Healthbeat Report: Pitching Injuries

May 14, 2009 These sports are not usually considered dangerous for young players, but there are risks.

When it comes to rough and tumble sports, baseball usually doesn't come to mind. But many doctors and coaches agree that throwing a baseball is one of the fastest and more violent maneuvers the body can experience.

Overuse injuries are on the rise among younger players. And there's new concern about the windmill softball pitch.

Jori Boren, 15, can rocket in a softball at about 62 miles per hour. Chris Skiniotes' pitching has been clocked at around 82 miles per hour.

These talented young athletes have more than speed in common. Unfortunately, they both suffered serious and surprising injuries to their shoulders.

"I felt a pop in my shoulder and I was like, oh that's not right," said Jori Boren, softball pitcher.

Jori isn't sure how she messed up her shoulder but it needed to be fixed with surgery. Her injury doesn't come as a shock to Nikhil Verma. His study at Rush University medical center is challenging the long held belief that the windmill pitch used in softball is easy to tolerate.

"I think the first thing we need to recognize is that overuse injuries do happen in the windmill pitch and so we need to kind of dispel this myth," said Dr. Nikhil Verma, Orthopedic Surgeon, Rush University Medical Center. Watch the full interview with Dr. Verma.

In a special motion, lab players did both windmill and over hand pitching. The results are eye catching. Muscle activity during the windmill throw is almost twice as active as during over hand pitching.

"That could be a cause of the anterior shoulder pain or biceps pain that we are seeing in these athletes," said Dr. Verma.

It's not just baseball careers that are threatened. Injuries to growth plates in the elbow or shoulder can leave permanent damage.

Many experts believe overuse is the main reason for these injuries. And that many younger athletes keep playing through the pain.

"It was a sharp pain whenever I would lift anything or do anything," said Chris Skiniotes, baseball pitcher.

Chris was used to being sore after a game. But then it started to hurt while throwing the ball.

"Post activity soreness is common, activity related pain is not," said Dr. Charles Bush-Joseph, orthopedic surgeon, Rush University Medical Center. Watch the full interview with Dr. Bush-Joseph.

Orthopedic surgeons at Rush say they are seeing an increase in more serious arm injuries. They recommend players and parents pay more attention to throwing mechanics and conditioning exercises. And they're supporting newer little league rules that limit the number and kinds of pitches youngster should throw.

For example nine to 10-year-olds are limited to no more than 75 pitches a day. For 17 to18-year-olds the daily limit is 105 pitches.

"Our recommendation to parents even kids who are really accomplished athletes should take at least a three month block off from a throwing sport like baseball," said Dr. Bush-Joseph.

Chris wonders if he and his parents had known more about pitching injuries when he was just a young boy if he could have avoided surgery. He now pays more attention to technique and how he feels.

"He's learned proper arm maintenance which is something a lot of pitchers don't learn you know. Now he understands and we understand that what comes natural sometimes needs help," said John Skiniotes, father.

Both Chris and Jori are back playing the sport they love.

Tears to cartilage surrounding the shoulder joint are among the most common injuries for pitchers.

Dr. Verma hopes the Rush study encourages guidelines for the younger female softball pitchers similar to what Little League now requires for it's players.

Dr. Nikhil Narayan Verma
Office Address: Midwest Orthopaedics at Rush
1725 West Harrison Street
Suite 1063
Chicago, Illinois 60612
(312) 243-4244
Windmill study published in: American Journal of Sports Medicine April 2009

Dr. Charles A. Bush-Joseph
Business Address: Midwest Orthopaedics at Rush
1725 W. Harrison St., Suite 1063
Chicago, IL 60612
(312) 432-2323
Managing Partner
www.rushortho.com
e-mail: cbj@rushortho.com
Report on Pitching Injuries: Sports Health March/April 2009

Little League Baseball: www.littleleaguebaseball.org

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