“Overuse” over-hype

Over the past month, about a dozen different people have forwarded to me an article from the Cleveland Plain Dealer featuring Dr. James Andrews, the renowned surgeon.  He has been in the news a lot lately with all the TJ surgeries in MLB last Spring.  Besides his famous patient list,  he has done great work in trying to understand the cause and prevention of elbow and shoulder injuries in youth pitchers.  Here is a copy of the Cleveland article.

From the start of the Gamers program in 2007, we have been at the leading edge of applying “healthy” pitching discipline in our program.  We implement all the preventive elements that the ASMI (Dr. Andrews’ research institute) recommends based on the medical research — specifically:

  • Healthy throwing mechanics (this is #1 cause of injury according to Dr. Mathews — no inverted W’s)
  • Age-based pitch count limits and rest between pitching appearances (unfortunately we cannot control April/May HS pitching)
  • No one in our program pitches more than 8 months competitively — March – October
  • Focus on overall athleticism and strength, not just sport-specific movements (like throwing)
  • Throwers 10 program

So, we have been strong proponents of Dr. Andrews and ASMI guidelines.  We are not perfect, but we try really hard.

Given the above, it is important to note that a number of Dr. Andrews comments in the Cleveland article are unfair and not supported by any research or any study that has been published by ASMI.  If you are interested in the actual medical research,  I have collected it in one place.  Click here for the batch.

Here are the comments that I find unfair — they are highlighted in yellow in the article:

“Now parents are hiring ex-pro baseball players as hitting and pitching instructors when their kid is 12 … they’re ending up getting the kids hurt” I have never seen any research or debate about hitting year round — or baserunning, or fielding.  So why is he talking about hitting?

Second, he later goes on to say that “bad mechanics” is the #1 contributor to pitching injuries.  You cannot have it both ways — you cannot say that a kid needs proper mechanics to prevent injury and then turn around and blame parents for taking their kids to instructors.

“The almighty dollar has a lot to do with it, yes. Some parents are putting a football or baseball in their kids’ hands when they’re 3 years old, and it’s not just for a fun little photograph…. What’s happening is, the tail is wagging the dog.” This comment reminds me of the former MLB player/commentators criticizing travel baseball, while at the same time marveling at Bryce Harper, Mike Trout and all the young pitchers throwing 98.  

Maybe, just maybe, the kids actually enjoy playing baseball and want to play as much as possible and at the highest level possible.  My data indicates that this is 6.5x more likely than a parent or travel coach forcing kids to play (being facetious about the stat. not the point).

The bigger point though is that Dr. Andrews’ comment above has nothing to do with medical research or technical expertise.  It is an opinion based on limited interaction with players/parents in pre-op and post-op rooms.  The tail is not wagging the dog in most cases.

“I said in the book, I want parents and coaches to realize the implications of putting a 12­ or 13­ year-­old through the type of athletic work done by a 25 ­year­-old. Parents and coaches, though they mean well, need to understand what the long-term effects of overuse can be.”  I have never seen a youth baseball workout or practice that even comes close to the athletic demands of a Division 1 college program.   The Gamers program has a very challenging and disciplined practice and workout routine — probably more so than other youth programs.  But, everything we do is age appropriate.  It is nowhere close to what a 20 year old, Division 1 college baseball player does. 

I understand that the medical research on this topic is lacking, so it leaves room for lots of opinions like the above.

But, these broad generalizations about select travel baseball are unfair and getting over-hyped.  Things have gone too far when you have position players citing “over-use” as an excuse for poor performance at the plate or pitchers worried that 50 innings over 4 months is “over-use”.  We do not need another “syndrome” or “condition” for young people/parents to use a crutch.  Especially, young people who are trying to work hard and pursue something they love at a high level.  Their efforts should be cheered, not discouraged as “over-use”.

What we do need is parent/coach education.  A 30 minute video class for baseball coaches, similar to what the Positive Coaching Alliance does, would go a long way.  Call it ASMI coach certification.  I would require every coach in the Gamers program to go through certification.  That would be a productive step — more than taking pot-shots at parents and coaches.   Coaches and parents want to do the right thing.  The baseball/surgery industry needs to arm them with the right education.  Right now, there is nothing out there.  Google “baseball pitcher arm health” .   Not much there .  A good education resource would go a long way!!

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