Why ‘science’ hasn’t solved baseball’s arm injury epidemic.

Introduction

My aim in writing this article is to open a massive can of worms and spur debate. We still have an arm injury epidemic in baseball, and I know why. Although there are multiple factors in play, one of the biggest reasons we haven’t reversed today's ongoing injury parade is significant problems with ‘science’ as it’s being applied to baseball pitching research. If science was going to yield a solution to this epidemic, that solution seems long overdue (or at least elusive).

From a scientific perspective, what is the single most important thing we've learned from extensive volumes of pitching research? The most dramatic conclusion we can draw from accumulated scientific study is that researchers haven’t supplied a definitive solution to keep pitchers from being injured. Stop and read that again.

Science is potent. If science holds the keys to eradicating baseball’s arm injuries, why in the world are pitching injuries still happening so frequently? Is it possible science can never provide an answer that keeps us from wrecking elbows and shoulders? Is it true pitching has to be an unnatural act? Is baseball doomed to the fate of keeping a stable of oft injured pitchers then putting them out to pasture at relatively young ages?

Is it possible there's no way to reverse the arm injury epidemic, or has something been overlooked? Could there be other solutions that haven’t been explored? We know current lines of inquiry haven’t solved the problem, so is there a different way of thinking that allows us to discard ideas that obviously don’t work? Either there is no solution or we’ve been looking in the wrong place.

Because of personal, longterm experimental research with pitchers, I’m hyperaware of a line of inquiry that hasn’t been fully explored by researchers: altering pitching mechanics to reduce injuries. In reality, it hasn’t been explored in any depth by the medical and research communities. I think I know why they haven’t gone down this road. Current lines of scientific exploration and expertise are preventing researchers from looking under a different rock. I’m going to explain how I know this, and am going to share what I’ve uncovered.

At the onset I’m going to tell you there’s already a solution to pitching injuries. The solution can revolutionize baseball, right now, today. The answer is stunningly simple. My perspective is worth listening to because I have found an arm injury solution no one in the scientific and medical communities is exploring. I found this solution by looking at pitching differently.

I know the problems pitching researchers face because, in 2003, out of sheer frustration I abandoned the same lines of thinking they’re still pursuing today. I am a scientist at heart. I studied Forest Management Science in college and understand the necessity of approaching science from different angles. Embracing a new line of thinking has enabled me to look at pitching differently. Because of this I’ve found a viable solution that protects arms. The solution works because my pitching students throw more than anyone else, with performance that meets or exceeds their peers, and they don’t get hurt. In 16 years none of my longterm students have suffered a structural injury, and I routinely fix pitchers who are hurting. 

We’ll come back to this, but I first want you to understand WHY I’ve searched for a solution that can end pitching injuries.

Why search for solutions?

The cost of pitching injuries is anything but boring. Major League Baseball is spending in the neighborhood of $1.5 Billion annually to cover the costs. These injuries spawn fear and uncertainty that impacts individuals and organizations alike. Careers hang in the balance and livelihoods are at stake. Teams win and lose on the strength of pitching. If key guys go down, playoff hopes are doomed. The money is a big deal. You would think MLB has economic incentive to fix the problem.

However, I believe something much bigger is at stake: the human cost. One of my sons was drafted by the Mets. On this journey I’ve experienced firsthand the toll this business of pitching extracts, both physically and mentally, and I want to spare others the cost I've witnessed.

For pitchers who are hurt, the injuries are agonizing. As an example, I recently consulted with a Doctor of Physical Therapy and his patient, a 23 year-old professional pitcher who just retired because of injuries. Retired, at 23. Bigger than physical pain, his dreams are dead. His 94-99mph talent was sufficient to throw in the Big Leagues, but elbow and shoulder problems turned that exquisite velocity into an 82mph nightmare. He’s just one more on the ever-growing list of studs who have flamed out and are put out to pasture. The human cost of pitching injuries is agonizing. The cost is written all over faces of young men and embedded in their body language.

There’s another factor in the arm injury equation. Youth baseball injuries are even more problematic than adult injuries. Growth plate damage has the potential to produce lifelong bone-deforming consequences. Beyond damage that leaves youngsters dealing with pain, these injuries damage the game’s long term future. It’s true we’re leaving deep scars on the talent pool.

Why have I been studying pitching injuries? I’m weary of how they devalue young men. This problem ranges from the youth ranks to professionals and no one is immune. With huge numbers of amateur players in the ranks below professional ball, this problem impacts countless youngsters and their families. On the pro side, I’ve been told point blank by an upper level MLB scout that “pitching is a meat market.” He’s right, and I think it’s time for outright revolt. Emphatically, I think it’s high time we quit looking at pitchers as commodities in a butcher shop.

In order to value these young men appropriately—and to understand how to eliminate pitching injuries—we must understand the backstory. In particular, we need to understand why current science-based efforts have failed to fix the problem.

I’m going to provide a framework for evaluating current scientific research that I hope will open eyes. I hope my thoughts will encourage researchers to start looking at this problem differently. I’ve already jumpstarted the process and can shorten the learning curve for anyone who wants to know how. It’s time to simplify this mess and implement a concrete solution that ends the epidemic.

Let’s look at why science hasn’t ended the problem.

What Is Science?

Yes, I’m really posing this question. On the surface it seems absurd. After all, everyone knows what science is. In reality I think the word is so often used that it’s become too familiar and void of meaning. It’s use in common language has lost it’s potency. ‘Science’ has become a catchword that sounds authoritative, yet misunderstanding the process of scientific discovery has a way of clouding issues and fostering the spread of misinformation.

To provide context for my thoughts we need to back up and look at realities of what science is, and what it’s not. To answer the question, ‘What is science?,’ we also need to examine the role scientists play in the scientific process, looking at limitations they operate under.

In our culture, science is often regarded as the driving force for exploring problems and providing their solutions. In many minds (for better or worse) science tends to take on god-like stature. We’ve been culturally conditioned to believe ‘science’ will resolve issues. If scientists and researchers say something is true we have been conditioned to believe they must be right. However, scientists are not golden unicorns that wave wands and solutions magically appear, and they are not infallible.

Science is a way of thinking. No more, no less. Science is merely a tool. An incredibly valuable tool that serves two functions. Science is a way of thinking we can use to test ideas. Equally important, science is also a way of thinking that allows us to discard ideas that don’t work. In the world of pure science, this process of examining ideas provides two valuable avenues. Research or experiments either continue down the original line of thinking or, if solutions are elusive, we can abandon broken lines of inquiry. Moving on should, in theory, allow us to look for solutions in different ways.

Science, by definition, is limited to what we can observe and then repeat. If you can’t observe an event and repeat it, the scientific process is not (and cannot be) at work. Anything else, by definition, is philosophy. However, it takes more than simply observing something broken to provide comprehensive solutions that resolve a problem.

Limitations of science (more appropriately, the limitations of scientists)...

Because science depends on observations, what scientists set out to observe and study holds the key to making discoveries. Occasionally we learn something by accident yet, in general, scientists can only observe what they predetermined to observe. It should seem obvious that studying the wrong things is not likely provide solutions, except by accident. The single most important factor that determines what scientists can learn resides in the questions they pose.

Scientific discovery is only as potent as the questions scientists ask. These questions (hypotheses in the language of science) are ideas they’re wanting to probe. Scientists and researchers are gatekeepers. The keepers to the gates of ultimate research knowledge are not perfect, neutral beings. Everyone has biases based on training and life experience. Bias impacts the questions researchers ask, which in turn limits what can be measured and studied. When researchers make wrong or biased assumptions, they ask the wrong questions. Ask the wrong questions and they observe or measure the wrong things. Measure the wrong things and we’re no closer to a meaningful solution.

We’re going to come back and apply this specifically to pitching research, but let’s first dig deeper into these limitations.

Repeating and observing events (what we tend to think of as experimenting) produces evidence. Documenting evidence provides other researchers the opportunity to explore what has already been learned. In theory, when multiple sources validate evidence we start moving from the realm of theory to the province of fact. But have we uncovered the right facts and how do we know if they are the right ones? The answer is simple. If evidence (facts) don’t reveal a concrete solution to a problem we’re probably not experimenting with the right things. We may have learned something but we haven’t learned the right stuff.

If we’re not uncovering the right facts—those that can solve a problem—we should quickly conclude that these are not limitations of science, but limitations of scientists. Science by itself is neutral and inert. If there seems to be a problem with science, it’s always wrapped up in the mindset of scientists. (It’s worth noting this problem trickles down to people who listen to them.)

It’s vital to remember that science is a way of thinking, and thinking drives the entire process. What we can learn from scientific discovery is limited by preconceived notions of scientists. Preconceptions impact the assumptions we all make, and this drives the questions we ask. Rarely does anyone set out to study something with a completely open mind. Sometimes researchers have jumped the gun and are trying to prove a foregone conclusion. This might be well intentioned on the part of the researcher, but if preconceptions prevent them from exploring what might be the right stuff, when they don’t know what the right stuff is, the entire process of discovery spins in it’s tracks. In addition to the possibility of not learning the right stuff, this can lead to unchecked mistaken conclusions.

It’s easy to assume science is a self-correcting process. In practice scientists don’t run around checking up on each other’s work. They have their own work to do. If their work relies on previous, unvalidated research findings and they make the assumption earlier evidence is correct, what happens if previous research is flawed? This creates potential for an authoritative-looking system that perpetuates a broken chain of evidence. This is how conclusions of flawed studies become citations used as supporting evidence for additional work. Houston, we have a problem.

There’s more. The scientific community is cloistered and protective of turf. New minds educated by old guard are indoctrinated with existing ways of thinking, so lines of scientific inquiry can be very slow to change. At it’s core, science is supposed to be highlighted by freedom to abandon lines of inquiry that don’t work, adopting new trains of thought. The key to solving any problem always lies in clearly identifying the issue, then approaching it from different angles and perspectives. Einstein wrote, “To raise new questions, new possibilities, to regard old problems from a new angle, requires creative imagination and marks real advance in science." Established lines of thinking certainly can provide foundational knowledge, but if outmoded thinking inhibits unique problem-solving approaches it more likely retards scientific progress.

Additionally, other challenges exist in the scientific process. There are other underlying dynamics in play. What happens if scientists make mistakes in their research? What happens if they study and measure the wrong things, in the wrong way? What happens if their conclusions are wrong? What happens if mistaken conclusions go unchallenged? What if they don’t clearly communicate their research findings? More specifically, what happens when the scientific majority forms an opinion and the collective opinion is mistaken? That’s been known to happen in the scientific community.

When Einstein published his landmark paper on relativity, the scientific community did not collectively exclaim, “Eureka, you’ve found it!” Instead, many prominent physicists submitted a signed letter addressed to Nature, the most prominent peer-reviewed journal, slamming Einstein and his work. Their most vocal objection: "you can’t simplify physics…it’s too complex." Then they started running the numbers. We know how that turned out. Einstein was correct and the majority was caught leaning off base.

What I’ve just described is precisely why baseball’s scientific research community hasn’t found a solution to the arm injury epidemic. It’s a problem of polluted thinking featuring a host of mistaken assumptions and misguided questions that CAN’T provide a solution. They’re looking under the wrong rock. Until they actually experiment with changing the act of pitching it will be impossible to repair deep wounds with anything besides bandaid solutions like pitch counts…and a visit to the surgeon. This poses big problems for the scientific community. How do researchers, who aren’t expert coaches, experiment with changes to the pitching delivery?

Let’s dig in and look at what we’ve learned from the volumes of current research.

State-of-the-art pitching science as we know it...

From a scientific perspective, what do we really know about pitching? It’s crystal clear we know we're using the human body in a way that causes injuries to pitchers and throwers. We know a great deal about the forces involved in current pitching deliveries, but we know with great certainty researchers don’t know how to mitigate them. So what has the process of scientific discovery taught us? We’ve learned lots of facts, but at the risk of repeating myself, the most dramatic conclusion we can draw from volumes of current scientific research into pitching is that researchers haven’t supplied a definitive solution to keep pitchers from being injured. We need to keep this in mind.

Current research with pitchers simply measures existing stresses or forces, again and again. We film pitchers in biomechanics labs filled with exquisite technology, measure movements, calculate stresses, rinse and repeat. We keep measuring the same things, measuring only current pitching deliveries, assuming how pitchers throw now is the only way to do it. The assumption is a mistake. On this track we will never reduce injuries unless we happen to find a solution by accident.

From biomechanics research and studies we know a great deal about stresses the arm and body undergoes while pitching. We know beyond a shadow of a doubt that fastballs, the way they are now thrown, generate enough force to cumulatively damage elbows and shoulders. By all rights, we know each fastball...one single fastball...thrown the way we currently throw them, generates enough force to potentially rupture the UCL. (If this is true how can anyone throw more than one?) We know conclusively that high velocity fastballs, the way they are now thrown, are more closely linked with Tommy John surgery than curveballs. (The myth that throwing curveballs is the primary cause of elbow injuries was debunked long ago, yet the myth persists.) And we know that current pitch counts, the way we now throw, aren’t protecting a huge percentage of youngsters who are following strict limits established by Pitch Smart.

One recent study by doctors followed a group of Little League pitchers for a year. Every pitcher was held to strict pitch counts per Little League’s guidelines. At the end of a year over 48% of these youngsters had arm damage, substantiated by comparative MRI review. The study’s title, “Are the Current Little League Pitching Guidelines Adequate?” seems to make sense. However, if we stop and think, the title reveals bias from the researchers. They’re assuming that the problem is overuse, so the questions they ask can only explore solutions that impose even stricter pitch counts. Their bias makes it impossible to look at alternative solutions.

Another recent study, Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates, looked at forces involved with throwing weighted balls. Twenty four percent (24%) of study participants throwing weighted balls suffered elbow injuries, either during the study or in the following season. None of their non-weighted ball participants suffered an injury. This led to the conclusion that throwing weighted balls requires caution (implying it's a bad idea). If you’re doing engineering research that’s called destructive testing. It should be highly concerning that medical professionals are doing destructive testing with young men. It’s almost as if their assumption was that throwing weighted balls damages arms, and they were willing to hurt young men to prove their point. However, not every weighted ball participant was injured. But nowhere in this study were questions asked to understand why some weighted ball participants WEREN'T injured. And because not all of the participants throw with identical mechanics, there is no TRUE control group. Does anyone else see the problem?

I could go on ad nauseum, dissecting study after study that documents current pitching deliveries and how the forces contribute to arm injuries. We can learn a great deal from reading only conclusions from a vast array of studies, yet the summaries reveal a problem. Many studies conclude with the sneaky little thought, “we learned something, but more study is needed.” It doesn’t take an elbow and shoulder surgeon to realize it’s patently obvious that measuring pitchers and gathering more data hasn't fixed the problem. At what point do we shift gears and pursue a different line of inquiry?

State-of-the-art research has only yielded solutions like pitch counts and arm care programs. On the surface it seems logical that limiting the number of times we do something damaging to the body makes sense. On the surface it seems logical that better training might possibly condition the body to handle the extreme stresses required to throw hard. Today’s elite pitchers are better conditioned and better trained, yet throwing fewer numbers of pitches than at any point in history. Yet we’re still seeing massive numbers of surgeries in spite of pitch counts and more advanced training. Why the disconnect? It’s because of mistaken ideas and unyielding thinking embedded in the current process of scientific discovery.

The failure to discard broken ideas leads to perpetuating mistakes—in this case making the same mistakes means continuing to wreck more arms. So what broken, preconceived ideas are we hanging onto about pitching, and what’s it going to take to abandon them?

The answer hinges on the human belief engine.

The Human Belief Engine 

Because of how our brains and nervous systems are wired, the belief engine produces beliefs (what we think we know) without any particular respect for what is real and true, and what is not. If we believe that limiting pitching—pitch counts—holds the answer to eradicating arm injuries, then that’s the path we explore in research. If we believe that pitching injuries are somehow accidental, rather than having specific causes, then we believe that pitching is an unnatural act that demands injury. If we believe that better training and conditioning will limit injuries, we are inclined to pursue it and stop looking for other alternatives. Why?

We are wired for homeostasis (for things to stay the same). It’s a survival mechanism, both physically and mentally. Because of this, fundamental change is very difficult...even if we know something is beneficial. This is why it’s difficult for many to lose weight and then keep it off. Change is difficult, and it’s true for scientists and non-scientists alike. Human beings tend to hold onto what we think we know, even when evidence points another direction. This is the Belief Engine at work. As long as people continue to believe what they believe, even when there is proof of something else, there is no hope of beneficial change.

The belief engine doesn’t really care about truth, logic and reason, it drives survival. But we are also creatures who thirst after truth, logic and reason. The problem is that we have a hard time distinguishing what originates inside the brain from outside world input.

To make the switch from inside to outside, we have to make a conscious decision to change, knowing that change is hard. Our brains are hardwired to resist. In the world of athletics we think of overcoming adversity as mental toughness. This quality is highly desirable. I suggest it’s time to transfer conscious decisions to be mentally tough to the scientific and research communities. In the case of baseball’s arm injury epidemic, we’ve got to change how we think. We must quit looking at it through a myopic and distorted lens that limits what we think we know.

The scientific process provides a way to do this, consciously, if we’re mentally tough enough to discard ideas that obviously don’t work. If we ignore this second half of scientific process and avoid the painful task of letting go of broken ideas, it leads to foolishness. The problem is we can see the error or foolishness in others much more easily than we can see it in ourselves.

Culturally, with respect to scientific discovery, the belief engine works something like this: we tend to think of science as something neutral and unbiased. It’s not. Underlying science are the agendas and egos of scientists. Scientists have different agendas and differing opinions. These agendas and opinions drive the preconceptions that influence every scientist’s work. (I highly recommend you read Robert Park’s book, Voodoo Science, The Road From Foolishness To Fraud. Park, emeritus professor of physics, delves into problems with science and scientists, exposing how differing factors impact what we can actually learn from the process of scientific discovery.) This aptly describes the problems with current pitching research.

Even though researchers are using the most advanced technology available to investigate pitching, either to learn more about how the body functions when we throw or in the belief they will find an injury solution, the problem persists. Making the wrong assumptions and asking the wrong questions and studying the wrong things, because we’ve locked in on limited lines of questioning, is precisely why we're no closer to solving the arm injury epidemic. We’ve been asking the wrong questions for so long that the belief engine sorely limits what we can learn. And because we’re conditioned to believe the scientists must be right, then the masses believe it must be true, even when it’s not. This is the belief engine at work.

Current mainstream assumptions—beliefs—about reducing arm injuries revolves around pitch counts and finding better ways to train. These assumptions have led to the genesis of ‘arm care’ programs. However, in spite of increasingly adept arm care and training routines, plus the adoption of pitch counts, injuries are still happening with boring regularity. Yes, it’s a good idea to build better athletes, and yes, it’s a good idea to monitor workloads based on true fatigue. But, if we’re truly pursuing science-based thinking, in light of ongoing injuries, we should be abandoning the ideas of pitch counts and arm care programs as curative solutions, and looking elsewhere for definitive answers.

Will researchers dig deep and choose to be tough enough to adopt a different mindset? The ones who do will be on the front lines of a sea change that revolutionizes baseball.

Summary and some final thoughts...

Pitchers are getting hurt in epidemic numbers and state-of-the-art scientific experiments haven't ended the problem. Regardless of the number and type of research experiments, the results of these studies from the scientific and medical communities haven’t supplied a definitive way to protect arms. Current research trends, following the same lines of inquiry and theory are not likely to uncover a solution.

By contrast, my experiments with altering the pitching delivery have yielded a solution that protects arms. The students I train throw significant numbers of high velocity pitches (one or two 100-150 pitch bullpens per week, in addition to competition), without pain and without structural injury. Their throwing volume is high enough to debunk the idea of overuse as a primary cause of pitching injuries. The differences in how they have been taught to use the arm and body, changing specifics parts of their delivery, enables them to accomplish this. These technique changes also allow them to do extremely high intensity weighted ball training on a regular, ongoing basis. All of these discoveries have been accomplished through longterm experimentation driven by the question, "Why do we have to throw the way we do now?"

Like Richard Feynman, Nobel-winning physicist, wrote, “It doesn’t matter how beautiful your theory is, it doesn’t matter how smart you are. If is doesn’t agree with experiment, it’s wrong.” Regarding pitching injury research, I’ll go a step further. If you’re only experimenting by measuring forces and body parts, it doesn’t matter how beautiful and exquisite your technology is, if you haven’t solved the problem you haven’t experimented with the right things.

There’s a better way to go about pitching science than following the status quo. I hope you want to know about it. After all, who is going to be better, pitchers who can work consistently at improving their craft without fearing injury, or those who can’t?

Because I’ve done what no other coach or researcher has done—conducting longterm experimental research that has revealed technique modifications which actually protect arms—I’m in a position to point out things no one else can.

I have identified measurable, observable minimums you need to know about how the human body is designed to work when pitching and throwing. Any program that doesn’t take these minimums into account is destined to wreck arms, regardless of how sophisticated and glamorous their training seems. I have examined many of the most prominent pitching programs available and have yet to see another one that will prevent injuries. Let me help you understand EXACTLY what these minimums are.

It’s time to shine this light on why current science will never protect arms and help you understand real arm injury solutions. I’ve already done the hardest part of the work for you.

If you, someone you know and love, or your organization suffers pain and loss from pitching or throwing, shoot me an email ([email protected]) and I can help. You have absolutely nothing to lose and everything to gain. Let me prove to you I know what I’m talking about. If you have high speed imagery of your delivery I’d be happy to review your mechanics and chat about changes you can make to stay healthy and boost your performance. It’s wiser to contact me now than to wait until you’re hurt.

If you’re serious about ending arm injuries and lessening the economic and human costs for your organization, this represents an opportunity to lead. Challenging? Yes, and the rewards can be measured on a legacy scale.

If this sounds like your kind of challenge, let’s band together and end the arm injury epidemic once and for all.

Copyright 2019, Bill Peterson, All rights reserved