Episode 63: Garrett Scott Bullock - What One Pro Pitcher Turned Doctor Is Doing to Understand and Prevent Throwing Injuries

Despite pitch counts, improved training methods, and greater awareness of injury prevention, elbow and shoulder injuries in baseball pitchers continue to rise, particularly among youth athletes. So what are we still missing?In this episode, Dr. Garrett Scott Bullock — physical therapist, quantitative epidemiologist, and former professional baseball player in the Houston Astros — joins host Andrew Rizza to explore the science behind throwing injuries. Drawing from his research at the Wake Forest Pitching Lab, Bullock explains why most throwing injuries stem from three major factors: workload spikes, poor mechanics, and weakness in the systems supporting the arm.The conversation dives into the growing pressures within youth sports, including playing multiple leagues, the pursuit of college scholarships, and how these factors may contribute to increased injury risk. Bullock also discusses emerging research on ball size for youth athletes, the limitations of pitch counts as a monitoring tool, and how new technologies such as markerless motion capture and radar-based tracking systems are transforming pitching analysis.Looking ahead, the discussion examines the future of sports medicine research, including individualized athlete monitoring, advanced biomechanical modeling, and the challenge of translating injury prevention research into real-world practice.MEET THE GUESTDr. Garrett Scott Bullock, PT, DPT, DPhil- Physical Therapist and Quantitative Epidemiologist- Researcher at Wake Forest School of Medicine- Former professional baseball player in the Houston Astros organization- Clarendon Scholar, University of Oxford TOPICS DISCUSSED- Why youth throwing injuries continue to rise - The "Three Buckets" of injury: Workload spikes, biomechanics, and weakness- Research on baseball size and youth pitching mechanics- The technology transforming pitching analysis - The future of injury prediction and biomechanical researchHIGHLIGHTS00:36 – Garrett's Background & Pro Baseball Journey02:39 – Being a Subject in a Research Study03:37 – Prevalence of Injury in Adolescents04:41 – The "Three Buckets" of Injury Causes07:02 – Community Education & Injury Prevention09:02 – Collaborating with Medical Providers Beyond Your Clinic10:35 – Marketing Yourself as a Specialist Clinician12:31 – Talking Performance with Parents and Coaches15:37 – Causes of the Upper Extremity Injury Epidemic18:05 – Pitch Counts and Rest Days to Reduce the Rate of Injury22:12 – The Pressure of Trying to Get a College Scholarship23:17 – How the Size of the Ball Correlates to Injury in Youth Athletes26:26 – Identifying Fatigue Markers in Pitchers29:27 – Arm Care and Strength & Conditioning Programs31:07 – Technology Used to Capture the Research33:01 – The Wake Forest Pitching Lab Model34:46 – Where the Research Is Heading37:05 – Fun Fact: Ballet & Vocal TrainingQUOTES:13:18 - "Yeah, I actually never really played the pro card, to be honest, the pro baseball card. I actually really don't like talking about that from a clinical side. Yeah, I always try to make it more about performance of the athlete and what they are in meeting their goals." - Garrett Scott Bullock22:51 - "They hear these different teams or different people saying like, 'Well, you need to play on my team or in this league at 11 to get ready for high school, which will get you a college scholarship.' And in reality, it doesn't matter what you do at 11, what team you're playing for, as long as you're getting the skills in, learning the fundamentals, and not getting injured, then you're fine at 11 or 12. But they don't know." - Garrett Scott Bullock35:30 - "Exercise, total body care, decreased sports socialization, 'Do multiple sports, rest a little bit.' We know that works, but translating from the bench to the community is not really working at all, to be honest, at this point. So, really thinking about it from a public health ecological level." - Garrett Scott BullockLINKSGarrett Scott Bullock - Wake Forest University School of Medicine: https://school.wakehealth.edu/faculty/b/garrett-scott-bullockDISCLAIMER The opinions presented on Behind the Sports Medicine are those of the host and guests. They do not necessarily reflect the opinions of any affiliated institutions or partners. The content is for informational purposes only and does not constitute medical advice. Always consult a licensed medical professional before making any health or treatment decisions. Behind the Sports Medicine and its affiliates assume no liability for the accuracy or application of the information discussed.#SportsMedicine #BaseballScience #PitchingInjuries #InjuryPrevention #YouthBaseball