Baseball Musings: Shoulder Development

February 28, 2008

Shoulder Development

Frank Stevenson looks at x-rays of pitchers and comes to a couter-intuitive conclusion:

In the old days, kids were not limited with any pitching counts or which kind of pitches they were allowed to throw. Instead they just kept pitching, and pitching, and pitching, and pitching over and over again. When pain began they would typically just keep pitching and pitching and pitching. Well, when comparing the x-rays we noticed that differences could be seen in the old timers vs the newer cases. For example, the AC joint was more flattened and smoothed out (both the clavicle and the acromion) in pitchers like Nolan Ryan's and others. This would allow the joint to continue being used without developing any friction or increased irritation which would latter result in rotator cuff injuries, bursitis, or extreme cases of early arthritis. The flattening of the bones that made up the AC joint were done EARLY when they were a kid; before the growth plates fused and before the bone ossified to adult "hardness". So, in other words, the over pitching and non-limitations allowed the joints and bone to change and be altered to a perfect "pitcher's joint" when they were young, which fused and hardened, and stayed that way into adult hood; allowing them to throw over and over again without injury-- in other words the joint ADAPTED to what it needed to be in order to be placed under that stress. Same goes with the elbow.
Now today we have limitations we place on little leaguers and pitchers. They are only allowed to throw so many pitches, so many innings, not allowed to throw curve balls until a certain age, etc, etc. The theory is that they AREN'T placing ENOUGH stress on these joints to alter them and instead the joint grows like every other persons; a normal AC and elbow joint. When placed latter in the big leagues these joints can't handle the stresses placed on them (the AC joint and elbow weren't created to withstand these pressures) and they blow out early ending careers way too early.

There may be something here, but I believe it's somewhat more complicated than this. Afterall, players there were a number of old players (Drysdale, Koufax) who threw all the time and saw their careers end early. I wonder how many of these pitchers with adapted shoulders and elbows had a genetic predisposition to that configuration?

Posted by David Pinto at 02:34 PM | Injuries | TrackBack (0)

Comments

I don't buy it at all. I don't think pitching injuries are particularly more frequent now than in the past; and I know that diagnosis, treatment and rehab are a hell of a lot better today. They used to just say a pitcher had a "dead arm" or some such; maybe he came back, more often he didn't. Now, most pitchers do come back.

I can't cite numbers, but if you looked at frequency of injury, time spent on the DL, average career length, and how careers ended, I'll bet that things are no worse today than they've ever been -- and in some ways, things are better.

Stevenson's piece cites X-rays of "Nolan Ryan's shoulder and elbow and a few other MLB pitchers." That hardly seems like a statistically significant sample. Ryan, in particular, was an outlier in every respect. Threw a billion pitchers, threw 300 innings, and pitched until he got his AARP card. His shoulder was probably a medical miracle from the day he was born.

Posted by: jvwalt at February 28, 2008 03:16 PM

And with the old timers, up to about the 1970s, if you couldn't pitch anymore because your arm hurt, you went to a real job. Especially Negro League guys, your arm hurt, well go pick cotton.
Real motivation to pitch through the pain.

Posted by: rbj at February 28, 2008 04:00 PM

Guys like Drysdale and Koufax left baseball early because they put so much stress on those joints that they eventually gave out (Koufax did not have the best mechanics - watch a video of him in slo-mo. Mark Prior has bad mechanics, too) Also, guys who throw curves and such early in life learn how to throw those pitches, and thus develop better mechanics. I was a pitcher until i was in my late 30s, and I started throwing curves at 9 or 10 - never an arm injury. There is something to this article, but it might be oversimpified.

Posted by: mm at February 28, 2008 05:15 PM

Here's another factor. If you let the kids pitch till they drop, you weed out the 'weak' guys before they make it to the majors because they break down when they're 20.

Posted by: tom at February 28, 2008 07:53 PM

I think this theory is without merit, but its interesting that someone came up with it. There is no mention of the sample size they are looking at, the age at which the x-ray films were taken, how much/often they were pitching, etc. There was no mention of a study of the pitchers mechanics either. This can certainly affect what goes on at the shoulder. So can many other movement disorders of the upper extremities.

There were plenty of "old day" pitchers like Koufax and Jim Palmer, Tommy John, etc. that had pitching arm problems. There were probably many more, but I'd have to ask my Father who they were (I'm 28).

In talking about Nolan Ryan, not only are you talking about one of the most well-conditioned pitchers of his era, but you're talking about perhaps the pitcher with the best mechanics EVER to play the game.

If you've ever watched film on Nolan Ryan, you can see that the majority of his pitches are released with a somewhat 'pronated' release, i.e. thumb down. This prevents elbow problems, and subsequent shoulder problems. Not only that, but he uses an extremely efficient, straight-line drive with his lower body towards home plate. He also keeps the ball close towards his body and never lets his elbow get close to, or above, shoulder level. This prevents excessive strain to the AC joint, rotator cuff, labrum, etc.

These mechanics are outstanding, and are the reason he never developed shoulder problems such as bone spurs in the AC joint, torn rotator cuff muscles, etc.

Further more, when you stress a bone, it stimulates bone growth. This is called Wolff's Law. Check it out on Wikipedia or Google. Long story short, when you stress a bone in a certain fashion repeatedly over time, the body lays down more bone matrix and you end up with...a bone spur!!

This is why construction workers and commercial painters often get bone spurs in their shoulders, and why kids who do a ton of running and excessive jumping can develop bone spurs at their knees (Osgood-Schlatter's) or at their Achilles Tendon insertion.

Posted by: Chris at February 28, 2008 09:50 PM

Shoulders are just like teeth according to the author...

Of course this "author" also wrote such masterpieces as this -http://www.armchairgm.com/Lockerroom:Why_Baseball_is_So_Great

If anyone is telling their 7 year old to throw more, they WON'T have to worry about their kid getting arm injuries in the majors because they'll be done playing by the time they are 10.

My favorite leap of faith comes here:

"they are saying they have never witnessed so many shoulder and elbow injures in young athletes. Reasons why the numbers are up? BECAUSE THE PARENT'S ARE NUTS and when a kid has any pain they run them into the doctor with fear of their future all-star injuring it further"

So according to the "author" - arm injuries are up because THE PARENTS ARE NUTS...

yeah, that the crux of the theory - Good one, "Frank"!!!

What a load of bovine feces...

Posted by: Manny Stiles at February 29, 2008 02:55 AM

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