This week we’d like to highlight a recently published clinical study assessing elbow MRI abnormalities in young baseball players. This well conducted study is a three year follow-up to a previously performed MRI study. In the current study the authors found that 58% of the young players had MRI abnormalities on the most recent MRI scans, up from 35% on the initial preseason MRIs at the start of the study.
There is increasing evidence about the risk to the young player’s elbow from year-round baseball participation. The risk is especially high for year-round pitching. This study along with other available evidence suggests that year-round pitching is not only a risk factor for an abnormal MRI but also a risk factor for injury and loss of performance. Most sports medicine physicians recommend that young pitchers follow guidance from MLB’s PitchSmart. We also recommend multisport participation for athletes up until about age 14.
The Little League World Series is well underway now, and it’s interesting to note the peak pitching speed of some of the athletes. This article notes that several pitchers are in the 65mph to 75mph range and one player actually hit 81mph on one of his pitches in this year’s tournament.
But at what cost? There is an interesting database that puts young pitchers into various categories based upon age, pitching speed, and maximum distance on the throw. An observational study published a few years ago suggests that pitchers in the three standard deviation range or higher on the accompanying chart are “elite” and at risk for arm injury.
Over the last several years there’s been a growing consensus that some sport behaviors place a young athlete at risk for overuse injury: single sport specialization before age 14, playing that sport in training and competition more hours per week than your age in years, and playing more than eight months out of the year. Sport specific recommendations such as PitchSmart have also emerged.
What was previously unknown was whether following these recommendations actually leads to reduced injury rates. Recently published research indicates that parents who are knowledgeable of the PitchSmart recommendations and follow them with their young pitchers show significantly reduced injury rates compared to parents who were unaware of those recommendations.