Surgeon sees alarming rise in baseball injuries

by Vicky Cerino, UNMC public relations | June 20, 2014

Image with caption: Matt Teusink, M.D.

Matt Teusink, M.D.

As an orthopaedic surgeon specializing in the elbow and shoulder, it bothers Matt Teusink, M.D., to see the alarming rate of elbow and shoulder injuries in baseball pitchers -- from Little League to professional. He said many of the injuries are preventable.

"One of the most alarming things with baseball in America is the increased rate of elbow injuries in pitchers. It's becoming an epidemic," said Dr. Teusink, assistant professor of orthopaedic surgery at UNMC. "This year, there have been 16 major league pitchers that have gone down with elbow injuries and it's a season-ending injury.

"It takes them out of baseball for at least a year," he said. "I think certainly any orthopedic surgeon or those in sports medicine find this trend very concerning."

Dr. Teusink said prevention is the key to avoid throwing injuries. His interest in baseball injuries stems from playing baseball from Little League through high school and seeing a high school friend's baseball career cut short by an elbow ligament tear.

The count

Dr. Teusink said pitch counts in Little League - based on age - may help prevent injuries. Pitch counts work well if players are pitching in just one league, but, he added, some are playing in multiple leagues, and year round, which increases the cumulative wear and tear and fatigue on the elbow.

The USA Baseball Medical & Safety Advisory Committee recommends the following pitch counts:

  • Ages 8-10: Maximum 50 pitches per game, 75 pitches per week.
  • Ages 11-12: Maximum 75 pitches per game, 100 pitches per week.
  • Ages 13-14: Maximum 75 pitches per game, 100 pitches per week.
  • Ages 15-16: Maximum 90 pitches per game, two games per week.
  • Ages 17-18: Maximum 105 pitches per games, two games per week.

"It's imperative that coaches and parents be educated on the importance of limiting pitch counts, especially at the younger youth levels," Dr. Teusink said. It's also important to take kids out when their arms get tired, as that is when mechanics break down and injuries occur.

"Perhaps the biggest key to preventing injuries is encouraging kids to take extended breaks from baseball (several months) and really emphasizing mechanics with core strengthening (abdomen, back, glutes and thighs) and stretching."

One of the most common injuries for pitchers is a torn medial collateral ligament on the inside of the elbow. If one wants to continue pitching, it requires Tommy John surgery, a procedure first performed in 1974 when John was pitching for the Los Angeles Dodgers. In the reconstruction, surgeons take a tendon, most commonly from the wrist and fashion it into a new ligament, weaving it through bone tunnels on the inside of the elbow, he said.

Dr. Teusink said surgeons have started seeing the injury in pitchers as young as 14 or 15. Little League pitchers also can suffer a growth plate injury in the elbow.

"The good news is that this injury heals if you just sit out a little bit and give it a chance to heal," he added. "But not all coaches are totally up to speed on how to prevent these injuries."

June 20, 2014 at 2:02 PM

FYI -- Not all youth play in accordance with Little League rules. Many organizations have inning limits as opposed to pitch counts. So, for instance, if a pitcher doesn't record an out, regardless of how many pitches he or she has thrown, then no innings accrue against his or her inning total. Just something to keep in mind if your child plays ball.