Arm strong: preventing pitching injuries in Central Oregon

Wave of Tommy John surgeries gets attention of prep baseball coaches, players


Published Jun 3, 2014 at 12:01AM / Updated Jun 3, 2014 at 06:02AM

Marc Horner has no regrets about the decision.

He concedes that perhaps he should have more strongly considered pulling J.D. Abbas. A Redmond High senior and the Panthers’ starting pitcher that day, Abbas was working toward 162 pitches.

But well after Abbas’ 10-inning outing, well after Redmond’s 5-4 loss to Sherwood in the 2013 Class 5A baseball state semifinals, Horner has no regrets at all.

“I have more regrets in having pulled kids too early and gotten heat from my team and parents and stuff like that,” says Horner, who coached the Panthers for 12 years before stepping down at the end of last season. “There’s been two times in my career that I let a kid go over 110 pitches.

“Still,” Horner adds, “162 is a lot of pitches.”

Pitch counts in baseball — 100 is generally considered a safe limit in the big leagues — are getting a lot of attention these days in the wake of an epidemic that is sweeping Major League Baseball in 2014, one that has opened eyes as to how fragile the arms of pitchers truly are.

According to Jon Roegele, a writer for the website The Hardball Times, more than 40 players so far this season have suffered injuries to the ulnar collateral ligament in their elbows, resulting for all of them in season-ending surgery — the increasingly well-known Tommy John surgery. All of last year, that number was about 50.

Dr. James Andrews, a world-renowned orthopedist, has found that UCL reconstruction, which involves replacing the approximately 2 1⁄8-inch elbow ligament with a tendon from another part of the body, has increased tenfold in the first decade-plus of the 21st century.

The harsh increase in the number of injured big league pitchers, however, has not drastically affected Central Oregon prep baseball coaches. It has not forced them to completely change how they train pitchers. But they are definitely looking closer for telltale signs that could lead to injury.

“I don’t think people are doing things differently because of more injuries,” says veteran Sisters High coach Steve Hodges. “I think these things go in waves. But we try to be smart in how we prepare.”

Smart like Ridgeview, which keeps tabs on each player’s pitch count and includes not just in-game throws but also warm-up pitches before and during the game.

In the Ravens’ 9-8 win last Wednesday over Cascade in the first round of the Class 4A state playoffs, for example, Ridgeview starter Dakota Schaumburg finished with 115 pitches in a complete game. But take into account his bullpen work and his warm-up pitches before each inning, and that number comes closer to 175, according to Ravens coach Josh Davis.

But it is a progression to get to that number of pitches. The second-year Ridgeview coach says that at the beginning of the season his pitchers are restricted to about 45 pitches per game. As the season rolls on, that pitch-count limitation eases.

Smart like Sisters, which warms up to warm up. Before loosening their arms, the Outlaws routinely run and stretch. They then throw from a short distance, allowing players to develop and execute proper throwing technique and to use their legs and lower back with each toss to ease the strain on their arms.

Smart like both programs, whose pitchers run daily — before and after competition. Hodges emphasizes that taxed arms recover quicker if players perform aerobic exercise to speed the flow of blood back into their joints and muscle tissue.

“We always have our kids elevate their heart rate, get blood flowing through the joints, before we ever pick up a baseball,” says Hodges, whose team is ranked No. 1 in Class 4A and, like Ridgeview, is playing in the state semifinals today. “That is a cardinal rule of our program and a foundational piece of how we approach arm maintenance.”

Conditioning plays a significant role in preventing these types of injuries, Hodges observes. Certainly, there are ways in which players throw that put more strain on their arms. That is why the Outlaws warm up to warm up.

“I never really realized how much running (pitchers) do,” Sisters junior Justin Harrer says. “But it’s really important to do that stuff. It’s maybe not the easiest thing to do. But it’s the right thing to do, and it’s going to preserve your arm down the road.”

High school coaches generally are mindful of the risks their pitchers face and are careful to protect those young, developing arms. This year’s apparent epidemic of serious arm injuries at the professional level no doubt is serving to intensify those concerns.

“It definitely opened my eyes for sure,” Sisters senior pitcher and catcher Joey Morgan says. “It kind of motivates me more to really take care of my arm and be smart about it. It definitely had a big impact on us and made us focus up more.”

Coaches look for warning signs — fatigue, decreased velocity and loss of control. For Hodges, those three factors trump simple pitch count.

“Nine times out of 10, when a pitcher consistently throws high (in the strike zone), they’ve lost their legs,” Hodges says. “And when they’ve lost their legs, they’re out of sync and out of rhythm and they’re not doing anybody good. … We tend to think that everything has to with the arm. But actually, in pitching, a lot has to do with their legs and their core.”

Yet the most important prevention factor is communication — between player and coach. If the warning signs are evident, coaches begin to worry. And if a pitcher says he is tired or sore, rare is the coach who will not call immediately for a reliever. Communication between player and coach is key.

“If his arm’s tired — ‘I’m not feeling right’ — I’d definitely take him out,” Davis says. “The kids know their bodies, the older kids. The younger kids, we monitor them a little closer.”

Overuse has often been cited as a cause for UCL tears. A study by Andrews found that pitchers who competed in leagues more than eight months a year were five times more likely to need surgery by the age of 20. Pitchers who regularly threw 80 pitches in a game were four times more likely to suffer injury. And players who regularly pitched with tired arms were 36 times more likely to need surgery. The biggest risk factors for UCL tears, Andrews concluded, were playing year-round baseball, fatigue and velocity.

“Arm injuries come from kids throwing max-out every single time,” Hodges says. “You’ve got a guy knowing he’s got to compete, and he throws his best fastball every single time. That’s when you start getting arm injuries.”

Ulnar collateral ligaments in high school pitchers, Andrews has observed, have not completely developed and cannot endure the same strain that older, more experienced pitchers may be better equipped to manage.

But that does not mean high school pitchers, at least here in Central Oregon, are not aware of the risks and how to train properly.

“Growing up, you’d throw and then maybe ice and not throw the next day,” Harrer says. “But up at this level, when you’re throwing hard and a lot of pitches, we’ve really learned that you’ve got to run every time you pitch and you’ve got to ice and make sure you’re doing everything right to preserve your arm and keep a healthy arm throughout your career.”

Last month, Dylan Forsnacht of Rochester (Wash.) High pitched 14 innings and threw 194 pitches. Horner cringes at the thought. He has a similar reaction to J.D. Abbas’ 162-pitch affair.

Abbas recalls his shoulder being sore for a week after that semifinal game, though he says it was a pre-existing condition. While at Chemeketa Community College in Salem this past fall, Abbas was diagnosed with tendinitis in his throwing elbow and was instructed to go through physical therapy until he was completely healthy. But before the spring season began, Abbas hung up his cleats and decided to focus on life after baseball.

Horner believes that one game does not define him as a coach, or Abbas as a player, especially since Redmond High followed a strict pitching regimen similar to that of other Central Oregon programs. It was an incredibly gutsy performance, Horner says, one that he will never forget — or regret.

Still, the former Panthers coach says, his decision to stick with Abbas was the coach’s responsibility, and Horner accepts that onus.

“I should have taken charge and probably just pulled him,” Horner says. “I could probably care less about the win. I’ve been doing it long enough to where I’ve got wins and won state championships. I wanted it for him. He wanted it for him, and his teammates wanted it for him and the team. I probably listened to the team a little bit too much.”

—Reporter: 541-383-0307, glucas@bendbulletin.com.

GAME OF THE WEEK

In the bottom of the sixth inning, freshman pinch hitter Ryan Cook singled to bring Alex Olivier home from second base and give Sisters a 3-2 win over Mazama in the first round of the Class 4A baseball state playoffs on Wednesday. After Joey Morgan pitched a shutout seventh to finish a complete game, Sisters advanced to the quarterfinals for the third straight year.

PLAYER OF THE WEEK

Tyler Ross went 4 for 4 and accounted for five Ridgeview runs in the Ravens’ 9-8 home win over Cascade in the first round of the Class 4A baseball state playoffs on Wednesday. The junior smacked a three-run, inside-the-park home run in the first and belted a solo homer in the third before doubling and scoring in the fifth.

STAT OF THE WEEK

Sixty-seven: The number of pitches Ridgeview junior Sara McKinney needed in a complete-game win in the first round of the Class 4A state softball playoffs on Wednesday. McKinney scattered four hits and struck out six in a 4-0 win that lasted barely over an hour.

In today’s state semifinals

Class 4A baseball

No. 4 North Marion (22-7) at No. 1 Sisters (24-4), 5 p.m.

Class 4A baseball

No. 6 Ridgeview (21-7) at No. 2 Henley (27-1), 5 p.m.

Class 4A softball

No. 6 Ridgeview (20-5) at No.2 McLoughlin (21-3), 5 p.m.