Helping Young Pitchers Toss Strikes Without Arm Injuries

There’s little harm in little arms throwing an occasional curve ball. At least that’s the opinion of one of the Dodgers’ top physicians.

Dr. Frank Jobe says new tests indicate there is less danger than once thought from throwing a curve ball, often blamed for injuries in young pitchers because it is released with a hard turn of the wrist that can strain the elbow.

The real cause of arm problems among youth, say Jobe and some of his colleagues, is overuse.

Too Much Practice

Speaking at a recent injury-prevention seminar for 200 high school and college baseball coaches, Jobe said: “The problem seems to be that kids don’t follow the rules of Little League which say that you can only pitch six innings a week. What happens is that they go home and practice another four hours that day and the next day, and if they get parental encouragement, they are able to practice until their elbows are sore and that’s where the damage begins.”

Jobe, an orthopedic surgeon, said tests performed on eight major league pitchers, for more than an hour each, reveal that they absorb no greater strain from throwing a curve ball, which drops when crossing the plate, than they do from throwing a fast ball, which travels in more of a straight line.

“Even though you can’t say scientifically that you will get the same results on kids that you got on adults, you can suppose it might work that way on kids,” Jobe added.

Unknowns Remain

He cautioned that it is still not known how many curve balls it takes to hurt the young pitcher’s arm, so it is better to throw predominantly fast balls and concentrate on accuracy. Parents, he noted, can help ensure the prevention of injuries by monitoring their children and establishing priorities.

Dr. Frederick Bost, orthopedist for the Oakland A’s baseball team, said he tended to believe the theory but that there had not been enough research done on Little League pitchers to verify it.

Bost said the research assumes that Little Leaguers throw with the same motion as major league pitchers.

He also said that the major league pitchers tested for the study might throw differently in Jobe’s laboratory than they would in a game.

To get at the facts regarding elbow injuries, Jobe attached electric wires to the arm muscles of major league players while they pitched in the Biomechanics Laboratory at Centinela Hospital Medical Center. The pitchers suffered equal strain throwing curve balls and fast balls, he said.

Dr. Lewis Yocum, orthopedic surgeon for the California Angels and Jobe’s associate at Centinela medical center, participated in the research. It is also supported by Dr. Arthur Pappas, medical director for the Boston Red Sox.

Jobe said the problem resulting from curve balls, sometimes called Little League elbow, is painful but probably not harmful. Permanent damage usually begins to develop from injuries sustained after the Little League years, he said, when the youngster is 13 or 14.

At that time a loss of blood supply to the elbow joint can loosen a piece of cartilage and bone which is “a precursor of arthritic change which can affect the player’s life,” he said.

The problem, called osteochondritis dissecans , is usually caused by overuse and is signaled by swelling and soreness as well as locking of the elbow. Pitchers who suffer pain should stop throwing until the pain subsides, said Jobe, and see a doctor if it continues.

Fun Comes First

“Probably the most important thing in Little League is to establish a purpose: fun, interpersonal relationships with peers, motor skills and hand-eye coordination are the goals,” he said. “Winning is the least important aspect from any standpoint: physical, sociological, psychological.

“The old adage that if you have a little pain, play through it, is a terrible thing. Just because a few people have been able to do it doesn’t mean it’s right. It’s more likely to cause damage in the joint than to make you play well.

“We have to realize that not everyone has the same (physical) equipment,” said Bost, who also made a presentation at the seminar. “Some kids cannot be be expected to play as long or throw as hard. What’s overuse for one person may not be for another.”

“There have to be guidelines (on limits),” said Pappas, who also addressed the conference. “And parents have to be advised. As (children’s) bones and joints are developing, they will not tolerate the same stresses as (those of) adults.

Climate Differences

“This whole thing of frequency is much more of a problem in this part of the country,” Pappas continued. “It’s exceptional in New England when you find a 14-year-old who pitches more than four or five months a year. Whereas by that age out here a successful pitcher could pitch 10 to 12 months a year.”

Pappas said one successful major-league pitcher told him that his father understood his developing bone structure and refused to let him pitch competitively until he was 14.

“If you can’t control their (pitching) environment, I don’t think that’s a bad idea,” he said.

Pappas said, “More and more young people are devoting 12 months a year to one sport. Two problems arise. One is that the continual demands on the same parts of the body as they are growing may cause significant physical injury. The second is the psychosocial cost of expending 10 years of your life and really not being a champion.

“A lot of these kids, when they get to be 15 or 16, have spent so much time doing these things that they have problems. If you’re a 15-year-old gold medalist, then you’ve got your medal, but if you’ve come in fifth in the Midwest regionals of your sport, where are you? You’ve got your own achievement, but you haven’t reached goals others set for you and, in many instances, it’s interpreted that you have failed.”

Overall: Out of Shape

Pappas said that although today’s athletes are better conditioned than their predecessors, most young people are in terrible shape.

He said the majority of youngsters are active until the age of 9 or 10. After that, the opportunity to remain active falls mostly to talented athletes who are selected for competitive programs.

“The number of kids in high school who are not on teams and who participate in physical activities is minimal,” he said. “In the mid 20s, after the individual has graduated from college and worked hard to get established on a job, the interest in physical conditioning begins to reassert itself. A chart of the interest in fitness would take the figure of an hour glass, with the low point in the middle about high school or college age.”

Injuries to athletes are most obvious on professional teams such as the Dodgers, where an arthritic pitching elbow ended Sandy Koufax’s career in 1966 and a ruptured knee tendon limited slugger Pedro Guerrero to 31 games last season.

Leagues Set Rules

Nevertheless, injuries occur in youth baseball, and many leagues enact rules to prevent them. In the Babe Ruth League Inc., for example, pitchers between 13 and 15 years old may throw no more than seven innings per week, while in Pony Baseball Inc., players from 11 to 16 can pitch only 10 innings per week.

League officials say that injuries are infrequent. A Little League study of 5 million players in 1967 showed that fewer than 2% were injured. Among them, 41% suffered contusions and 19% fractured bones.

Dr. Ralph Gambardella, a team physician for the Dodgers, said moderate conditioning could help prevent many of those injuries.

“A young person may get away with (not doing) it sometime because he can rehabilitate more quickly,” Gambardella said. “But sooner or later he is going to get injured. There are three key areas: flexibility, strength and endurance.

“It’s important nothing is taken to excess,” he said. “Usually the child doesn’t want to take it to excess. Frequently, that is the result of parents’ expectations. It’s the overuse syndrome again.”