Pitching Problem: Arm injuries serious issue in youth baseball
By Greg Bach
The number of young athletes with achy arms visiting Dr. Christopher Ahmad at his office at the Columbia University Medical Center in New York is on the upswing.
And is indicative of a national epidemic showing no signs of slowing, either.
“In my office the amount of Tommy John surgery that I have been doing has been rising,” says Ahmad, who is also the head team physician for the New York Yankees. “Some people don’t believe that we’re in a crisis with these injuries with our youth athletes. They feel like kids are playing and they are having fun and they are training, but they don’t recognize that we have a problem. I have research that shows that the age group that is most at risk and requires the most Tommy John surgery is not the college kid and it’s not the professional athlete. It’s the 17- and 18-year-old.”
Ahmad teamed with John Gallucci, Jr. to write PLAY BALL: Don’t Let Injuries Sideline You This Season. The book features a goldmine of information examining the rise in baseball injuries and covers elbow and shoulder injuries, common overuse injuries, Tommy John surgery, strength and conditioning, hydration and nutrition, and more.
“We have a problem, but we can control it,” Ahmad says. “It’s being able to recognize that when a player has a low-level injury, which we typically call a strain or soreness, that could be the start of a fire that’s going to cause a real injury. So it’s getting into the minds of parents and coaches that they can take care of the kids.”
We spoke with Ahmad, who has been the Yankees team doctor for the past nine years, to get his insights on the growing problem of youth sports athletes being sidelined by arm injuries. Check out what he had to say:
SPORTINGKID LIVE: What inspired you to do this book?
AHMAD: The office for my sports medicine practice is flooded with young throwers who are getting injured. In many ways, these kids are getting younger and younger and they’re getting more mature injuries. It used to be only professional athletes who needed Tommy John surgery and now I’ve got middle school kids who need Tommy John surgery. As this problem is rising it became clear that while I’m taking care of them I’m acting like an ambulance at the other end of a cliff where these kids are falling off, and the reason to write the book was so we could create guiderails so that these kids don’t fall off the cliff and have to be fixed. Our biggest tool for managing injury prevention is education. There are a lot of myths out there and there is a lot of pressure on young kids, families and coaches to perform at the highest level.
SPORTINGKID LIVE: Why don’t many parents and young athletes seem to take Tommy John surgery seriously?
AHMAD: Amongst all the injuries we take care of in sports medicine there’s a sensationalism around Tommy John surgery. And I have even studied why; I’ve studied how often Tommy John surgery gets mentioned during baseball games and how it’s celebrated when a player comes back because they are throwing so well. There is a bias; if they’re playing in a Major League game and there’s media attention around it that’s because they succeeded. We don’t get to hear about the players who went through the process and never made it back, or who needed a second Tommy John surgery. The cavalier attitude stems from that and some kids will throw through elbow pain and they’ll throw when they feel like they may be partially injured or developing an injury because they think the surgery is a so-called rite of passage and ‘everybody at some point has to get it done so I might as well get it done now.’ And there’s also a thought that if I have the Tommy John surgery I’m going to be better and stronger. What’s even more amazing is some kids will come to the office and their parents, even though it may just be a little bit of soreness, are requesting the surgery when they are not even injured. I’ve done some research in this area where 50 percent of kids would have the operation if they felt it would enhance their performance, and they do believe it will enhance their performance. It’s almost like offering them Performance Enhancing Drugs and that kids will opt for it even though they don’t recognize fully the downside of what’s involved with the risk, the rehab and the length of time it takes to get better.
SPORTINGKID LIVE: How do we change this?
AHMAD: Parents and coaches and kids themselves need to know that it’s not OK to throw with elbow pain or shoulder pain and if they have pain they need to tell their mom or dad. The current culture is ‘well, you’ve got to throw through it, you got to suck it up, you’ve got to be tough’ and then these poor kids get hurt and then they break down. Establishing a culture when they are young that says ‘no, that’s not right. Let’s give you a period of rest and if it’s not going away let’s have you evaluated by somebody who is knowledgeable in this area.’ That I think is going to be one of the biggest features of taking care of this. Parents and coaches need to know what the risk factors are. Some kids that are super-talented, for example, get a lot of playing time and they tend to throw in the most competitive situations and they so-called get abused because of their talent. They throw more, and they throw harder, and in some ways just being talented is one of the biggest risks for getting hurt.
SPORTINGKID LIVE: How effective are pitch counts?
AHMAD: Pitch counts have numerous flaws. They aren’t perfect because different kids have different levels of physical maturity and it’s not just their chronologic age. Two 14-year-old boys can be much different in their physical development, so it doesn’t make sense to have a 14-year-old who just hasn’t started his growth spurt yet and who has weakness in his core muscles and leg muscles, to have the same pitch count as somebody else. We are also seeing kids who are throwing with more and more intensity, so if one kid has a pitch count and he’s throwing all fastballs as hard as he can, or sliders which are very aggressive pitches, his pitch count of 100 pitches is different from somebody else who has 100 pitches who’s changing speeds and not throwing maximum velocity on every pitch. So pitch counts are flawed in many ways but it is a working model that we have right now.
SPORTINGKID LIVE: What would you like to see now that the book is out?
AHMAD: The real heart of why the book is here is that we need to educate and it is a vehicle for us to start the education process. We have to make sure that parents know that if somebody is playing with pain it could have a serious impact on their playing career and it’s not just get surgery and then you make it to the big leagues. So our goal is making sure people understand exactly what is involved with getting injured, especially at a young age. There is no reason why a kid should play through pain. If he has pain, we have to develop a culture where he can speak freely about it and not feel pressured that he is letting his team down or that he is weak if he needs to rest for a period of time.
Dr. Christopher Ahmad
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