By Luga Podesta, MD
Podesta was the team physician for the Los Angeles Dodgers (1990-’06) and Los Angeles Angels (2010-’13). He is currently the Director of Sports Medicine at St. Charles Orthopedics and he is our Injury Prevention Expert.
It’s March and another baseball season has come. The difference this year however is that the National Federation of State High School Associations (NFHS) and specifically, New York State’s (NYSPHSAA) new pitch restriction rules for the spring 2017 baseball season take effect. Each member state association has been required to develop their own policy on pitching restrictions based on the number of pitches a player can throw during a game and the rest required after pitching. These new pitch restriction rules are designed to provide players’ arms the necessary rest they need in order to avoid serious orthopedic injuries. Restrictions are based on age (Varsity, JV/Freshman, Middle School), number of pitches thrown, and required days rest after a specific number of pitches.
Prior to the new pitching restrictions, previous rules regarding high school pitching restrictions included limitation of the number of innings a pitcher could pitch in a week’s time. High school baseball coaches will now have to work with far more defined restrictions’ that now will require a pitching restriction policy.
As a sports medicine physician I have cared for far too many, numbering into the hundreds, of young baseball players with throwing related injuries involving the elbow and shoulder every year. These rules could not have come at a better time! These injuries are occurring at rising rates and in younger and younger ages. Injuries once found primarily in professional players are now occurring at epidemic rates in high school and little league age athletes.
It is imperative that all youth, high school and travel ball coaches understand that these players are still children, still skeletally immature and has not reached full physical development (although they may appear so). Allowing them to play beyond what their body was designed to do at their age can have catastrophic consequences. There has been an epidemic rise in the rate of Tommy John surgery in young throwing athletes aged 15-19 requiring surgical reconstruction of the elbow’s ulnar collateral ligament (UCL). This procedure is often indicated for individuals who have sustained an injury or tear of the UCL resulting most frequently from overuse of the arm due to throwing.
A recent study reviewing national insurance records showed that the number of Tommy John surgeries increased by approximately 4 percent each year between 2007-2011, with that increase occurring greater than double (approximately 9 percent) among high school pitchers. That same study showed that more than half of the Tommy John surgeries were on teens between the ages of 15-19 years old.
Overuse injuries among high school baseball players are a problem that is recognized and being addressed at national and state levels like never before. Year-round playing on multiple teams, in widespread pre- and post-season games, on club and travel teams, participation in show cases, with rigorous practice schedules, with little or no rest of players’ young arms have been the identified as the primary cause of overuse and injury. The changes instituted for the Spring 2017 are a hopeful sign that arm injuries in young athletes are being taken seriously at the state and national level. Although I do not agree with NYSPHSAA’s recommendations as they are, it is a start and need to be reviewed and revised for next season with regard to players ages (not just Var,JV/Frosh etc, Post Season Restrictions and definitions regarding “days off”).
I can promise that adherence to the new pitching rules is completely worth the potential frustration that comes with following any type of new “rule” preventing injuries in the long run. On the player, coach and parent levels, I hope these new guidelines, although not yet perfect, will be embraced in the spirit in which they were developed – to protect the current and future health of our young throwing athletes.
Sources:
http://m.mlb.com/pitchsmart/tommy-john-faq/
https://www.nfhs.org/sports-resource-content/baseball-rules-changes-2017/
http://www.newsday.com/sports/high-school/baseball/nfhs-mandates-pitch-counts-in-high-school-baseball-1.12083167
http://www.timesunion.com/sports/article/NYSPHSAA-implements-pitch-counts-for-high-school-10889280.php
