WAAC and PAAC Are At Root of Epidemic of Pitching Injuries

By Ken Reed

As with virtually every contemporary sports issue, win-at-all-costs (WAAC) and profit-at-all-costs (PAAC) mentalities are at the foundation of the numerous pitching injuries we’re seeing in baseball.

The American Sports Medicine Institute (ASMI) has called the rise in the number of professional pitchers requiring ulnar collateral ligament reconstruction (“Tommy John surgery”) an epidemic.

The problem starts at the youth level. Travel leagues, showcase tournaments, personal pitching trainers, indoor pitching facilities, etc., have led to a growing number of young athletes becoming year-round, one-sport athletes, including those who specialize in pitching. Pitching without extended breaks is a recipe for disaster.

Youth and high school coaches too often put winning games, tournaments and leagues ahead of the long-term health of their young athletes. At the college and professional level, and increasingly at the high school and youth levels, the quest is for more velocity, higher spin rate and greater break on breaking balls, seemingly without concern for what those goals do to young arms. Winning now is the overarching goal, not long-term athlete health.

Meanwhile, we have a growing number of youth sports entrepreneurs (aka youth sports vultures) who are driven by the almighty dollar. These folks create travel teams, showcase tournaments and pitching clinics in order to make a buck off the backs of young athletes and their parents.

That said, parents need to take some blame too, as too many are focused on getting their youngsters college athletic scholarships and a piece of the growing NIL pot at the college level. To that end, they are making their kids year-round, one-sport specialists as early as seven years old.

In the book, “Grit,” Angela Duckworth writes:

“Sports psychologist Jean Côté finds that shortcutting this stage of relaxed, playful interest, discovery, and development has dire consequences. In his research, professional athletes like Rowdy Gaines who, as children, sampled a variety of different sports before committing to one, generally fare much better in the long run. This early breadth of experience helps the young athlete figure out which sport fits better than others. Sampling also provides an opportunity to ‘cross-train’ muscles and skills that will eventually complement more focused training. While athletes who skip this stage often enjoy an early advantage in competition against less specialized peers, Côté finds that they’re more likely to become injured physically and to burn out.”

Many medical doctors, researchers, sports physiologists and trainers agree with Cote.

ASMI biomechanist Tony Laughlin believes you can’t examine the rise in UCL injuries requiring Tommy John surgery at the MLB level without also examining what’s taking place in youth baseball.

“There’s a lot going on in youth baseball, where they’re pitching a lot and pitching year-round, where they’re just riding these ligaments into the ground,” says Laughlin. “We want the focus to be for parents and younger kids to give their arms a rest.”

MLB pitchers in the ’70’s and ’80’s, grew up in the ’50s and ‘60s. The vast majority of them played three sports. One-sport athletes were a rarity. Kids in that era partook in many other activities in the summer besides baseball, including riding bikes, fishing, roller skating, swimming, exploring nature, etc. Today’s kids spend very little time on these kinds of activities. Travel baseball schedules are daunting. Down time for today’s youngsters typically includes hours spent on cell phones and video games. Moreover, kids’ parents tend to drive their children everywhere, making bikes a lot less needed than in decades past.

At the big league level, MLB organizations are paying athletes for increased velocity. The chance for a bigger salary is driving young pitchers to try and throw as hard as possible. But there’s definitely a downside to maxing out on velocity.

“Velocity is a factor,” says Dr. Glenn Fleisig, research director at the American Sports Medicine Institute. “All things being equal, throwing 95 mph is more stressful than throwing 90.”

College and pro teams are also pushing pitchers to boost spin rates and movement on pitches. Big-breaking sweepers are the latest evidence of that. These types of pitches are very hard on elbow ligaments.

Some MLB pitchers are suggesting that the introduction of the pitch time clock is a big part of the increase in pitching injuries. I don’t think so. Arm and shoulder injuries have been trending up for a couple decades now. Serious arm injuries, like those requiring Tommy John surgery, were rare in the ’80’s. When they happened, they usually hit older veteran pitchers, not youngsters in their teens and 20’s. Also, the length of games in the ’70’s and ’80’s was shorter than the games played since the advent of the pitch clock. Pitchers threw quickly in that era without the amount of injuries we see today.

There isn’t one simple answer to the pitching injury epidemic but the beginning of a solution starts by looking at the WAAC and PAAC mentalities that are at the root of this issue.

— Ken Reed, Sports Policy Director, League of Fans