Youth baseball coaches take less blame in search for elbow injury answers

Youth league baseball coaches have been inducted into Baseball’s Hall of Shame right next to gamblers, steroid users, and ballpark vendors who sell hot dogs inside stale buns for $7. When a prominent pitcher injures his arm, the coach of the player when he was 12 is often retroactively fingered as the culprit because he let the pitcher, when he was young, throw curveballs or too many pitches.

Yet at a recent Major League Baseball owners’ meeting, which was held in the wake of a rash of arm injuries to prominent pitchers like the Miami Marlins’ Jose Fernandez, the Arizona Diamondbacks’ Patrick Corbin and the Atlanta Braves’ Kris Medlen, Major League Baseball Commissioner Bud Selig made a declaration that finally, apparently, let youth coaches off the hook and aimed for a real resolution.

“We have some great young arms, it’s very sad,” Selig reportedly said. “Let’s see if we can find some answers. Nobody has them.”

Selig created a committee to study the issue, not an inquisition to flog youth coaches even more.

Suddenly, the youth league baseball coach is not the only villain in the surge of arm injuries, which typically requires so-called Tommy John surgery, replacing the ulnar collateral ligament in the elbow with another ligament plucked from the body. It was named after the left-handed pitcher who had 288 wins, half of them after he was the first to undergo the UCL procedure in 1974.

“I have never bought into the idea that a boy throwing 40, 50 miles per hour off a small mound, and throwing in a game twice a week, was the cause of all these arm injuries,” said Jared Vailes, the coach of Team Easton, a team for 15-year-olds in the Atlanta area, and a professional pitching coach. “I’ve studied this; I’ve read everything I can about it, and I have coached kids, and you can’t blame youth league coaches.”

Any number of culprits exist, such as the presence of radar guns that encourage maximum effort from pitchers, which stresses the arm; or the pitcher’s own adrenaline, which urges him to throw still harder.

There is also the clear fact that training regimens are producing more pitchers who are throwing 95-plus miles per hour, thus there are more candidates for arm stress and arm injury.

Another argument recently presented is that pitchers have become Goliaths, 6 feet 3 and taller, and they stand tall to throw with their arms rather than the old drop-and-drive technique favored by Mets legend Tom Seaver or the 5-foot-11 San Francisco pitcher Tim Hudson. Drop-and-drive involves more use of the lower body and less stress on the arm.

Youth coaches have, in reality, been educated to take care of young arms. Many youth coaches use a pitch counter and limit young pitchers to 50 to 70 throws. If they do not have a pitch counter, coaches are under rules of their organization about a limit on innings pitched. If they are in a Triple Crown Baseball Tournament for travel teams, for instance, the coaches have a strict limit per tournament of six innings for 8- to 12-year-olds, seven innings for 13- and 14-year-olds, and eight innings for 15- to 18-year-olds.

The pitch count limits and innings pitched limits, set in the last five years, came about largely because of the influence of the American Sports Medicine Institute (ASMI) in Birmingham, Alabama. Renowned orthopedic surgeon Dr. James Andrews and his colleague and research director, Dr. Glenn Fleisig, started ringing alarm bells in the 1980s and 1990s on the overuse of young pitchers and how it could lead to arm injuries later in their careers. Little League Baseball, Inc., heard ASMI’s warnings, and limits were put on pitchers. Other youth organizations followed suit.

Fleisig disagrees with Selig about baseball not having any answers. Fleisig said “overuse” of young arms is still a dominant factor.

“We found scientifically [with] the ones doing too much competitive pitching that it was a very strong correlation to who got injured,” he said. “The [professional] pitchers today are showing up with more wear and tear. The structure of adolescent baseball has a lot to do with it.”

But Fleisig also agreed that there are other factors. He said the spigot is wide open with the numbers of pitchers being produced who touch 95 to 97 miles per hour on the radar gun.

“You could look back and say, ‘Hey, Nolan Ryan threw hard, Billy Wagner threw hard,’ and these injuries didn’t occur at this rate,” Fleisig said. “What’s different is those two guys were the exception back then. They were freaks. The ceiling didn’t go up, but it has gotten more crowded near the ceiling. Many more pitchers are stressing their arms at the 95-miles-per-hour level.”

Atlanta relief pitcher Jonny Venters, who has had two Tommy John surgeries, owns a 96-mile-per-hour sinker when healthy. He said there were 26 high school pitchers who are going to be part of the 2014 June first-year player draft who throw over 95 miles per hour.

“That’s amazing, there weren’t that many five years ago,” Venters said. “Maybe that’s why there are more injured arms. There are more hard throwers.”

So what is the solution? Does baseball really need a committee to study it?

“The solutions are pitch less or don’t throw as hard, and maybe the solution is a little of both,” Fleisig said. “The best pitchers mix it up, and they don’t use maximum effort on every pitch. It’s not like the answer is not out there.”

Fleisig also blames the presence of radar guns behind home plate. College and professional scouts hold them to measure a pitcher’s velocity. When young hurlers see the radar gun, they reach back and try to throw even harder to impress the coach or scout. College coaches are also getting more scrutiny over pitch count. The college baseball news and analysis website Boyd’s World listed nearly 350 games in which college pitchers threw 120 or more pitches in 2014.

Medlen, the right-handed pitcher for the Braves, is not so sure that overuse as a young pitcher should be blamed for the rash of injuries. Medlen underwent his second Tommy John surgery in March, but he said he was not overused as a young pitcher.

He said his arm injury had more to do with poor mechanics than overuse. One issue he does see with young pitchers is that they are being made to specialize in high school and become pitchers only, and that could have some lasting impact.

“I did not play travel ball when I was younger, I played in a recreation league,” Medlen said. “And I was an infielder.”