Pitching pain

UF Health researcher asks if new guidelines go far enough to protect young arms

By Leah Harms

As the 2017 baseball season dawns, a University of Florida Health physician is researching whether new rules designed to protect the health of high school pitchers go far enough.

Last fall, the National Federation of State High School Associations required that its members create and enforce rules limiting the number of pitches each pitcher may throw in a game and outlining how much rest they should receive between outings. The Florida High School Athletic Association is following the Major League Baseball’s Pitch Smart guidelines on the maximum number of pitches per game and the amount of days of rest.

Jason Zaremski, M.D., CAQSM, FACSM, FAAPMR, an assistant professor in the department of orthopaedics and rehabilitation in the UF College of Medicine, examines how pitching year-round may pose an increased risk of throwing injury. In light of his findings, he has begun a new study looking at the total number of pitches thrown per game by a pitcher, including pitches thrown in the bullpen and warm-up pitches between innings, a statistic that is not currently included in the new state regulations.

This type of research has not been published before and he hopes this could lead to new ideas of how much pitching is too much, particularly for adolescents and high school students.

“The purpose of days of rest between pitching outings is to prevent wear and tear on the arm,” Zaremski said. “This will allow pitchers to recover from their pitching outing, allow for muscle and soft tissue to recovery and provide opportunities to build strength in the pitching arm as well as other areas of the body, such as the legs and hips, to provide a stable base.”

Pitching restrictions were brought into question after a high school coach in the state of Washington came under fire when one of his pitchers threw 194 pitches during one game. Since 1914, only six Major League Baseball games have had pitchers throw 190 or more. Additionally, overuse injuries have become more common in teenage pitchers as well as older players, resulting in long-term injuries and surgery.

Zaremski previously compared pitchers in the Southeastern Conference, or SEC, and the Big 10 Conference and found that pitchers in the SEC had a 5 to 6 percent higher rate of surgical reconstruction to the ulnar collateral ligament in the elbow. This is the so-called Tommy John ligament, named after a former Major League pitcher whose reconstructive surgery dramatically altered the recovery from this ligament tear.

“The increase in the number of overuse throwing injuries are preventable,” he said. “With continued grassroots efforts to provide information on the recommendations to prevent these throwing injuries to all throwing athletes, parents and coaches, our hope is the number of these injuries will decrease in the years to come.”