What We Don’t Know In Athletics Can Hurt Us

What we don’t know can hurt us.  Those words are true across much of sports, but especially when dealing with kids.  Young athletes depend on parents and coaches for knowledge and guidance for the few decisions left up to them.  How much to train, how much to listen to their bodies and how much to rest are influenced by the advice of adults.

Unfortunately, many parents and coaches are driven by emotions rather than data.  Wanting to see their player and the team succeed, they push the limits of physical endurance since they often don’t have objective data with warning signals that a training threshold has been crossed.  Coaches often don’t know what a player does after they leave a training session, while parents don’t get accurate details of the workload that their son or daughter endured while at practice.  Now, new research highlights this miscommunication in baseball with surprising statistics about the injury rate of young pitchers.

In most sports health disciplines, the last several decades have seen improvements in the knowledge, treatment and outcomes of sports-related injuries or conditions.  Not true for baseball pitchers.  According to Joseph Guettler, M.D., an orthopaedic surgeon and sports medicine specialist at Oakland University School of Medicine, serious arm injuries requiring surgery are occurring an incredible 16 times more often than 30 years ago.

Guettler and his colleagues developed a survey to ask pitchers, with ages between 9 and 18, about their pitching habits, quantity and any soreness or injuries they encountered.  “Our goal was to develop a national study so that we could look at pitchers from all over the country,” said Guettler. “The ultimate goal was to figure out what was going on. What risk factors were associated with injury and what could we do to cut off this rise.”

The American Orthopedic Society for Sports Medicine sponsored the three-year study.  Dr. Guettler describes the study in this video.

In what became the largest national study of its kind, 754 boys, with an average age of 14, participated from across the U.S.  Stats on their pitching habits included:

  • pitching 5.2 months per year with an average of 5.4 innings per week, but 13% pitched for more than 8 months in one year.
  • 56% pitched on back-to-back days with 19% pitching more than one game in a single day.
  • half pitched for a travel team and 42% attended a pitching camp while â…“ played for more than one team.
  • throwing curve balls, known for the strain on the arm, at an average age of 12 years old.

The standout stats detailed the alarming injury rate:

  • one third of the 754 boys reported a pitching related injury in the last 12 months
  • 70% endured arm tiredness in the last 12 months
  • 40% had significant arm pain in the last 12 months

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“Our research team and colleagues from around the country, saw several recurring themes,” says Dr. Guettler. “It became very clear that dangerous pitching behavior is occurring among pitchers as young as little league all the way through their high school years.”

So, given all of the national guidelines for young pitchers, why are coaches and parents ignoring expert advice and allowing their sons to overuse their arms?  It turns out the fault may fall more with the parents and pitchers, especially when the player is on multiple teams. “The blame doesn’t usually lie with the leagues or coaches,” warned Guettler. “Most were found to be adhering to nationally recognized guidelines for pitch limits and rest. It seems much of the blame lies with behavior of parents and their kids.”

Are parents intentionally trying to hurt their kids?  No, but without a hub of data to record practices, games, pitches thrown, soreness and other important variables, both the parent and the athlete lose track of the workload during the season.  As with any athlete, baseball pitchers need a training log that can also be accessed by their parents and all of their coaches.  Plotting physical activity and the body’s reaction to it over time will not only show trends leading to injuries but also performance ups and downs.

To help prevent injuries, Dr. Guettler recommends his “Rule of Ones” for pitchers to avoid overuse injuries:

  • One game per day followed by at least one day of rest
  • One team at a time
  • One pitch type only, prior to high school (not a curve ball)
  • One season per year playing a different sport
  • One complaint of arm soreness or tiredness results in one week of rest

By tracking data and setting rules for responding to this new information, young pitchers can enjoy years on the mound.


Daniel Peterson is an author and consultant specializing at the intersection of neuroscience and sports performance. He is the co-founder and director of 80 Percent Mental Consulting, along with Dr. Leonard Zaichkowsky, world-renowned sports performance psychologist and former professor at Boston University. Their new book, The Playmaker’s Advantage,  published by Jeter Publishing/Simon & Schuster, is available wherever books are sold.

National data actively tracking the safe return of youth sports activities

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