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Limiting Pitch Counts to Reduce Injury: Is the Formula that Simple?

Posted August 24, 2016

By: Claudia Curtis, MS, LAT, ATC

As a heavily media influenced society, we’ve become hyper aware of some of the major injuries of sports. For example, we frequently note concussions in contact sports such as football and ulnar collateral ligament (UCL) tears leading to Tommy John surgery in baseball.

Football’s answer to reducing the concussion risk in young athletes has been to limit contact practice time on a weekly basis.1 Baseball has been following suit as of late, as many high school associations have adopted stricter rules on pitch and inning counts.2,3 These counts allow associations to place quantitative restrictions on a problem that is far from black and white. The intent is honorable, knowing that most elbow and shoulder injuries in baseball are chronic and related to overuse. However, if we set forth guidelines to reduce the risk of overuse, do we reduce the risk of injury?

According to Dr. James Andrews, a name synonymous with youth sports injuries and UCL reconstruction, he’s seen a five to sevenfold increase in UCL injuries requiring surgical reconstruction in high school athletes since 2000. He cites the top reasons for UCL injury as poor mechanics and overuse, noting the combination of the two is lethal to the UCL.4 Instituting the previously mentioned pitch count restrictions addresses the second risk factor of overuse, but not the first.

Imposing these limits on contact time, instituting pitch counts and limiting the age soccer players are allowed to head the ball are all designed with the noblest of intentions. The goal is to find ways to control injury risk and impose less harm on young bodies and brains. All of the aforementioned actions are technique based. My question for injury prevention personnel is, are we doing enough to address technique issues at a young age? Would we see a larger drop in injury if technique was a larger focus? With the current coaching structure in the United States, is this a reasonable approach to consider?

Resources

1. Jones, Brandon. “States Adopt Plans to Limit Contact in Football.” https://www.nfhs.org/articles/states-adopt-plans-to-limit-contact-in-football/

2. Unruh, Jacob. “NFHS Mandates Member States to Adopt Pitch-Count Rule.” http://newsok.com/article/5509251

3. Mercogliano, Vincent Z. “Why Haven’t More States Implemented High School Pitch Count Rules.” http://usatodayhss.com/2016/why-havent-more-states-implemented-high-school-pitch-count-rules

4. Berra, Lindsay. “Force of Habit.” http://espn.go.com/mlb/story/_/id/7712916/tommy-john-surgery-keeps-pitchers-game-address-underlying-biomechanical-flaw-espn-magazine