TO THROW CURVES OR NOT TO THROW CURVES? THAT IS THE QUESTION

                                Kallas Remarks by Steve Kallas

             

For young pitchers (say, 13 and younger), for decades the recommendations of noted doctors have been don’t throw curveballs until you can shave or until you’re 14 or until you’ve reached puberty, etc.  Of course, anyone who turns on any game of the Little League Williamsport tournament (coming to a TV station near you in the next four weeks) will see 12-year-olds breaking them off like there’s no tomorrow (and for some of these kids, whether they (or their parents) understand it, eventually there will be no tomorrow when they’re on the operating table at 14 or 16 or 18 for Tommy John surgery).

           

But, apparently, there’s a new thought in town about whether the curveball is harmful or not.  Culminating last week in an article by author Mark Hyman in the New York Times (Sunday, July 26, 2009), two recent studies apparently claim that throwing a curveball is not as bad as throwing a fastball.  Aside from standing decades of research on its collective head (including research done by one of the very same doctors who now states the fastball may be more damaging), these newer studies have to be viewed very carefully (skeptically?) before you, the parent and keeper of the health of your child’s arm, should even think about allowing your youngster to start breaking off those curveballs.

                                

In fact, it says here that parents should not allow their kids to throw curveballs until they are at least 14 years old.  Much more important, the great Dr. James Andrews, despite being involved in at least one of the recent studies, says the same thing.

                          

THE RECENT STUDIES

                             

Well, there are two of them.  The first was published in the American Journal of Sports Medicine in July of 2008.  Its authors included Dr. James Andrews and his number two man at the American Institute of Sports Medicine (ASMI), Dr. Glenn Fleisig.  After studying (only?) 29 pitchers (apparently between 9 and 14-years-old) who threw five fastballs, five curveballs and five change-ups, the researchers concluded that “in general, elbow and shoulder loads were the greatest in the fastball … .”  The clinical relevance of this is that “the curveball may not be more potentially harmful than the fastball for youth pitching.”

                        

          Yikes!

                  

The second study was headed by Dr. Carl Nissen and is published in the latest edition of the American Journal of Sports Medicine (August 2009).  This study looked at (only?) 33 “adolescent” pitchers and concluded that “in general, the moments on the shoulder and elbow were less when throwing a curveball than when throwing a fastball.”  The clinical relevance is that “the findings based on the kinematic and kinetic data in this study suggest that the rising incidence of shoulder and elbow injuries in pitchers may not be caused by the curveball mechanics.”  It’s important to note that the age of the adolescent pitchers in this study range from 14-18 (i.e., past the time that Dr. Andrews and many others recommend that pitchers CAN throw curveballs).

                     

     Yikes again!

       

THE “OLDER” STUDIES

    

Most of the articles that I’ve written in the past (see, especially, Rick Wolff and Steve Kallas, Is Winning More Important Than Safety?) were based, with respect to curveballs, on two studies done by Drs. Andrews and Fleisig.  The first, done in 1996, is entitled “How Many Pitches Should I Allow My Child To Throw?”  This was based more on the response of baseball “experts” rather than actual study of youth pitchers.  It concluded that “In general, a child can start throwing a fastball at age 8, a change-up at age 10, and a curveball at 14.”  This would certainly seem to conflict with the more recent studies.

           

As a follow-up to this, Drs. Andrews and Fleisig, in 1999, studied 476 youth pitchers aged 9-14.  These 476 pitchers pitched 3,789 games during the 1999 spring season (now, that’s a sample).  As a result of this study, and as published in the American Journal of Sports Medicine in 2002, the authors recommended “that pitchers between the ages of 9 and 12 should limit themselves to throw only fastballs and change-ups, and NOT THROW SLIDERS AND CURVEBALLS.” (emphasis supplied).

          

That conclusion seems pretty clear to this youth sports parent.

                             

THE NEW YORK TIMES ARTICLE

                    

Author Mark Hyman correctly points out that these new studies leave, arguably, some parents and some doctors in a quandary:  To throw or not to throw curveballs, it seems, is now the question.  Dr. Fleisig is quoted in the article as saying “I don’t think throwing curveballs at any age is the factor that is going to lead to an injury.”  Dr. Nissen, one of the authors of the latest study, is quoted as saying “I can comfortably stand up and say the curveball is not the problem.”   

           

But, thankfully, Dr. James Andrews, maybe a little older, maybe a little wiser, clearly sees the potential problems with the new studies (one of which his name is on). While author Hyman states that Andrews does not challenge the ASMI study (remember, Dr. Andrews is the chairman and medical director of ASMI), he nevertheless has a lot of caveats to this study.

                 

“It may do more harm than good – quote me on that” said Andrews in the Times article.  While it’s not clear whether he’s referring to throwing curveballs or the findings of the new study, it’s clear that Andrews would say it refers to both.  Andrews told Hyman that children should not even think about throwing curves until they are 14.  Dr. Andrews states that the study has limitations such as that it was conducted in a lab.  Andrews states that things might be different in a real game on a real field.

                     

WHERE DOES THAT LEAVE YOU, THE PARENT?

                        

Well, it leaves you, hopefully, on the side of intelligence and caution.  It’s hard to believe that you now have some authority to back you up if you think it’s no big deal to have your 12-year-old breaking off curveballs at an alarming rate (and yes, if you’re at all involved, you know that there are parents, and especially coaches, who think it’s no big deal – just win, baby).

          

But, despite all of these findings, Dr. Andrews tells Mark Hyman of the 12-year-old (yes, 12) who he had just operated on.  The kid “tore his ulnar collateral ligament in two.  His travel ball coach called 30-something curveballs in a row.  He became fatigued.  Then he threw one that snapped his elbow.”

                         

You, the parent, should be very careful.  There are more of these horror stories coming down the pike now that a coach can wave a study at the parent and say “look, these are the doctors talking, not me.  It’s all right here in the latest study.”

                     

SOME FLIES IN THE OK-TO-THROW-CURVEBALLS OINTMENT

    

Just this month (July 2009), in Sports Health [A Multi-Disciplinary Approach], Drs. Fleisig and Andrews, among others, wrote an article entitled, “Baseball Pitching Biomechanics in Relation to Injury Risk and Performance.” That article concluded that, “to enhance performance and reduce injury risk, pitchers need to learn proper fastball mechanics at an early age.  A changeup is recommended as a safe secondary pitch to complement the fastball; the curveball can be added after fastball and changeup mechanics are mastered.”

                         

Even the new Nissen study states that “further evaluation of adolescent and adult baseball pitchers is warranted to help determine and subsequently reduce the risk of injury.”  And, again, the subjects in this study were already “of age” (14-18) for throwing curveballs.  They weren’t in the 11-13-year-old range that’s been discussed for years.

                         

A March/April 2008 article entitled “Prevention of Arm Injury in Youth Baseball Pitchers” in the Journal of the Louisiana State Medical Society (pp. 97-100), which includes Drs. Andrews and Fleisig among its authors, cites the 2002 study with approval and notes that the USA Baseball and Medical Advisory Committee recommends to young pitchers “Do not throw breaking pitches (curveballs, sliders) until puberty (about age 13).  Instead, a youth pitcher should focus on a fastball and change-up, and also pitch control.”

         

The caveats, set forth above by Dr. Andrews himself, to the recent Andrews/Fleisig study should give any parent pause before they allow their young kid to throw curveballs.

                         

ONE FINAL THOUGHT

                            

The author of this article has written for years on this topic.  I interviewed Drs. Andrews and Fleisig separately about two years ago and felt that Dr. Andrews clearly understood the problems that were coming down the pike with this new view.  As you know, Dr. Andrews, the foremost youth pitching authority on the planet, still has serious misgivings about curveballs and, despite the recent studies, still recommends that kids not throw curveballs until they are 14.

                       

While the author of this article is not a doctor, I did pitch a lot at Power Memorial Academy in New York City (in the tough New York City Catholic league, the CHSAA) and a little at Division I New York University (in addition to Brooklyn’s famed Parade Grounds League).  I would say the following, as a pitcher whose curveball was far and away his best pitch:  if they ever do a study where the realities of pitching are considered (a virtually impossible thing to do in a lab) or where a pitcher, for study, throws 30 fastballs in a row and then 30 curveballs in a row (or vice-versa), a lot more pitchers will wind up on Dr. Andrews operating table from throwing excessive, consecutive curveballs, like the example he gave in the New York Times article, than from throwing plenty of fastballs in a row.  You may have to be a fatigued pitcher to understand that, but I think it’s pretty clear.

                      

Parents, beware:  I wouldn’t let my son throw curveballs at a young age and nothing in these new studies changes my mind.  What about you?      

                     

© Copyright 2008 by Steve Kallas.  All rights reserved.