It’s no news to anyone watching the Major League Baseball playoffs that pitchers’ arms tire out pretty fast.

But just how much harm pitchers and other throwers may be doing to themselves is just now becoming clear. Not only does throwing too much damage muscles, ligaments and tendons, it can actually prevent a pitcher’s bones from developing normally.

That’s the report from researchers at Jefferson Medical College. Writing in the journal Radiology today, they say they have discovered a new type of injury. Bones in the shoulder blade may fail to fuse properly in teenage pitchers, they say. They call this condition “acromial apophysiolysis,” and say it increases the risk of serious injuries such as rotator cuff tears later in life.

The researchers identified the problem in both male baseball players and female softball players.

They only followed the players into the players 20’s. But if you think being older than that or not playing baseball provides you some protection against rotator cuff injuries, think again. As we age, less blood circulates to the rotator cuff. And bone spurs can develop, rubbing against the tendons. So the risk increases with age.

Tennis, Volleyball, Other Sports Affected

In addition to baseball, softball, tennis and golf, these injuries can affect handball players, volleyball players, javelin throwers and participants in any other sport that involves throwing or hitting.

It can happen to weight lifters as well. And my friend Sandra Razieli, who teaches yoga, says she’s seen shoulder injuries in yoga, especially among women.

Injuries to the elbow follow a similar pattern. Young players, whose bones have not fully grown, run the risk of “Little League elbow,” an injury to the growth plate at the joint.

Older athletes, whose bones are fully developed, are more likely to injure the ulnar collateral ligament that helps hold the elbow together. (Severe injuries of this type have gotten a lot of attention because of the increasingly common Tommy John surgery used to treat professional pitchers.)

Throwing and hitting can cause other types of injuries, such as “tennis elbow” and “golf elbow,” which are injuries to tendons connecting the elbow to muscles in the forearm.

So how can you prevent this type of injury? Most injuries occur from overuse. Over time, joints simply wear out. So until now, the official medical advice could be boiled down to one word: moderation.For example, beyond a vague mention of stretching and warming up, the American Academy of Orthopedic Surgeons simply advises pitchers to pitch less.  It quotes the USA Baseball Medical Safety Advisory Committee in setting pitch count limits:

Pitch Counts

Age	Max. Pitches/Game	Max. Pitches/Week
8 – 10	50	75
11 – 12	75	100
13 – 14	75	125
15 – 16	90	2 games / week
17 – 18	105	2 games / week

 

And it gives guidelines on the proper age for learning various types of pitch:

Fastball	8
Change-up	10
Curveball	14
Knuckleball	15
Slider	16
Forkball	16
Splitter	16
Screwball	17

You’ll notice these authorities leave adults to fend for themselves. Since the risk of injury may actually increase with age, I don’t advise anyone to exceed the limits here for 18-year-olds.

The most helpful advice is probably the most obvious: when your arm hurts, let it rest until it feels better. Ice and anti-inflammatory medicine may help as well.

But I also believe there is more that athletes can do to protect their arms. Some recent studies have begun to show the benefits of specific strengthening exercises.

I’ll describe these in detail in part II of this series.

Featured image by Bradley P. Johnson. Some rights reserved.