Maine soon could join a growing number of states to implement a pitch count in high school baseball.

Alabama and Texas are the latest states that have recommended switching to a pitch count rather than an innings limit for pitchers. Maine, which uses the innings limit to determine a pitcher’s availability, is in the early stages of such a discussion.

At the core of the change is a concern for safety, in part because of the dramatic rise in Tommy John elbow surgeries among adolescents. Advocates for a pitch count say young pitchers need to have their arms protected.

“I think when we’re looking at the over-use issue of a pitcher’s arm, (a pitch count) is a much better indicator of the use and how many pitches they’ve thrown, as compared to just limiting the number of innings,” said Mike Burnham, an assistant executive director of the Maine Principals’ Association.

“I think we all know that on a given day, the number of pitches can get very high in a very short period of time.”

But Maine high school coaches aren’t sure a change is needed. Those interviewed for this story said they already rely on pitch counts, among other factors, when determining how long a pitcher can go.

“I think most coaches are very, very conscious about a pitcher’s arm,” said Portland High’s Mike Rutherford. “And I think that the rule that we have works. Show me evidence why the innings rule doesn’t work.”

The MPA’s baseball committee is gathering information from medical experts and baseball officials to determine whether to change to a pitch count.

“We’re going to take our time,” said Phil St. Onge, the assistant principal at Nokomis High in Newport and head of the committee. “It might be two years before we put anything in. We’re in no rush.”

St. Onge said the MPA wants to cover all factors in this decision.

The current rules stipulate how many days of rest a pitcher must have after throwing a certain amount of innings. For example, a pitcher who throws four or more innings cannot pitch until three calendar days have elapsed; a pitcher who throws just one inning can pitch the next day.

Maine coaches like those rules. But, Rutherford said, “If they adopt (the pitch count), we will adapt.”

They may not have an option. The National Federation of State High School Associations, which establishes playing rules, is also considering a switch to a pitch count.

“We will be making that recommendation to our membership this summer,” said Elliot Hopkins, the director of Sports, Sanctioning and Student Services for the NFHS.

“Innings worked when we didn’t know any better. We know better now and we look to do something better.”

If the NFHS passes the pitch count rule this summer, as expected, states would have to adopt it by the 2017 season. Hopkins said the national federation will follow the recommendations of USA Baseball, which instituted a Pitch Smart program in 2014, and its medical advisory committee in making the switch to a pitch count.

But Hopkins said the NFHS will leave it up to each state to come up with the pitch-count limits.

“We’re not as restrictive as to give a magic number because we know what they do in Alaska is different from what they do in Mississippi,” said Hopkins. “We know from our sports medicine committee and USA Baseball that volume matters.”

The MPA included an advisory in its baseball bulletin this spring that asked schools “to track pitch counts for all pitchers.”

Apparently that message was not received by everyone. Not one high school coach interviewed for this story was aware of that request.

SURGERIES ON THE RISE

A 2015 study by the American Academy of Orthopaedic Surgeons noted that 57 percent of the 790 Tommy John surgeries performed between 2007-2011 were on high school pitchers aged 15 to 19, with an average 9 percent increase per year in among that age group.

Tommy John surgery is a procedure to repair the ulnar collateral ligament in the elbow. It involves a graft of a tendon from elsewhere in the body.

While the MPA does not keep track of injuries, national data suggests that arm injuries are increasing. According to the High School RIO report, a national survey that collects injury data from high schools in every state, the number of arm/elbow injuries in high school baseball has increased steadily over the last decade, from 5,503 (or 9.1 percent of all baseball injuries) in the 2006-07 school year to 7,011 (15.9 percent) in the 2014-15 school year.

While acknowledging that arm injuries occur for many reasons, those advocating for the rule change say this is a move to curtail the risk of injury.

Dr. William Heinz, an orthopedist at Orthopaedic Associates in Portland, is also the chairman of the national federation’s medical advisory board and serves on the MPA’s Sports Medicine Committee. He realizes that there are those who will oppose the move, but said it is important to limit the number of pitches a high school athlete throws.

“What we’re trying to do is educate not only players and their parents but coaches,” he said. “We have to watch out for their arms. We have to educate people that it’s not right for (the pitcher) to throw just a couple of more innings.

“People have to be educated about over-use, rest, fatigue. We need a way to track how much kids are throwing.”

Jeff Fahey, the coach at Bangor High’s baseball power, said coaches already do that.

“To me, any responsible coach is going to be aware of the pitch count,” he said. “We chart our pitches as well as our opponent’s. We chart every pitch.”

Scarborough Coach Mike D’Andrea, regarded as one of the top pitching coaches in the state, said coaches should know how to handle their pitchers.

“It’s all very individualized for me,” he said. “I have some pitchers that I wouldn’t throw more than 80 (pitches) because of the way they rebound or don’t rebound. Every pitcher is different. This isn’t a cookie-cutter rule for me.”

That’s why, said Heinz, the national federation would leave it up to each state to come up with its own regulations.

“We’re not saying that one pitch count will be accurate for every pitcher. We know every pitcher is different,” said Heinz. “But a pitch count is a more accurate assessment than what we have now for how much a pitcher is throwing. We need to look at how many days of rest a pitcher needs after throwing. We need to look at the whole picture.”

For those unsure where to turn, Heinz and Hopkins suggested USA Baseball’s Pitch Smart program, which was established in conjunction with Major League Baseball in 2014. USA Baseball had published recommended pitch counts as early as 2007, which is when Little League baseball adopted pitch counts for its age group.

The Pitch Smart program sets limits according to the age of the pitcher – breaking them down into two-year increments – as well as how much rest a pitcher needs between appearances.

For instance, pitchers aged 13-14 and 15-16 would be limited to 95 pitches per day. Pitchers 17-18 would be limited to 105.

Required rest days would be the same for pitchers in the age groups 15-16 and 17-18: 30 pitches or less (can pitch the next day); 31-45 pitches (one day of rest); 46-60 (two); 61-75 (three); 76-plus (four).

Rick Riccobono, the chief development officer for USA Baseball, said his organization has done a lot of work coming up with those figures.

“We want to make sure we’re doing a good job monitoring and tracking fatigue,” he said. “There’s two types of fatigue: long-term fatigue over the course of a career and short-term fatigue where it’s how tired someone is on a given day or week because he’s thrown two or three days in a row.

“When it comes to that, tracking innings is not a good way of tracking how many pitches someone throws. You can throw a four-pitch inning, you can throw a 30-pitch inning.”

He said the biggest change might be in the mindset of baseball’s older coaches.

“Culturally changing that mindset is where the discussions have to be,” said Riccobono. “We know we’ve gotten to the point, first of all, where the majority of good high school coaches across the country are tracking how many pitches their kids throw. They may be operating within a set of rules that say they can throw X amount of innings in a given day or week, but they’re still tracking pitches.”

IN OTHER STATES …

If a pitch count were to be implemented in Maine, one challenge would be to figure out how to keep track of pitches thrown. That seems to be a major concern of the coaches.

Greely Coach Derek Soule has two people keep the pitch count now – one in the scorebook, the other with a counter – “and usually by the end of the game they’re one or two off.”

Vermont has shown it can be done. Vermont has had a pitch count for 10 years, according to Jeff Stetson, the athletic director and baseball coach at Mt. Abraham High in Bristol. He was one of the proponents of the change after years of using an innings limit.

“We used to have a rule where you could pitch up to 12 innings in a 72-hour period,” he said. “We were finding that a guy might pitch seven innings on a Thursday and throw 120 pitches, then come back on Saturday and pitch the first five innings and throw another 100. We felt it was detrimental to the health of our pitchers and their arms.”

So Vermont went to a pitch count and Stetson said there have been great results.

“I know we’re not a huge state, with thousands of schools, but since we instituted the pitch count, to my knowledge we have not had anybody require Tommy John surgery, like in other states,” he said.

Unlike Pitch Smart, Vermont’s pitch count is not based on age. Instead, a pitcher on a varsity team is limited to 120 pitches, a junior varsity pitcher 110 and a middle school pitcher 85. A pitcher can surpass that total to complete pitching to one batter.

“I like that,” said Stetson, who has served on the NFHS baseball rules committee. “It takes into consideration a kid’s maturity level and body type.”

And he said it’s easy to keep track of the pitches. An adult in each dugout tracks both pitchers. They meet behind home plate between innings to check the number of pitches. If there is a discrepancy that they cannot solve, the home plate umpire steps in.

Texas became the latest state to establish pitch count rules, which would got into effect in two years. What’s interesting is that it was the Texas Baseball Coaches Association, working with the medical advisory board of the Texas University Interscholastic League, that spurred the change.

“To be honest, we just saw it as something that was going to happen whether we wanted it to or not,” said Rex Sanders, the executive director of the coaches association there. “And if it was going to happen, who better knows than a high school coach?”

Kate Hector, the media coordinator of the UIL, said the proposal is based on the age of the pitcher. Pitchers 14-16 will have a maximum pitch count of 95, those 17-19 a maximum of 110.

The Texas proposal also includes rest days: 0-30 pitches (0 days); 31-45 (one); 46-65 (two); 66-85 (three); 86-110 (four).

“The coaches here are already keeping a close eye on pitch counts,” said Hector. “This is something they’re concerned with, something they wanted to be involved with.”

The UIL oversees 1,495 member schools. There are 844 high school baseball teams in the association. Hector said the proposal will be reviewed in June and then likely presented to the full body next October for a vote.

“We need to be smarter, we need to take better care of the arms of our kids,” said Sanders. “If you ask a pitcher if he needs to come out, if he’s a competitor he’s going to say, ‘No, I can get this next batter.’ We’re the adults. We’ve got to know when enough’s enough.”

Colorado and Kentucky also use pitch count rules. Alabama and Arizona have approved pitch counts for 2017. Wisconsin is among those states, like Maine, considering switching from innings to pitch counts.

There are states where officials are reluctant to change what has worked for them.

Cindy Adsit, an assistant executive director of the Washington Interscholastic Activities Association, said there is little support among its members to change, even as the association’s Executive Board has proposed a switch to the pitch count.

“I don’t anticipate it will pass,” she said. “When the national federation puts the rule in, we will follow it. If (a pitch count) is the way is should be, it should be a national rule. Right now they’re all over the place.”

She said she spoke to many of the state’s athletic directors at a recent conference and found no support for a change.

“We’re kind of an isolated spot out here,” said Adsit. “If we had a lot more kids who played at the pro level, maybe they would (support the change).”

CARING FOR YOURSELF

There are those who would prefer to see more effort put into educating high school coaches and pitchers about their pitching.

Charles Barnard, a senior pitcher for Portland High, missed much of his sophomore year because of a rotator cuff injury in his right shoulder. He said he learned during his recovery that he wasn’t taking care of his arm properly and that his mechanics were flawed. Now he pitches pain-free.

“I understand the desire to put in the pitch count,” he said. “But what I think it comes down to is there needs to be a greater education for high school pitchers on how to take care of your arm, whether it’s more running, heating, icing, stretching, whatever you need to do.

“I know I put in a lot of work on my own to take care of my arm and make sure it’s ready for the next game.”

Ryan Twitchell, the highly regarded junior pitcher at Greely High in Cumberland, said the majority of high school pitchers don’t know how to take care of their arms. “And that’s why you get problems at the end of the season,” he said.

He learned to take care of his arm after not pitching in the sixth grade because of growth plate problems.

“Right now I’m doing fine,” he said. “That year off made me think about what I had to do as a pitcher to take care of my arm.”

Lincoln Sanborn is an assistant coach at St. Joseph’s College. He underwent Tommy John surgery after his sophomore season there. Now he works with his father, Will Sanborn, the head coach at St. Joseph’s. They also work at Command Central Pitching, which aims to teach pitchers everything about their craft.

“The big thing we touch on is the health of pitchers,” said Lincoln Sanborn.

They stress finding a routine between starts that will allow your arm to recover while also building arm strength.

“A lot of it is what happens between starts,” he said. “That probably is where a lot of the damage is done. Kids are either not throwing enough or throwing too much.”

Lincoln Sanborn said he was never on a pitch count. “I always threw hard and had a rubber arm,” he said. “I did a lot of throwing with my dad growing up and I think that helped me. I had a strong arm.”

Will Sanborn said arm injuries always force you to wonder why it happened: “Was it an over-use thing? Was it one particular pitch? Was it a fraying over time of those fine fibers that create the tendons?”

He does think that something is needed to protect young arms.

“A pitch count is probably a lot more accurate than an innings count because you can throw 130 pitches in five innings,” he said. “But I do think whatever standards they come up with, the coaches ought to be heavily involved.”

And, he added, a pitch count might be needed more in northern states like Maine “where the kids don’t have as much of an opportunity to prepare as in other states.”

Baseball coaches have also said that a pitch count would change strategies. Batters would likely take more pitches early in the game to run up a pitcher’s pitch count. And teams that have deeper staffs could have an advantage.

One positive is that it might force teams to develop more pitchers.

“It’s all about participation,” said the NFHS’ Hopkins. “If a coach spends a little more time with a kid, he might be able to use him as a No. 4 or No. 5 pitcher. Before he might not have needed him. Now he will.”

Like all coaches, Greely’s Soule has some concerns, mainly about how it will be tracked. But he looks at this as a positive step.

“There’s always going to be arm injuries,” he said. “Hopefully this is a step to prevent some of them down the road.”