The Importance of Pitch Count

Image Courtesy of: Jeff Chiu/Associated Press

As a college athlete Stephen Strasburg was one of the most sought after pitchers in the history of baseball. He destroyed opposing batters with a ridiculous fast baseball and off-speed pitches that seemed to roll off of a table. In 2009, he was the number 1 overall draft pick by the Washington Nationals. Soon after he blitzed through the minor leagues with a stat line that made fantasy baseball owners drool. In his major league debut he recorded 14 strikeouts, 0 walks and 2 earned runs. This Superman was real and he had arrived. However, this Superman also had his own kryptonite – the Ulnar Collateral Ligament.

In August, 2010, the Nationals announced that Stephen suffered a torn Ulnar Collateral Ligament (UCL) and would undergo surgery. Recovery from this surgery is at least one year. He was able to come back and finish off the 2011 season, in a limited fashion while in the minor leagues. Finally, at the start of the 2012 season he came back to the big leagues. So far all is well in 2012. He is arguably the most dominant pitcher in MLB. But his time will end in just a few days.

The Washington Nationals Senior Management and Medical Staff have imposed a 160 inning pitch limit on Strasburg to ensure longevity and health. That 160 inning limit will be reached this month – Strasburg will be done for the season. The first place Washington Nationals lose a significant weapon and the late season run and world series may be in Jeopardy.

A pitch limit seems logical – if you are not pitching you can’t get hurt right? If you limit pitches it must prevent damage right? Wrong! There is little to no scientific evidence to support the limited pitch count to prevent injury theory. According to A 2010 study, the maximum pitches thrown in a game declined from highs in the 160s and 170s in the 1980s and 1990s to highs in the 130s in the 2000s (1). However, over that span the number of injuries and times spent on the disabled list has increased significantly. Certainly, this is not data that correlates with limited pitch count.

Some will argue that fatigue brings about mechanical breakdown, which is known to be a cause of injury. However, a study done by Escamilla, et al, found that pitch mechanics did not change during high pitch counts (2). Additionally, the researchers found that shoulder and elbow torque was not effected by fatigue (2). Again, this is not data which supports limited pitch count.

There are studies which discuss recovery time. Kibler, et al, found that glenohumeral internal rotation is deficient for 72 hours after throwing (3). At 72 hours the range of motion returns to baseline levels. Limited internal rotation has been linked to shoulder and elbow pathology. If a pitcher begins to throw prior to obtaining baseline GIR, it can precipitate or worsen injury of the upper extremity.

Performance levels decrease with limited rest. Potteiger et al,  examined muscle fiber damage with periods of two or four days of rest. Like the Kibler study, this data shows muscle damage had returned to baseline levels after 72 hours (4). In addition pitchers had less velocity with two days of rest compared to four days (4).

So, the question remains; is sitting Strasburg beneficial to his health? The above data would suggest otherwise. Data suggests recovery times of 72+ hours allows for return of normal arthrokinematics (GIR) as well as reduction of muscle soreness and enzyme levels in muscle tissue (3, 4). When it comes to injury prevention, it appears days off is more important than pitch count. Neuromyofascial hypertonicity, poor recruitment patterns, and suboptimal arthrokinematics are common with pattern overload and these can be corrected with focused rehabilitation.

What are your thoughts? Should he be benched?

References:

  1. Bradbury, JC, and Forman, S. The Impact of Pitch Counts and Days of Rest on Performance among Major-League Baseball Pitchers. J Strength Cond Res. 2012 May;26(5):1181-7.
  2. Escamilla RF, Barrentine SW, Fleisig GS, Zheng N, Takada Y, Kingsley D, Andrews JR.  Pitching biomechanics as a pitcher approaches muscular fatigue during a simulated baseball 16 game. Am J Sports Med. 2007; 35(1):23-33.
  3. Kibler WB, Sciascia A, Moore S.  An acute throwing episode decreases shoulder internal rotation. Clin Orthop Relat Res. 2012. Jun;470(6):1545-51.
  4. Potteiger JA, Blessing DL, Wilson GD. Effects of varying recovery periods on muscle enzymes, 2 soreness, and performance in baseball pitchers. J Athl Train. 1992; 27(1): 27-31.

3 thoughts on “The Importance of Pitch Count

  1. Jamey Gordon, DPT, ATC, CSCS

    The studies you cited were done on healthy pitchers. Keep in mind this is Strausburg’s first full year back after TJS. Limiting innings this year is a long-term rehab consideration, not an absolute for all pitchers. The question you raise about pitch counts is valid, just not for Strausburg in this case. A more pertinent question our research needs to answer is whether there are certain biomechanical issues that predispose one to UCL injury. We discovered factors related to ACL injuries in female athletes, let’s do the same for our pitchers.

    Reply
    1. Josh Stone, MA, ATC, NASM-CPT, CES, PES, FNS

      First and foremost thanks so much for the input. I completely agree with your statement – Strasburg is a long term investment. But, I posted this as a debate – I have yet to see evidence that a limitation works, have you? Likewise, how many pitchers have had recurrent UCL tears? Very little. How many of those are because a pitch count was not imposed? I cannot think of one such example.
      I agree we need more refined questions in research to understand the cause of UCL. Does fatigue alter mechanics and increase rotational torque at the elbow? Yes, poor neuromuscular hip control has been proven to precipitate ACL injury. However, the question of shoulder mechanics has been raised many times – but significant data lacks regarding the link between shoulder mechanics and elbow torque. Little work has questioned distal mechanical issues precipitating elbow injury. A recent study indicated that pro-supination limitations created altered glenohumeral mechanics. Maybe this is a cause?
      Cheers

      Reply
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