Softball pitchers could face arm injury due to overuse

Softball pitchers could face arm injury due to overuse

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Softball pitchers could face arm injury due to overuse

Rye Neck pitcher Diana King warms up before a home game April 28, 2015.

Rye Neck pitcher Diana King warms up before a home game April 28, 2015.

For aspiring baseball pitchers, the throwing arm is treated as a fragile package — an object that must be cared for, tended to often, and capable of being damaged at any moment.

Precautions such as pitch counts and days’ rest are used by coaches to keep arms healthy, but despite all of the attempts to protect pitchers, the number of Tommy John surgeries — the usual end result when a pitcher’s arm is injured from overuse — continues to soar.

Softball pitchers, on the other hand, are throwing multiple complete games a week. Few coaches and physical therapists, if any, express concern over the number of pitches thrown. There are no established guidelines on how many pitches are too many, and no regulations are being considered, though some researchers suggest that the number of girls being injured is significantly underestimated.

Younger baseball pitchers are undergoing surgery at an “unprecedented” rate, Dr. James Andrews, one of the top Tommy John surgeons in the world, told MLB.com.

A survey conducted in 2012-13 among active major league baseball players revealed that 25 percent of pitchers underwent the famed elbow-ligament replacement surgery at some point in their careers.

But when it comes to softball, girls rarely, if ever, injure their arms from overuse severely enough to require surgery. Of course, how you throw a pitch makes a difference.

“The only time I’ve seen injuries with the shoulder or the arm is when (a pitcher) didn’t have proper mechanics,” said Suffern coach Melissa Luciano, a former catcher at Western Connecticut. “Overhand (throwing) has more force on the elbow and the shoulder. With underhand, there’s not as much pressure, it’s more getting momentum going into (a pitch).”

Pearl River sophomore Emily Turilli said she has “no idea” how many pitches she throws each game, and chuckled at the thought.

“I’ve never thought about that,” she said.

Suffern pitcher Kate Wood pitches from a kneeling position at the start of her warmup before a home game April 28, 2015.

Suffern pitcher Kate Wood pitches from a kneeling position at the start of her warmup before a home game April 28, 2015.

“Your shoulder is not really made to be whipped into thousands of circles a week”

Dr. Stephen J. Nicholas, who is the director of the Nicholas Institute of Sports Medicine and Athletic Trauma, with offices in Scarsdale and Manhattan, said that poor technique is the number one cause of softball-related pitching injuries. Overuse is right behind.

“The problem with women’s softball is that they have not caught up with men’s baseball in that there’s no pitch count for these girls,” he said. “These girls go out there and they can pitch doubleheaders; they can pitch consecutive days; and really good softball pitchers are being burned out all the time because of pitching too much.”

Nicholas attributed the rise in softball injuries to the sport being played year-round, much like baseball has been for years. Pitchers in both sports should not be pitching in consecutive seasons throughout the year, according to Nicholas.

“They’re getting too many reps and too many throws on the arm,” he said. “The arm needs a period of time to adjust and to accommodate the stress that it gets put under.”

Clarkstown South senior Briana Keaveney suffered a rotator cuff injury years ago due to overuse of her shoulder between softball and swimming, but pitched every game for the Vikings last season.

Pitching in an underhand motion may be more natural than an overhand delivery, but the SUNY Cortland-committed hurler is still conscious that it can’t be safe to be pitching game after game.

Clarkstown South's Briana Keaveney delivers a pitch during a game at Pearl River May 2, 2015.

Clarkstown South’s Briana Keaveney delivers a pitch during a game at Pearl River May 2, 2015.

“It’s a dangerous thing when pitchers are pitching all the time and not icing. It puts a lot of pressure on your shoulder,” said Keaveney, who struck out 10 in leading the Vikings to their first-ever section title Saturday. “Your shoulder is not really made to be whipped into thousands of circles a week.”

Numbers don’t lie, but they can embellish

There are a significantly greater number of boys playing baseball — including professional leagues — than there are girls playing softball. While there is no denying that the overwhelming majority of pitching-related injuries occur in baseball players, some medical experts claim the numbers can be slightly misleading.

Nicholas said the ratio of baseball injuries to softball injuries he sees is about 5:1, but that’s only because of the much larger number of baseball players, compared to softball players.

For every 1,000 players of each sport, including levels beyond high school, Nicholas said the number of injuries among both would be “pretty equal.”

Nicholas, a former physician for the Jets, Islanders and Hofstra University, said he’s seeing “more and more” women with ulnar collateral ligament injuries — for which Tommy John surgery is prescribed. He has performed seven or eight Tommy John surgeries on softball players in the last three years, which he said was “very, very rare.”

The number could be higher. There are no options for professional women’s softball after college, so if a player requires surgery, Nicholas said she will most likely stop playing. Boys might still have a small chance to play professional ball — overseas, minor league, for an independent team or major league baseball — and so may consider surgery no more than a bump in the road.

“Girls are more likely to stop playing if they needed Tommy John surgery, versus young boys, who will have the surgery and go back to play the game,” said Nicholas, who estimated he operates on well over 80 baseball players a year. “You don’t need Tommy John surgery if you have no desire to play the sport.”

Rye Neck pitcher Diana King during a game with Ardsley at Rye Neck April 28, 2015.

Rye Neck pitcher Diana King during a game with Ardsley at Rye Neck April 28, 2015.

“There’s never been much discussion on it at all”

Beginning at the Little League level, baseball pitchers must rest a certain number of days between starts depending on their pitch count from the previous game. Meanwhile, softball pitchers as high as the Division I college level often throw every game.

Doug Little, who pitched for Florida State from 1983-86, owns the Division I baseball career record for innings pitched with 549. The Division I record for most softball innings pitched in a career belongs to Tennessee alumna Monica Abbott, who threw 1,448 innings from 2004-07.

Last May, Rye sophomore George Kirby threw 153 pitches during a game on only three days’ rest, helping to bring home his team’s first Section 1 championship in three decades.

Local baseball fans were outraged at head coach Mike Bruno. Many thought Bruno put Kirby, a college prospect, in a dangerous situation, allowing him pitch so much after so short a rest. A pitcher usually throws about 100 pitches per game and Kirby, fans said, could have hurt himself during the game, or put an unneeded strain on his arm resulting in an injury down the road.

Kirby demanded that he be kept in the game, and later said it felt like he was “throwing a normal game.”

Two games later, when the then-16-year-old went to make his next start, all eyes were on his pitch total. Kirby led his team to their first-ever regional championship in another complete-game effort.

This time he threw just 76 pitches.

After the game, Kirby said he felt “fine.” Bruno publicly discussed what he had already told his team in regards to the previous game.

“That’s on me. It wasn’t on the kids, and I’ll take that,” he said. “I told the kids, ‘George did nothing wrong.’ He did what anybody would want your star pitcher to do and I’ll take all the criticism.”

Bruno admitted that he “probably wouldn’t do it again” if given the same situation, but tried to explain his motives to fans. “At that moment, if you were at the game, you might understand why I did it.”

Kirby committed to play baseball for Elon University a month later.

North Rockland pitcher Kayla McDermott during a game at Suffern April 28, 2015.

North Rockland pitcher Kayla McDermott during a game at Suffern April 28, 2015.

By contrast, when North Rockland junior Kayla McDermott and Suffern junior Allie Wood faced off this April, the two pitchers threw a combined total of 359 pitches during a single softball game.

On April 30, McDermott and Wood battled in an epic pitcher’s duel that lasted 11 innings, during which the Manhattan-committed McDermott threw 176 pitches, a career high, striking out 18 batters in all 11 innings.

Wood threw 183 pitches and struck out 10 batters.

Unlike with Kirby, there was no outrage from fans or whispers throughout the section, and McDermott didn’t have the luxury of three days’ rest.

“I usually pitch five days a week, sometimes six, so my arm has been fine with pitching multiple games in a row,” McDermott said after the game. “It’s not really a factor for me.”

Cathy Allen, New York State Public High School Athletic Association softball coordinator and former Berne-Knox-Westerlo coach, said she never kept track of pitch counts.

“It’s never been brought up and there’s never been much discussion on it at all,” she said.

Coach Luciano, however, keeps an eye on things.

She said she regularly checked on Wood during the game and asked if her arm was getting sore. She saw no signs of fatigue, which she said is a more important factor than the pitch count.

But had Wood reached the 200-pitch plateau, Luciano said she would have pulled Wood from the game, regardless of the pitcher’s wishes.

“At that point, I’d be like, ‘Alright, enough,’ just because they’re still young,” Luciano said. “I do trust all of them in telling me that when they’re getting tired or getting fatigued to kind of give me the head’s up.”

In their next starts, the girls had vastly different results. McDermott pitched a 14-strikeout complete game the following day. Wood was pulled after 1 1/3 innings after giving up seven runs to a powerful John Jay-East Fishkill lineup.

Rye Neck pitcher Diana King during a game with Ardsley at Rye Neck April 28, 2015.

Rye Neck pitcher Diana King during a game with Ardsley at Rye Neck April 28, 2015.

“It’s just an athlete thing”

Wood’s older sister, Kate, is a senior heading to SUNY Oneonta, which lets the girls coordinate their workout schedules. The girls, who play 50 out of 52 weeks every year, said that off-the-field training is essential to protecting your body on the field.

Allie Wood said that she could have thrown more pitches had the game remained tied. “That’s partly adrenaline rather than stamina,” she said.

Both girls admitted that they’re usually sorer from outfield practice — when they’re throwing overhand — than a day in the circle, but they had divergent views on the possibility of injuring themselves down the line due to overuse of their arms.

“I don’t really like to think about that,” Allie Wood said.

Kate Wood was much more direct.

“I think, no matter what you do, you’re going to be in pain at some point in your life later on,” she said. “Soccer players are going to be in pain; baseball players are going to be in pain; so softball players, if you get a little bit of pain, I think it’s just an athlete thing.”

Rye Neck senior Diana King, one of the top pitchers in the section, was diagnosed with medial epicondylitis, commonly referred to as “golfer’s elbow,” and a strain in her right tendon in April. The senior said the diagnosis is from “constantly pitching,” but called it “nothing serious.”

Doctors have advised her to rest so that she can heal the injury, but King, who pitched the Panthers to their first section title since 2002 on Saturday, said she has no plans to sit.

“If I took a few months off, I just wouldn’t feel that much pain anymore,” she said, “but that’s not gonna happen.”

Panthers coach Joan Spedafino, the section’s all-time winningest coach, was a baseball pitcher during her adolescence. The 30-year coach said the highest pitch count she’s seen was around 130, and expressed surprise when she heard about McDermott and Wood’s pitch counts from April 30.

“That’s why it’s so vital to be accurate,” said Spedafino, who estimated that King’s pitch count each game is between 90-100 and that she will pull King whenever she finds an opportunity.

Spedafino, said she does not have a single-game pitch limit, and instead watches the pitcher, much like Luciano.

“You see how they’re feeling, see how they’re going,” she said.

Twitter: @Zacchio_LoHud, @LoHudSoftball

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