent abnormal movements. A sprain occurs when a ligament is stretched to far, Davis explained.
In the case of a baseball pitcher, a sprain usually occurs where the shoulder and upper arm join or at the elbow. A strain is usually associated with the muscles in the upper arm. Symptoms include swelling, pain and bruising.
Davis recommends application of ice as soon as possible to reduce swelling and pain.
Davis recently attended a conference where Dr. Joseph Chandler, team physician for the Atlanta Braves, made recommendations when young baseball players are allowed to throw breaking pitches.
The average age to begin throwing a change-up is 11.6 years of age. The average age to begin throwing curve balls is 14.8 years and 17 years to begin throwing sliders. Throwing curveballs should be introduced at the junior high school level and throwing sliders should be introduced at the high school level.
Throwing breaking pitches puts much more stress on the arm and shoulder than throwing change-ups or fastballs. Davis said throwing breaking pitches at too early an age could result in injuries referred to a Little Leaguer's elbow or Little Leaguer's shoulder.
The growth plate is an area of tissue at each end of long bones that grows during childhood and adolescence.
Another factor in protecting young pitching arms has to do with the number and type of pitches per game. Typically, there are rules that regulate the number of innings a pitcher can pitch, but most experts agree that regulation of the number of pitches per game is more appropriate.
According to a USA Baseball/American Sports Medicine Institute survey, players 8-18 years of age should be limited to two pitching appearances per seven-day period. Pitchers should rest for three days between appearances.
The following recommendations are offered: * Pitchers ages 8-10 should not throw more than 50 pitches per game; only fastball pitches are allowed. * Pitchers ages 11-12 should not throw more than 70 pitches per game; fastball and change-up pitches are allowed. * Pitchers age 13 should not throw more than 75 pitches per game; fastball and change-up pitches are allowed. * Pitchers age 14 should not throw more than 75 pitches per game; fastball, change-up and curveball pitches are allowed. * Pitchers age 15 should not throw more than 90 pitches per game; fastball, change-up, knuckleball and curveball pitches are allowed. * Pitchers age 16 should not throw more than 90 pitches per game; fastball, change-up, knuckleball, slider, forkball and curveball pitches are allowed. * Pitchers ages 17-18 should not throw more than 105 pitches per game; fastball, change-up, knuckleball, slider, forkball, screwball and curveball pitches are allowed.
Davis is associated with The Orthopaedic Center, which has a location in Madison and four other locations in the Huntsville area. He earned his credentials at Stanford University and has considerable experience in sports medicine.