Preventing Baseball Injuries: Actions Speak Louder Than Words

Written on January 3, 2016 at 7:33 am, by Eric Cressey

We're at a point in time where just about everyone knows that throwing a baseball year-round is a bad idea. Moreover, we know that it's best for kids to avoid early sports specialization. 

Dr. James Andrews has been outspoken against early specialization and year-round throwing for roughly a decade.

John Smoltz devoted a big chunk of his Hall-of-Fame acceptance speech in Cooperstown to discouraging kids and parents from early specialization and year-round baseball.

Seahawks coach Pete Carroll recently referred to the trend of kids playing only one sport as "an absolute crime."

USA Baseball launched their Pitch Smart campaign - featuring an advisory board of many MLB team doctors and athletic trainers - to prevent overuse in youth baseball.

All the way back in 2006, a landmark study by Olsen et al. clearly demonstrated strong associations between injuries requiring surgery and pitching "more months per year, games per year, innings per game, pitches per game, pitches per year, and warm-up pitches before a game" as well as showcase appearances during adolescence. Overuse is the one factor that predicts injury over and over again in the research.

A 2011 study demonstrated that players in warm weather climates had less shoulder strength and more problematic range-of-motion adaptations than those in cold weather climates. And, speaking from personal experience from having Cressey Sports Performance facilities in both states, it's been far more challenging to develop players in Florida than it is in Massachusetts. There is simply too much baseball competing with general athletic development.

These are just a few examples, too. Hundreds of professional athletes have spoken out against early sports specialization. College coaches have in some cases refused to recruit one-sport athletes. And, there are more anti-specialization posts and websites freely available on the Internet than one could possibly imagine. Yet, the problem isn't even close to going away, and injuries still at all-time highs.

Now, I can understand how some players, parents, coaches, and scouts don't stay on top of the American Journal of Sports Medicine and might have missed this important information. What I can't understand is how they'd miss it when the world's most recognized orthopedic surgeon is speaking out against it. Or how they can miss it when one of the most accomplished pitchers of the last century devotes the biggest media spotlight of his life to bashing early sports specialization. Or how they'd overlook one of the premier coaches in the NFL so vehemently putting down the practice. Or how a governing body like MLB would devote time, money, and resources to a problem that they think will have a significant negative impact on the future of the game beyond just the billions of dollars that are already being wasted on players on the disabled list.

The problem is not a lack of knowledge; the problem is a lack of action and consequences.

When you were a little kid and stole a cookie from the cookie jar - even after your mother told you it was off limits - you got punished for doing so. If you didn't have consequences, you'd keep stealing cookies. Unfortunately, this isn't an option with youth baseball. Really, the only consequence is injury, and it's surprisingly not that great a teacher.

A lot of kids and parents continue to make the same mistakes even after an arm surgery and extended layoff. They've been brainwashed to think that the only way kids can succeed in baseball is to play year-round to keep up with other kids and get exposure to college coaches and pro scouts. There are too many coaches, showcase companies, and scouting services lining their pockets by lobbying hard to make these false assumptions stick. 

If knowledge ("eating too many cookies is bad for you") isn't working, and it's hard to deliver consequences, what's the next step? You've got to make it really hard to get to those cookies - and they better taste like crap if you do manage to do so. 

Stepping away from this analogy, the big governing bodies that matter need to step up their game. Here are six quick changes that I personally feel could have a profound impact on reducing injury rates across all levels:

1. Major League Baseball needs to implement a high school scouting "dead period" from October 1 through January 1. It is entirely hypocritical for MLB to push PitchSmart, but turn a blind eye when literally hundreds of scouts are showing up for October-December showcases and tournaments that directly compete with the PitchSmart initiative. Most of the highest-profile players aren't even attending these events anymore (advisors know it's an unnecessary injury risk), and there is absolutely nothing a scout would see in November that they can't see in the spring during the regular season.

2. MLB should also mandate that no pitcher can throw in more than three consecutive games - including "getting hot" (throwing in the bullpen, but not entering the game). Some might criticize me for this, but after extensive interaction with relievers at this level, I firmly believe that bullpen mismanagement is one of the biggest problems in MLB pitching injuries. Fans and the media only see the actual number of appearances, but when you factor in the number of times a pitcher "gets hot" without entering the game, you have relievers who are literally throwing over 120 times in a season.

3. The NCAA needs to implement innings limits on freshman and sophomore pitchers. Keep freshman pitchers to 120 innings and sophomore pitchers to 140 (combining the college season and summer ball). Additionally, any pitcher who throws more than 120 innings during the spring/summer should have a mandatory 60-day period of no throwing prior to starting fall ball.

4. The NCAA should also implement a conservative pitch count limit for college starters. I think 130 is a good place to start, and while I still think it's unnecessarily high, it reins in those coaches who'll leave a guy in for 150+ pitches. Sadly, this happens far too often in college baseball these days, and there are zero repercussions (although I do commend ESPN's Keith Law for always calling these coaches out on Twitter).

5. State athletic associations in warm weather climates need to structure high school seasons to allow for athletes to compete in multiple sports. As an example, in Massachusetts, the high school baseball season begins on the third Monday in March, while the first basketball practice is November 30. If a high school basketball player wants to play baseball, he might only have a 1-2 week overlap during that month - and it only happens if his team goes deep into the playoffs.

Conversely, the high school baseball season here in Florida begins on January 18, while the last regular season basketball game doesn't occur until January 30. The state championship games take place February 23-27 - which is roughly halfway through the baseball season! There is absolutely no reason for a high school baseball season (in which teams play about 30 games) needs to start prior to March 1.

That extra six weeks would make a huge difference in getting more baseball players to also participate in winter sports and help to get a baseball out of young hands a bit longer. And, you'd see a lot more players well prepared on day 1 of baseball tryouts because they'd have more off-season preparation under their belts. It would simply force teams to play three games per week instead of two; this is exactly what's done in Northern states (and they'll sometimes play four, if weather interferes).

6. Similar to point #4, state athletic associations should also have regulations on permissible pitch counts for high school arms. I think 115 pitches is a good number.

Closing Thoughts

I should note that I actually think Little League Baseball does a solid job of disseminating information and including specific regulations within the game and between games. The changes - at least in my eyes - should rest with high school athletic associations, the NCAA, and Major League Baseball. Impact will come from the top down.

As you can see, with only two exceptions, I'm much more about managing the competitive year than I am about micromanaging pitch counts. And, the two pitch count recommendations I put out are remarkably conservative and just reaffirm common sense (which, unfortunately, isn't so common anymore). Pitch counts alone haven't proven to be tremendously effective, but do have a place when implemented alongside guidelines for managing the overall baseball calendar.

There is absolutely no reason for skeletally immature middle and high school baseball players to have longer competitive seasons than professional players.

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