The Denver Post
SPORTS PITCHING EVERY GAME RAISES SAFETY CONCERN
But many high school softball coaches disagree with their concern
Valor Christian rolls into the state softball tournament this weekend as the heavy favorite in Class 4A, thanks largely to its undefeated ace, senior Ali Kilponen, the state’s top collegiate prospect. She has pitched every inning for the Eagles this fall.
Kilponen’s dominance aside, the fact that she gets the ball every game — not uncommon in high school softball — raises a number of questions.
Is it safe for one player to pitch every game? Should there be a limit on pitching — as there is in prep baseball — in prep softball? And is a culture change necessary in a sport where the idea persists that pitchers, unlike their baseball counterparts, can throw as much as they want without suffering an injury?
Answers depend on whom you ask.
For her part, Kilponen is happy carrying the entirety of the Eagles’ pitching load, especially if that results in a fourth consecutive state championship.
“I know I’ve prepared myself to throw as much as I have this season, and I always want the ball,” Kilponen said. “I’m definitely not the only pitcher in the state who feels that, and who feels like I can throw all the games when it matters most.”
Valor Christian coach Dave Atencio remains firm in his belief that, with proper technique and guidance, softball pitching overuse is a nonissue
“It’s a different arm motion, and the wear and tear on the rotator cuff is not there,” said Atencio, who was a fast-pitch softball pitcher for more than two decades.
The majority of Atencio’s peers agree with him — all but one of a dozen local softball coaches contacted for this story said they would oppose pitching limits — but some orthopedists say they’re starting to see first-
hand proof that concern about unregulated pitching is warranted.
“I’m telling you, I’m hearing it from the grassroots — people are saying we need guidelines, we need pitch counts, we need more effective long-toss programs,” said Dr. Steve Jordan, an orthopedic surgeon for the Andrews Institute in Florida, who estimates that he has seen about a threefold increase in softball pitching injuries at his practice over the past decade.
The majority of that concern, however, isn’t necessarily directed at high school-sanctioned softball, where teams in Colorado have a regular season of only 19 games apiece.
“Travel ball and those elite summer teams is where we’re really having trouble, because what we know from epidemiological work at the high schools is that girls who had more seasonal exposure — in other words, more pitches per season — were at a higher risk,” Jordan said. “What we found is that some of these girls are pitching as many as 1,000 or more pitches in a weekend summer tournament — which is equal to the risk factors we saw in an entire season of high school ball.”
Also at issue, said Dr. Kristen Thomas, an orthopedic surgeon in Oregon, is the validity of the argument that underhand pitching can’t be harmful.
“There’s this conception that softball pitchers don’t get injured, but biomechanics studies have shown that throwing a pitch underhand is equally as stressful as throwing an overhand pitch to the shoulder, and in fact, it has a higher rate of stress to the biceps tendon than an overhand throw,” said Thomas, who specializes in shoulder injuries.
She conducted a 2010 research study that examined the effect of range of motion, shoulder strength, pitch count and pitch frequency on 50 pitchers at various NCAA programs.
“There’s a big disconnect between the players and the coaches, because anytime I talked to a coach and said, ‘Hey, can I come talk to your players about shoulder injuries?’, the coach would say to me, ‘You can come here, but I don’t have any pitchers who are injured. All my players are doing fine and they don’t have any shoulder pain or problems,’ ” Thomas said. “But when I actually talked to the players, the fact is there’s a large amount of players who play hurt, who played injured and who end up getting surgery in the offseason.”
But a gradual culture shift — highlighted by more pregame and postgame arm-care awareness at the lower levels of softball — might be resulting in a change in the thinking of young pitchers.
“It gets to a point where practice and games become detrimental,” said Columbine freshman pitcher Korbe Otis, a Louisville commit who leads the Rebels’ Class 5A state tournament push. “I think pitchers shouldn’t throw more than five days in a week, even in the offseason, because that will cause your arm to eventually give out.”
Rule book unchanged
So, if top doctors maintain that too much pitching can be dangerous, why isn’t anything done about it?
The bottom line is that the hard data here — injury statistics through High School RIO, the National Federation of State High School Associations’ digital collection tool — doesn’t support such a move.
“There really hasn’t been a ton of information out there to indicate that overuse injuries in softball are prevalent,” said NFHS director of sports Sandy Searcy. “So, as far as pitch count, when NFHS instituted a pitch count in baseball, everyone turned to softball and wondered if that would be good for that sport, too. But everything we’ve been presented with by (High School RIO) and our Sports Medicine Advisory Committee has not indicated there is the need to create a pitchcount rule or mandatory rest days for softball.”
High School RIO’s original softball data in 2005-06 listed the sport with an injury rate of 1.1 for every 1,000 participants. That injury rate increased to 1.34 in 2016-17.
But further data breakdowns show decreased throwing-related injuries. In 2005-06, 17.2 percent of reported injuries were to the shoulder or arm and 10.4 percent of reported injuries were to pitchers, while last year’s data says 8.8 percent of reported injuries were to the shoulder or arm and 8 percent of reported injuries were to pitchers.
That data is in line with the thought process of successful, longtime Colorado high school softball coaches such as Legacy’s Dawn Gaffin, who, like Atencio, opposes limitations on pitch counts. Gaffin argues that the connection between coach and player — which Thomas found to be lacking in her study — is crucial in maintaining a pitcher’s health, as is having a minimum of three quality arms on the staff during the club season.
And while the coach and the doctor differ on their stance on the need for limitations, Gaffin and Thomas agree that with no rules in place, the onus is on the coach to know when it’s time to make a switch from pitchers whose competitive pride, like a dazed quarterback after a big hit, can hinder any admission of pain.
“It’s a checks-and-balances type of situation — you’ve got to constantly be checking in with your pitchers, and you need to know your kids,” said Gaffin, who has guided Legacy to six state championships using a combination of ace and staff approaches. “You know what your kid looks like when they’re fatiguing and when there’s no more pop left in their pitch, or you can even tell by the look on their face and their mannerisms on the mound.”
At the Colorado High School Activities Association, assistant commissioner Bert Borgmann said the organization’s position on softball arm injuries is that the issue isn’t as pressing as the larger scope of the problem caused by the culture of year-round sports.
“I look at the softball piece as a microcosm of some of the issues that you have in many sports, which is repetitive injuries,” Borgmann said. “And I do know conversations have occurred with the NFHS about the concern with repetitive injuries, but like how I see it, it wasn’t necessarily about strictly baseball and softball, but also volleyball and swimming and other sports where it’s also a problem.”
Future of care
The traction toward an actual rule change on pitching limitations in prep softball is in its infancy. But that doesn’t keep those who have made study of sports injuries their life’s work — such as Jordan, Thomas and Dr. Stephen Nicholas — from raising the caution flag.
“We’re abusing softball pitchers’ shoulders because we’re not allowing them to recover appropriately from the stress incurred during a game,” said Nicholas, the director of the Nicholas Institute of Sports Medicine and Athletic Trauma in New York. “The main factor in those resulting injuries is chronic overuse, period. No matter what, the arm needs time to rest, and that has to be addressed.”
But until there is tangible data to support that view, prep pitchers will continue to be able to throw every game.
“Good grief, I hope coaches are using common sense enough that they’re not injuring their girls,” Gaffin said. “Or else CHSAA would have to step in and impose some kind of pitch count.”