Good grief...Ethan Small needs Tommy John

[Todd4State]

Pitching off a mound with max effort too much is what you have to limit. Throwing year round should be fine.

Exactly. Much higher leverage situation for a younger player in a tournament setting vs. playing in a sugar cane field in the Dominican. The Dominicans don't have people pushing them until they are in their teens. I remember an interview with John Smoltz and he attributed his arm issues with having to pitch so much in the playoffs.

[ShotgunDawg]

1. Inning total are certainly part of the issue, but it's an easy target IMO and one I which not much research exist. It's true that the less amount of innings you throw, the more likely you are to not get hurt. However, TJ is caused my numerous reasons and the anger towards little league coaches is injustified and just an easy target.

2. To echo Brian Bridges, cutters do out out slightly stress on the elbow than fastballs. When holding the ball off center, it redistributes the weight of the ball and you also throw a cutter with a stiffer wrist than a fastball.

3. Another problem is spiked curveballs. If you hold an curveball or slider by its traditional grip, the tendon in your forearm is nice and relaxed, however, when you spike an curveball with your pointer finger, it causes the tendon on the bottom of you forearm to tighten, which can cause additional stress on your elbow.

4. Lastly, I think more tommy johns are happening because players figured out that throwing hard makes you money and Major Leagues front offices have figured out that velocity+command has the highest correlation to collecting outs than anything else. All this equals more guys trying to throw hard.

[ShotgunDawg]

Pitching off a mound with max effort too much is what you have to limit. Throwing year round should be fine.

This. Flat ground places far less stress on the elbow.

[BB30]

I would slightly disagree on number 4. You either naturally throw hard or you do not and by hard I mean mid upper 9s. Most people that throw that hard and have arm trouble have a mechanical flaw aka Strasburg etc. If you are mechanically sound and throw 97 you are just as likely to get TJ as the kid that throws 85 and is mechanically sound. Inning total is an easy culprit, I agree but there is some validity there. Just like any other ligament injury if you are tired/warn out the chance for injury goes up significantly. I really think a large portion of the problem is the fact that kids aren't playing different sports and are specializing in just one. Complimentary muscles are very very important especially developing them at a young age. I also think that a lot of damage is actually done in highschool when the stud of the team is asked if he can go on 2 days rest and throw to secure a playoff spot or to throw in every game of a 3 game set regardless of if he is up to it or not. A competitor is never going to tell his coach I am not ready to go when the season is in jeopardy of being over. Watched a kid two years ago that played for a small private school under a coach that was a 3rd round pick and bowed out due to injury throw this kid 7 innings in game one two days later started him in first game of dh kid threw 5 and lost and in rubber game came in and threw the last 3 same day. kid logged 15 innings in 2 days with one days rest in between. That is how you place stress on the UCL.

[SPMT]

Exactly. Much higher leverage situation for a younger player in a tournament setting vs. playing in a sugar cane field in the Dominican. The Dominicans don't have people pushing them until they are in their teens. I remember an interview with John Smoltz and he attributed his arm issues with having to pitch so much in the playoffs.

Dominican kids don't have to be pushed. For most baseball is their only opportunity out of poverty. For them it is also like soccer in other countries, it's what they do. They are going to do it daily in some form or fashion. In Jamaica, this is the case with track. They have injuries when irresponsible coaches run them too hard, too frequently. In Jamaica they are going to run year around though and it is obvious the coaches have learned to not crush the kids at a young age, in general.

It makes sense that the raised mound is a huge culprit for youth arm injuries. I think it is that and too frequent competition. Kids often participate in these sports year around:

1. Martial Arts
2. Track - on club teams
3. Boxing

What those sports don't do is compete in multi-game tournaments three weekends per month, month after month. They will train and practice year around in some form or fashion, but they will have 1-2 competitive seasons or tournaments that are spaced out reasonably, i.e. months apart.

So, if parents and coaches would say.....ok, let's do a park league and some tournaments, then continue to practice, work on specific skills, work on general athleticism and then crank it back up for another tournament or two, etc. Periodize from preparation to a competitive season like other sports. Track is probably the best at all around planning of training and competing. It is essentially "athletics". And they know not to compete year around or run the same distance year around. They will start longer distance and work their way down or they will start shorter distance and work their way up. It depends on the particular coach.

[Political Hack]

Genetics & training vs. over use & over exertion.

It's pretty simple. You can control 3 of those. Control them.