Pitching Injury Prevention

10/20/2009
Updated 3/10/2011

My work on pitching injury prevention is quite widely read and well known the youth through major league levels. However, every week or so I get an e-mail from someone asking my opinion about some aspect of pitching injury prevention that I have already addressed.
     While this frustrated me at first, I have come to understand that what these e-mails are telling me is that what people need is a primer that pulls together, at a high level, all of my current thinking about pitching injury prevention. They can then drill into the different aspects of pitching injury prevention that interest them.
     This page is my attempt at putting together such a primer and an overview of my current views with respect to pitching mechanics.

Overuse: The Biggest Problem
Facing Younger Pitchers

The biggest problem facing young pitchers — and by that I mean pitchers who are younger than 16 and who generally still have open growth plates in their elbows and shoulders — is not the curveball, it's overuse.
     ASMI recently completed a study of youth curveballs which suggests that the forces that result from throwing a youth curveball aren't great enough to cause the kinds of injuries that young pitchers are experiencing. Instead, it appears that the primary things that are driving up injury rates in young pitchers are...

   - Multiple pitching appearances in a single tournament.
   - Travel teams.
   - Year-round play.
   - Premature pitching specialization.

In my opinion, the reason why curveballs were blamed for these problems is that you only tend to see them in more advanced pitchers, and by that I mean pitchers who are much more likely to travel, play in multiple tournaments, and pitch in multiple games in those tournaments (which make them vulnerable to overuse injuries).

PAP is (Mostly) Crap

I do not believe that metrics like Pitcher Abuse Points (PAP) or PAP3 (PAP cubed) are, in and of themselves, good predictors of pitching injuries. If there were, then durable old Randy Johnson wouldn't appear at the top of nearly every career PAP3 list I see.
     If abuse, as it is defined by PAP3, is so bad then why has Randy Johnson been able to tolerate it so well?
     I do believe that there is some interaction between abuse and pitching mechanics. I think it's plausible to believe that if you abuse a pitcher with poor pitching mechanics, like Dusty Baker did to Mark Prior, then he will break down sooner.[1] However, if you heap the same level of abuse on a pitcher with good pitching mechanics, he will tolerate it.

My Current View of Dr. Mike Marshall

Anyone who has followed my work for any period of time will know that my thinking about pitching mechanics has been heavily influenced by the work of Dr. Mike Marshall. Dr. Marshall was the person who convinced me that it was a worthwhile effort to drive down the rate of injuries in pitchers.
     However, anyone who has closely followed my work also knows that I have become increasingly uncomfortable with many of Dr. Mike Marshall's latest ideas. While I am a big fan of his ideas about pronation and conditioning, I  have come to believe that, in an effort to differentiate his work and demonstrate how much he has broken with the establishment, Dr. Mike Marshall has basically gone off the rails. I explain this in more detail in my essay, Dr. Mike Marshall: My Current View.