SEVERAL generations of pitchers have been taught that curveballs are kryptonite, especially for young elbows. But research has yet to prove the theory true. In fact, a recent spate of studies throw previous assumptions into question.
The first, published in the April issue of Shoulder and Elbow Surgery, suggests that throwing a greater percentage of fastballs places athletes at higher risk of sustaining elbow ligament injuries. The pitchers in the study—83 major leaguers who'd had Tommy John surgery—had thrown on average 7% more fastballs than a control group. The authors, physicians at Henry Ford Hospital in Detroit, concluded, "Stresses due to the amount of high velocity pitches thrown ... lead to an increased risk for [ulnar collateral ligament] injury in MLB pitchers."
The immediate takeaway might be less heat, more junk, but it's not that simple. In May a different study, in Sports Biometrics, by James Andrews and Glenn Fleisig, the medical director and research director of the American Sports Medicine Institute, respectively, looked at 111 healthy pitchers from the youth level to the major leagues. The data showed pitch type made no difference in shoulder and elbow stress. "The relationship of torque for fastballs and curveballs is the same for adults and kids," says Fleisig.
If the type of pitch doesn't make a difference, why the spike in elbow injuries? It seems longer seasons and more pitches play a role. "It wasn't the invention of the curveball that increased risk," says Fleisig. "It was year-round baseball."
Fleisig's observation comes on the heels of a May article in Arthroscopy written by a group led by White Sox team doctor Anthony Romeo. It reports that some young pitchers showed fatigue-related changes in their throwing motion after as few as 30 pitches, with the majority faltering by 90—the max workload recommended for 12- and 13-year-olds. "Fatigue seems to be the underlying issue in most Tommy John injuries, and younger arms fatigue more quickly," says Stan Conte, a former trainer and physical therapist for the Dodgers and the Giants and, like Romeo, a member of the Pitch Smart advisory committee.
Conte's advice to avoid arm trouble: "Muscle strengthening, especially of the core and legs, can be part of preventing injury." One more thing: throw curveballs, throw fastballs. Just don't throw too many of either.
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White Sox doctor Anthony Romeo offers three moves that build leg and core strength, which can reduce the strain on a pitcher's arm.
Holding a medicine ball or a weight, lunge forward, dropping hips straight down and keeping foot and knee aligned. Rotate torso toward the front leg.
Hold a front plank for 10 seconds, rotate into a side plank and hold for 10 seconds, return to front plank for 10 seconds, rotate to opposite side for 10 seconds.
Holding a medicine ball or a weight, execute a half-squat, alternately rotate to each side without twisting hips. Continue for 30 seconds.
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