Dr. Timothy Kremchek, team physician and chief orthopedic surgeon for the Cincinnati Reds, is on a mission to save the arms of young baseball pitchers.

        “Its been said that the motion of overhead throwing is one of the most unnatural acts in sports,” Dr. Kremchek says. “To throw that way in a repetitive nature and with mechanics that might not be proper places undue force and stress on youngsters.”

        The Kid Glove Game Program estimates at least 50,000 kids play organized baseball each year in Greater Cincinnati. The biggest group for potential arm injuries is pitchers who are between 11 and 15 years old, Dr. Kremchek says.

WHAT COACHES CAN DO

• Define your team's age group and get guidelines as to the appropriate number of pitches, types of pitches, how many innings, and how many games per season pitchers can play.   • Depending on the age group, help players with conditioning and exercise programs for the shoulder and elbow in the off-season.   • Whenever a pitcher throws, the shoulder joint is going to swell. Ice packs decrease the swelling and make it feel better.   • Resist the tendency to let your best pitcher keep throwing.   • Tell players, “If you are sore, let me know.” If they are throwing the ball differently than usual, that may mean they are hurt or fatigued.   Information on age-appropriate guidelines for pitching is available from Beacon Orthopaedics & Sports Medicine in Evendale, 956-5060; (888) 773-4353.

        “That's when (players) become very competitive and will do whatever (it takes) to win.”

        Sterling Jackson, manager of a team in a College Hill Knothole Baseball District, agrees.

        “Sometimes, as coaches, we stress that "we got to have this win,' and the pitchers and kids go beyond the call to get that done, and they'll go through injuries and won't say anything.”

        Arm injuries are caused by the amount young players throw, the type of pitches they throw and the mechanics or the way they throw. “We've learned that fatigue leads to injury,” Dr. Kremchek says.

        “If they become fatigued, they change the way they throw. This places more abnormal forces on the shoulder and the elbow and something has to give, (resulting in) breaks of bones or growth plate and ligament injuries.”

        Assistant Coach Steven Carter's son, Steven Jr., is a pitcher on Mr. Jackson's team.

WARNING SIGNS

If any of the following red flags persist for more than two weeks, consult a sports medicine specialist:   • Sharp pain to the shoulder that increases with throwing.   • Painful clicking, catching or popping with throwing or overhead movement.   • Increased, unexplained weakness in the shoulder, forearm or wrist.   • Increased prolonged achiness to the shoulder following throwing.   • A painful arc of movement when raising the arm.   • Numbness or tingling in the forearm and fingers.

        “It's his fifth year of pitching,” Mr. Carter says. “I've been trying to inquire about (age-appropriate pitching) from some guys that play at a higher level. One guy told me, "Don't let him throw too many breaking pitches at such an early age.' But my son's 13, and I think his arm can handle it without too much damage.”

        Studies show that throwing a straight overhand fastball is safest for all ages. A change-up, which looks fast but you actually throw your arm down to make the ball come in slower, is OK for ages 10 and up. Curveballs are OK after age 14, knuckle balls at age 15.

        A slider or fork ball shouldn't be thrown until age 16, a screwball until age 17.

        Of all types of pitches, the change-up is probably the easiest on the arm, studies show.

        “Our goal is to make some of these guidelines rigid rules,” Dr. Kremchek says. “A lot of leagues have gentleman agreements where if you are a certain age, no curveballs (can be thrown), just fast stuff. It works pretty well, but there is nothing set in stone yet.”

KEEP PITCH COUNT

Safe number of pitches per game   • Ages 8-10: 50 pitches.   • Ages 11-12: 65 pitches.   • Ages 13-14: 75 pitches.   • Ages 15-16: 90 pitches.   • Ages 17-18: 100 pitches.   Source: Beacon Orthopaedics and Sports Medicine in Evendale

        “I throw a knuckle ball, a sidearm, a fastball and a curve,” says College Hill Knothole pitcher TaMarko Richard King, 13, a student at Pleasant Hill Elementary in North College Hill. “Sometimes when I try too hard, my elbow starts to hurt ... My parents are more worried about my arm than they are about the team. To me, winning games is more important.”

        Coach Jackson asks his players to be honest, and if they are hurting, to let their parents and coaches know. And to the parents, he says: “When (players) get home, ask them, “Is everything all right, did practice go good, do you have any injuries or soreness anywhere?”

        “Major leaguers can play with pain,” Dr. Kremchek says. “Some high school players can play with pain. Little leaguers should not have pain. Any Little Leaguer that has pain should be shut down from playing and be evaluated by a physician.”
       

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