A Plan to Stop the Arm Injury Epidemic in Baseball

by Derek Peterson


In all levels of competitive baseball one thing remains consistent: the abuse and neglect of arm care, as it relates to the volatility of the repeated motion to throw the baseball. The arm abuse incurred at the amateur level in today’s evolved world of sports medicine is simply unacceptable.

The problem is that hyper-competitive youth sports programs operate through a win-at-all-cost mentality. This environment leads to coaches taking advantage of youth players who, from a communication standpoint, cannot properly represent themselves to adult coaches.

Photo Credit: Ben Hershey

Photo Credit: Ben Hershey

As a baseball player myself, I have seen many of my fellow teammates incur career-ending injuries under the authority of negligent coaches whose only concern was winning. This is a problem because youth sports, by design, should be for the development and fun of the players rather than for the self-fulfillment of a “winning” coach. Without the proper communication channels, coaches will not have the information needed to protect and monitor the players, and parents will remain uninformed from the coaches.

When looking at the ecosystem of baseball, we can find that the problem is systemic. Many youth pitchers typically experience arm abuse in Little League, which then sets the seeds for a catastrophic injury later in the players’ career. If that same player is then recruited to a college on a scholarship to play baseball, the looming injury in many cases occurs because of the increase in demand of throws made on top of those risk factors developed in Little League. The school in this case is then burdened for investing money in that student’s service that cannot be completed. Furthermore, that same player may even be drafted to a professional team with his given track record of arm injury. In the transition from college to professional baseball, the player is then expected to play twice as many games and throw twice as many pitches.

The constantly-increasing demand of growing players, combined with the improper care for players’ bodies, have led to the epidemic of shoulder and elbow (Tommy John) surgeries we see today. All while noting that the initial abuse derived from an ill-informed Little League coach in a youth baseball game, which forever changed the landscape for that players career and the millions of dollars spent by the teams to utilize the player’s skillset.

Photo Credit: Neonbrand

Photo Credit: Neonbrand

The Problem:
In the realm of youth sports the relationship between player and coach is authoritative. The coach has a direct power over the player, which leads to malpractice, or bad decisions. Due to this issue the dialect between player and coach is always at the liberty of the coach. If a player were to speak up to a coach over mild soreness or minor injury it is to be seen as weakness rather than an obstacle. Furthermore, the players’ teammates would also be more inclined to side with the coach for the betterment of the team concept that is portrayed throughout youth sports. Through my own experience as a baseball player I have witnessed on several occasions a concern that was voiced in private from a player concerning injury, and that information being shared with the team exploiting that players concerns and putting them in an unfavorable position. These abuses only lead to silence victims who sacrifice their bodies for the authoritative coach and passive teammates.

The other problem lies in the expert information being implemented at the amateur level. Information that is captured at the professional level is hoarded due to competitive advantage. Major League teams have their own doctors and trainers to deal with health issues problematically. This creates a problem for the flow of information,
there is yet to be one platform for research and industry health facts to be delivered to the public for implementation across the board. Each level of baseball has their own health and safety committee, but yet each team acquires staff of higher expertise to treat and monitor players specifically. This information flow needs to reach the very bottom level in the little leagues. A recent study found that the little league coaches who do become informed rarely utilize the information.

Photo Credit: Neonbrand

Photo Credit: Neonbrand

“Coaches of youth baseball teams in Kyoto, Japan, completed a questionnaire assessing knowledge of and compliance with recommendations. Team variables and coach-related factors concerning elbow pain among young baseball players were surveyed, and the questionnaire investigated demographic data and elbow pain history in the previous 12 months. In total, 123 baseball coaches and 654 baseball players aged 6 to 12 years participated in this study; data were analyzed for 113 coaches and 339 players. Among coaches, 39.8% had accurate knowledge of the recommendations (similar to the US data) and 28.3% complied with them (lower than the US data)” (Aoyama).

This leads to the third problem that expert information needs to be implemented, monitored and regulated through a committee of sorts. To be a youth baseball coach, although authorized on a volunteer basis needs to be conditioned with some sort of licensed to operate. This would limit the number of coaches who volunteer for the wrong reasons.

The last problem is the medical advances have led many to assume that getting
injured and having Tommy John Surgery, or shoulder surgery is a viable option. This
option has revealed at the professional level an increase in pitching velocity after
surgical reconstruction (Merril). This is due to many factors, the first being the level of
surgeons is much higher than those operating on youth arms, the second is that
physical therapy for these injuries is more readily available for professional pitchers and
the physical therapy process is heavily monitored. At the youth level, the physical
therapy routines are not followed through precisely and go unmonitored. Recent
testimony I gathered from my teammate Zach White revealed a communication pattern
that answered the question to why this is happening. “My coach never contacted my doctor to find out the proper diagnosis, and my doctor never followed through with my physical therapists to make sure my rehab program was fitting…also due to the cost to physically complete the program under the watchful eye of my physical therapists cost additional insurance money that the baseball club was not willing to account for. When I finally got back from surgery the first thing my coach asked me was ‘when will you be able to throw
again? I responded with the duration of time my rehab program was meant to be
for, thirteen months. My coach responded by saying we should have you up on a
mound throwing in nine months, and that was the final timeline.” (Zach White).

The communication channels simply do not exist, and there is no one to monitor these
channels to insure that they do exist. Coaches need to listen to players when they
become injured, when they do actually get diagnosed with an acute injury the doctors
need to communicate with the coaches and the physical therapists need to then refer
back to the coach what the proper timeline is. Meanwhile, a third party who has the best
interest of the player needs to monitor this process to ensure the communication is
achieved. This is the step that separates professionals from amateurs’; professional
players are allowed to have talent agents that represent their best interest. The NCAA
has made is a bylaw that no player is to have an advisor or an agent that acts in
partnership for the best interest of the player or else the player can no longer be
considered an Amateur. When amateurism is no longer present that player can no
longer participate in intercollegiate sports (NCAA).

Plan for Health Promotion:

We need to restructure and regulate the way players, parents and coaches
communicate for optimal efficiency as it relates to the health of the player. We fully
understand the Cultures Perspective Model (societal influences and norms for a given
culture take aim at how a given circumstance is seen as) as it relates to the forces that
drive bad decisions. Due to this fact we will adopt a Perceived Support Model, where
support is given on a need basis. The communication platform will adopt a systems
theory approach where there will be input, throughput, output, feedback and action.
The platform for this type of promotion will have to be through the Internet of
sorts. Ideally it would be best through a VPN client (virtual private network). This would
allow each player; parent and coach to have a login profile under one cloud of
information and communication. The health and safety experts would act as
administrators of the network. For operational purposes the VPN could be programed to
filter data or message alerts for information that would cause concern.
The input forces will come from three influences, the player, the coach and the
experts. The player will be able to input his concerns for physical and mental health on

a daily basis through an anonymous status entry. The coach will also have input
qualifications for uploading statistical data of pitch counts, types of pitches thrown, and
performance. The pitch counts and types of pitches thrown would allow coaches,
players and health administrators to carefully monitor each players pitching history. The
experts on a need to contact basis will be able to monitor the network for player, or
coach alerts. When alerts are seen the experts can then contact the coach and player
for reporting any type of abuses. When a player reveals an injury or concern the expert
will also be able to administer the appropriate action such as immediately stop activity,
or consult with a local physician. When this action takes place the sports related
medical report should then be directly shared with the coach and league expert.
The throughput would function as connecting player to expert, or coach to expert
on basis of concern. All players will have ease of access to league experts for training
tips, and sustainable pitching practices. The coaches will also have experts at hand to
consult with for their prospective coaching styles and information on how to effectively
treat youth pitchers with arm troubles. Parents will also be able to connect with coaches
and experts on dealing with issues such as playing time or their sons physical health
concern that might arise. Communicating on this platform will eradicate verbal or
physical encounters that those coaches, parents and players might have on a day-to-
day basis.

The output in this system can serve as the effective and efficient coaching
decisions made through this system. With more information comes better decision
making, I truly believe that most coaches are simply clouded with expectations of
winning because that’s all they conceivable know how to measure success. In this model, with more information at hand success can be modeled through player development and lowering risk of injury because the data is now available for analyzing.

The feedback is then garnished as the result from the output. We can now see if the
decision was to pitch a fatigued player and the performance was bad, the evidence to
why that was a bad decision is now present.

Photo Credit: Neonbrand

Photo Credit: Neonbrand

The basis for this change to be made is to regain the purity of youth sports by
lowering competitiveness, increasing player development by decreasing risk of injury,
and allocating room for fun. By making a completely transparent model of
communication by reducing authoritative obstacles fair play in all aspects of the sport
will be evident. The idea is to recreate a pure realm of physical growth for the youth to
prosper in. When people refer to the term the “Coddling of America’s Youth” I think not
that the youth is emotionally softer but rather those responsible for teaching have quit.
This is an age of confusion for American Youth because there is to much control and
not enough rich interaction between child and teacher. Communication has been
negated and decisions are being made without the proper information at hand. The
promotion for a better tomorrow, is to have those who adults who hold the responsibility,
to make better decisions based on more quantitative and qualitative information; thus
bringing more transparency to direct communication for higher growth outcomes.
As a student-athlete myself I have experienced far to many teammates crying out
for help and coaches abusing the authoritative power given to them by parents.
Although this solution only solves a problem in one aspect of youth sports, I believe it
can act as a template for a superior communication model that can benefit problems
such as sexual abuse, drug abuse, and even depression symptoms in young adults.

The viability in this platform lies in the fullness of communication contributors and the
censorship that administrators can have in detecting problems by monitoring both
communication and hard statistical data.