Local physicians weigh in on MSHSL pitch count rule

Sports Editor

Editor’s note: this is the third of a three-part series story on the Minnesota State High School League’s pitch count rule and it’s intended effect on young pitchers. You can read the first part of the series online at http://bit.ly/2tGjjSN. You can read the second part of the series online at http://bit.ly/2vDfdyz.

While the Minnesota State High School League just implemented a pitch count rule prior to the 2017 season, many local physicians have been clamoring for a similar rule for years.

“Most of the studies show that pitch count is directly related to injury rate in the shoulders and elbows of overhead athletes,” Dr. Heather Bergeson, a physician at TRIA Orthopaedic Center who focuses on sports medicine and pediatrics, said. “By restricting their pitch count, we are then going to load the joints less.

“They can still get injured, even with the pitch counts they have, and every kid is different and can tolerate different amounts, but this is a good step to limit the number of injuries we’re seeing and to keep them in the game.”

With the pitch count in place, Bergeson believes it is a good first step toward limiting younger pitchers’ arm injuries.

“The younger kids, 15 or 14 and younger, still have open growth plates and it all comes down to maturity and puberty in the shoulder and elbow to see when the growth plates close, but definitely before age 14 there are a lot of open growth plates, which are weak links,” Bergeson said. “The more they’re throwing, the more you can injure those growth plates and have problems.

“The older the kids get, the plates start to close and the structure that becomes more of a concern is the Tommy John ligament, or the ulnar collateral ligament, on the inside of the elbow. If we can start with these kids even younger and make sure they’re not pitching too much, too fast, too soon or a certain type of pitch they’re not biomechanically ready to pitch, work on their mechanics and work on core strength, then we can prevent these from happening.”

Dr. Frank Norberg, a sports medicine fellowship-trained surgeon with Twin Cities Orthopedics, agreed with Bergeson, but also said that not every high school pitcher is capable of throwing 105 pitches in an outing.

“I think what we’re seeing is that if everybody could pitch and pitch at a high level, they would do it,” Norberg said. “A lot of people don’t have those capabilities to throw those pitches at that velocity, and I think what we’re seeing is our athletes being trained from a younger age with a focus on the strengthening and conditioning, so they throw harder and faster at younger ages.”

As a outing continues, the fatigue that sets in for high school pitchers makes their mechanics fall apart, which could open up the possibility for injuries.

“The more fatigued they get, the worse their mechanics are and that sets them up for injuries,” Bergeson said. “They might looks and feel like they can pitch 105, but if you look at the way they are throwing, there already are signs they’re fatiguing earlier.”

While a pitch count rule is a good first step in helping young pitchers stay healthy long-term, Bergeson believes more steps must be taken in order to fully prevent arm injuries for young pitchers. One of those steps, Bergeson said, is having pitchers wait until they are older before they learn to throw breaking pitches.

“It’s a little controversial, but what we recommend is that kids don’t throw a curveball or a breaking ball until they are 14 or shaving, because then their growth plates are more likely to be closed,” Bergeson said. “The bone is then more mature and ready to take on the stress of those pitches.

“However, there are biomechanical studies that show that actually it’s the fastball that puts more stress on the elbow, but it makes sense that it takes more finesse and appropriate mechanics to throw the other pitches. We really say to focus on the fastball and before you worry about force and velocity you need to worry about control and accuracy and get that down, then start to work on velocity.”

While pitchers in the past were often able to throw more pitches with less rest without worrying about injuries, both Bergeson and Norberg agree changes to the way the sport is approached from a young age have increased young pitchers’ chances for injuries.

“Sports have really changed, it used to be that you would play all the different sports in different seasons,” Norberg said. “You would rotate out of things, you wouldn’t pitch year-round, and I think there has been a change with a lot of things in baseball, especially with the way a lot of pitchers are throwing.”

Even if young athletes play multiple sports, Bergeson said the possibility for injuries remains the same unless they give their arms a rest in different sports seasons.

“It’s a new sports culture, we are now training these kids like little professionals and they are playing year-round,” Bergeson said. “Normally we recommend that they have three months off from an overhead sport per year to give their shoulder and elbow time to rest.

“They’re not getting that, so now we’re sending these kids in with an altered anatomy and we’re going to see more of these injuries if that continues.”

If young pitchers can make these alterations to the way they approach the game, there is a chance we could see less arm injuries to young pitchers in the future.

Follow Chris Chesky on Twitter at @MNSunSports or @SunSportsChris, or on Facebook at SunSportsStaff.