By John Erardi
The Cincinnati Enquirer

Josh Ingram, 10 of Mt. Carmel works on his throwing at the Champions Baseball Academy. (Photos by Jeff Swinger/The Cincinnati Enquirer)

Philip Santoro, 14 of Madeira works his arm at Tri Health Summit Woods physical therapy center.

Physical Therapist Troy Merckle works with Lynzi Engel, 14 of Loveland at Tri Health Summit Woods physical therapy center. Lynzi is a fast pitch softball player.

Many boys' baseball arms are where many girls' soccer knees were a decade ago: in need of protection.

Just as girls needed to strengthen their thigh muscles to protect their knees, boys need to strengthen their shoulder and upper back muscles to protect their elbows.

As boys play more and more summer baseball - 55 to 60 games for 10- to 14-year-olds is not unusual - arm injuries are mounting in the Tristate, especially among pitchers.

It is consistent with a nationwide problem in youth sports that involve a lot of throwing and more games than kids are accustomed to playing.

The arm bug is even affecting some female softball players who throw overhand from their infield and outfield positions.

"I've seen it all out there - kids throwing too many pitches, pitchers who play catcher after they're done pitching - when they should be resting - and kids who haven't warmed up properly coming in to pitch," said youth coach Jack Kuzniczci, who is also the Madeira High School varsity coach.

YOUNG ARMS

• Over-the-top pitching throws off young arms • Case studies • Every player under count • Decision protects son's arm • Coach K's 10 tips • Knuckle curve easier on the wrist • Q&A: Dr. Timothy Kremchek • Q&A: Larry Redwine • Q&A: Ted Power • Fast facts

With the summer baseball season about to kick in, the Enquirer went in search of some numbers and the stories behind them. Here are the results:

Two years ago, the leading Tristate expert on throwing-arm injuries - Reds medical director Dr. Tim Kremchek - evaluated 40 patients of high school age or younger with shoulder and elbow injuries and did surgery on three.

Last year, the number of throwing-arm injuries he evaluated among young baseball players doubled to 80, and surgeries on elbows and shoulders went up nearly sixfold to 17.

"And I firmly believe there are three or four times as many problems out there as I see in the office," Kremchek said. "So, we're talking hundreds of kids."

It isn't known exactly how many of the 8,000 Tristate kids ages 9 to 18 who play spring and summer youth baseball have suffered or will suffer preventable arm injuries this year because of a lack of protection and knowledge.

But Kremchek expects the number to go up again.

It isn't just the select teams that are a breeding ground for problems, but 55 to 60 games a summer are a lot. It isn't unusual to play five or six games in a summer weekend. You'd better have a lot of pitchers on your team to get through that many innings without stressing an arm.

Kuzniczci has nine pitchers on his 12-player team of 12-year-olds, the Madeira Mustangs.

But not everybody's Jack Kuzniczci.

Every one of the 20 parents the Enquirer contacted for this story reported various horror stories of overpitching youngsters holding their arms. Some of those youngsters were crying.

"I have a number of these kids, especially the kids who have broken the bone (on the body-side of) their elbow," Kremchek said. "The story is very consistent:

" 'It's been hurting for a while. I pitched through it thinking it would go away, and finally it snapped.' Three starts ago, if they had come in, we'd have seen the widening on the X-ray, shut you down, let you heal, and you would have avoided an operation."

So, what's the message in all this? Simple, Kremchek said.

"When you do hurt, come in," he said. "We're not trying to find ways to keep you from playing. We're trying to find ways to protect you and make playing more fun."

E-mail jerardi@enquirer.com