Farewell to young baseball arms

ESPN knows it has snared a ratings smash in its glove with Little League World Series popularity, which is why you get 10 days of gavel-to-gavel coverage starting this weekend. Grown-ups love watching kids play baseball and borrowing successful formulas that teams and players use to advance to Williamsport, Pa.

Dr. David Geier will watch, and worry.

The director of MUSC Sports Medicine knows the Little League World Series reflects so much that is wrong with youth baseball. And it's not just the big stage. One Lowcountry children's baseball organization has declined Geier's offers to speak to its coaches because they don't want to hear him rebuke their teaching philosophy, which includes the frightening theory that curveballs are fine and dandy.

"There is a huge problem out there," Geier said. "It's difficult to tell if it's the curveballs or the number of pitches. The thing is, the kid throwing the curveball is usually the same kid throwing 150 pitches a game."

Geier has become a pied piper of baseball caution, a nationally recognized expert who has given speeches around South Carolina to coaches, physicians, physical therapists, trainers and parents about the dangers of kids throwing too many pitches and too many curveballs too early.

"I think it's important because at the youth level we're running these kids' arms into the ground," Geier, 35, said inside his James Island office. "We're probably shortening their careers. I mean 'we' as the collective: Coaches, parents and doctors."

Curveball warning

Other youth sports have as many or more rising injury problems as baseball. Some parents push young girls way too hard. Thus, Geier said, anterior cruciate ligament damage continues to spread in girls soccer, volleyball and basketball.

But those sports aren't on nationally televised display.

Curveballs, Geier and other experts believe, should not be attempted until a boy is 14. Geier has developed his opinion over years of study, including a stint working as an orthopedist with baseball's St. Louis Cardinals and the NFL's St. Louis Rams.

"An easy rule of thumb is a pitcher is mature enough to throw a curveball when he is old enough to shave," Geier said.

But check out those 12-year-olds at the Little League World Series. Geier winces as he offers statistics showing that the number of starting pitchers throwing 75 or more pitches per game at the Little League World Series jumped from 50 percent in 1996 to 80 percent in 2006. The percentage of curveballs rose from 23 percent in 1991 to 31 percent in 1996 and held steady through 2006.

This despite the following lines from Little League's own Web site: "As of now, there is no solid medical evidence that these pitches (curveballs and sliders) are detrimental. However, Little League and many experts recommend they not be thrown until age 14."

Also note that while many competitive 12-and-under leagues play on fields in which the mound is 50 feet from the plate, the Little League World Series distance remains 46 feet.

If watching Williamsport makes you sick, consider Winterville. At the 10U Cal Ripken Baseball Southeast Regional last month in a little town just outside Greenville, N.C., virtually every team had at least one 10-year-old pitcher throwing curves and the best teams had more than one kid instructed to throw many curves per inning.

"It does not surprise me," Geier said. "Right or wrong, we're a society of 'win now or else.' It's only natural for coaches to want to win and throw their best pitcher and encourage that pitcher to throw the pitches that get the players on the other team out. That coach doesn't really have to deal with the consequences of a pitcher getting hurt, as the consequences build up over time. A 10-year-old pitcher may not get hurt until he's 12 or 13 or 16.

"But it's not just the coaches. It's the parents who think if their son misses one season throwing a certain pitch or learns a pitch one year later than his neighbor, somehow he's going to fall behind and not be as successful down the road."

Some studies, Geier concedes, show curveballs might not be as damaging if thrown properly. But you're rolling dangerous dice if you think the pitching guru down at the ballfield is qualified to teach "properly." And Geier disagrees with the "properly" argument, even if your hired instructor is a big league pitching coach.

"Are the muscles in a kid's shoulder and elbow strong enough to resist the forces that the curveball puts on their shoulder and elbow?" Geier asks. "Because if they're not, the bones and ligaments are going to bear that stress. Really, at an early age the only two safe pitches are the fastball and the change-up."

Most youth baseball organizations in South Carolina have some kind of limit on the number of innings a pitcher is allowed to throw per week (six, for instance, for a 10-year-old), though some leagues loosen restrictions for the postseason. Little League now limits players 10 and younger to 75 pitches per game and players 11 and 12 to 85 per game.

USA Baseball's Medical and Safety Advisory Committee in 2006 recommended the following pitch limits: 50 per game and 75 per week for ages 9-10, 75 per game and 100 per week for 11-12, 75 per game and 125 per week for 13-14.

Tommy John myths

Most baseball parents have heard warnings and advice.

The truly scary part is a pair of reactions, both potentially damaging to kids:

1. "I know my kid isn't headed for big-league stardom so I don't care if curveballs damage his arm or not. I just want to see success now."

2. "No big deal, we'll just have Tommy John surgery."

Dr. Frank Jobe performed the cutting-edge surgery on Los Angeles Dodgers pitcher Tommy John's elbow in 1974. The reconstruction of the ulnar collateral ligament uses a tendon from elsewhere in the body, typically the forearm.

Geier in his talks cites an American Sports Medicine Institute study showing how the number of Tommy John surgeries done on high school baseball players averaged five per year from 1995-2000 and jumped to 61 in 2004.

"There's this myth out there that kids get stronger after Tommy John surgery, that they can throw as hard as they want and for as long as they want and then have surgery and get even better," Geier said. "That's a horrible idea."

Tommy John surgery recovery lasts 12 to 14 months, enough to impact two seasons. Enough to ruin a high school career, or force a player to lose interest in baseball.

"Sure, a high school pitcher comes back stronger than just before he was operated on and was weak," Geier said. "But while healing he is growing and had he not had surgery would have grown stronger anyway and would have had more velocity in his pitches anyway. So, of course, you're stronger after the surgery but it's not the surgery, it's because you had aggressive rehab and because you're older and stronger anyway."

Some baseball trends do not bother Geier.

"I'm a big supporter of travel ball," he said. "A lot of these kids are good enough to need better competition. The problem with travel ball is sometimes it doesn't allow for enough rest. You really need at least three months in a row of consecutive rest completely away from a throwing sport."

But, hey, Doc ...

What about when I was a kid and kids played ball on the sandlot all day all summer with no pitch counts?

What about all those kids in the Dominican Republic who play ball ... What? Every day including Christmas?

Why the need for all these prissy rules now?

"The problem in these anecdotal stories is that we don't really know what happens to Dominican kids or sandlot players," Geier said. "But we do know that studies by Dr. James Andrews in Birmingham and other studies have shown that the number of Tommy John surgeries has gone up many, many fold among high school kids in the last decade. That's purely an overuse injury. That is an injury that used to only be seen in professional pitches. The overuse problem is going up astronomically and there is no refuting that."

So enjoy the Little League World Series.

Reach Gene Sapakoff at gsapakoff@postandcourier.com.