Physical Therapy, Baseball, Pitching
Joe Midgett
Early Sports Specialization

Early Sport Specialization (ESS)

Before I explain why, lets briefly get on the same page with a definition for Early Sport Specialization (ESS). Typically ESS refers to year-round (for at least 8 months) intensive training or competition in an organized sport by young athletes (<12 years of age) while excluding all other sports.

Injury Risk

One of the most studied problems with early specialization is increased injury risk compared to peers. The biggest factor contributing to this increased risk was participation in any individual sport for greater than 8 months of the year3. This is especially true in baseball pitchers where pitching for more than 8 months per year was correlated with a 500% increase in risk for Tommy John surgery. (I discuss this and other risk factors for UCL injury in my blog “Minimizing the Risk for UCL Injuries in Throwers” *hyperlink). Across all sports there is an increased injury risk of 1.81 times in highly specialized athletes compared to their multi-sport peers5.



Early Sports Specialization
Physical Therapy, Baseball, Pitching
Joe Midgett
Protecting Pitchers Elbows

Minimizing the Risk for UCL Injuries in Throwers

The Biomechanics of the baseball throw:

Baseball fans thrive on interesting facts and statistics, but out of all of these facts, the science behind throwing a baseball has to be the most fascinating. The way that an elite athlete’s body can act as a coiled spring, transmitting the necessary forces to turn a baseball into an eye-blur is truly awe-inspiring. During the throw the elbow functions as a hinge joint, going through rapid extension at about 2400°/s for a professional pitcher. (Which is the equivalent of saying that in 1 second the arm could whip around 360° nearly 7 times). Accelerating to this incredible speed places a force on the Ulnar Collateral Ligament (UCL) of your elbow reaching 64Nm (nearly 50lbs).4 Not surprisingly, there is some fallout over time due to the transmission of this high force.

Protecting Pitchers Elbows

Tommy John

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Early Sports Specialization

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Early Sports Specialization

Early Sport Specialization (ESS)

Before I explain why, lets briefly get on the same page with a definition for Early Sport Specialization (ESS). Typically ESS refers to year-round (for at least 8 months) intensive training or competition in an organized sport by young athletes (<12 years of age) while excluding all other sports.

Injury Risk

One of the most studied problems with early specialization is increased injury risk compared to peers. The biggest factor contributing to this increased risk was participation in any individual sport for greater than 8 months of the year3. This is especially true in baseball pitchers where pitching for more than 8 months per year was correlated with a 500% increase in risk for Tommy John surgery. (I discuss this and other risk factors for UCL injury in my blog “Minimizing the Risk for UCL Injuries in Throwers” *hyperlink). Across all sports there is an increased injury risk of 1.81 times in highly specialized athletes compared to their multi-sport peers5.



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Protecting Pitchers Elbows

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Protecting Pitchers Elbows

Minimizing the Risk for UCL Injuries in Throwers

The Biomechanics of the baseball throw:

Baseball fans thrive on interesting facts and statistics, but out of all of these facts, the science behind throwing a baseball has to be the most fascinating. The way that an elite athlete’s body can act as a coiled spring, transmitting the necessary forces to turn a baseball into an eye-blur is truly awe-inspiring. During the throw the elbow functions as a hinge joint, going through rapid extension at about 2400°/s for a professional pitcher. (Which is the equivalent of saying that in 1 second the arm could whip around 360° nearly 7 times). Accelerating to this incredible speed places a force on the Ulnar Collateral Ligament (UCL) of your elbow reaching 64Nm (nearly 50lbs).4 Not surprisingly, there is some fallout over time due to the transmission of this high force.

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Shohei Ohtani Update

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Why can he hit but not pitch at this point in his rehab following tommy John surgery (October 18’) to reconstruct the ulnar collateral ligament? The function of the UCL is to protect the arm from a valgus force. A valgus force is a lateral to medial force on the arm that causes a gapping at the medial elbow if the ligament fails to protect the arm from the force. As a right handed thrower each time Ohtani goes into the cocking phase of throwing (when the arm is in end range external rotation to create torque) a valgus force occurs on the arm. Tommy John surgery is performed to reconstruct the UCL so while the arm is healing it cannot tolerate this valgus force during the throwing motion. How hitting is different is that in Ohtani’s case he is a left handed hitter meaning his operative elbow is the front arm in his batting stance.

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As he goes through the swing, a Varus force is put through the elbow which challenges the LCL (lateral collateral ligament of the elbow) which was not operated on. The only time in the left handed swing that that Right UCL is challenged is to slow the swing down during the follow through. This may impact how Ohtani follows through in his swing. Although he is closer to reaching the end of his rehab for his torn UCL, He may choose to shorten his follow through at times or use a two handed follow through to reduce torque through the reconstructed ligament.