Hideyuki Ishibashi, a former first-team training coach for the Hiroshima Toyo Carp who also worked with the Boston Red Sox, argued on note that parents of young pitchers diagnosed with baseball elbow have a role that goes far beyond waiting for the pain to fade.
The starting point is a question he said he saw on an internet Q&A site: a fourth-grade boy told his parent his right elbow hurt after practice, was told to refuse any pitching request while it hurt, said the next day that it no longer hurt, and then showed an obvious problem throwing from shortstop to first base in a game — after which he was diagnosed with baseball elbow, note reported.
That sequence captures the dilemma. Pain is something only the child can feel, Ishibashi wrote. If a child says the next day that it no longer hurts, a parent has little choice but to watch and wait. And after a baseball elbow diagnosis, many parents assume the only thing they can do is wait for the pain to go away.
The 2021 study that tied severe elbow pain to stress in 223 pitchers
The assumption deserves a second look, because research points somewhere else.
Participants answered a one-time questionnaire about shoulder, elbow, wrist and lower-back pain from the previous season, along with the strength of their psychological stress responses, measured with the SRS-18 scale covering irritability, anxiety and depression. When the researchers split the 223 pitchers into two groups — those whose elbow pain was severe enough to keep them from playing baseball, and those whose pain was not — the pitchers sidelined by pain were significantly more likely to report moderate or higher stress responses.
The same association appeared for lower-back pain severe enough to stop play, but not for pitchers’ shoulder or wrist pain, and not for position players at all. Because the study captured answers at a single point in time, it cannot establish which came first — the pain or the stress.
Stress, stiff muscles and the risk of another injury
On that chain of reasoning, caring for a young player’s mind while he cannot throw is part of caring for the injury itself — not a distraction from it.
That reframes the reflexive question parents ask. Wanting a child to heal quickly is exactly why “Elbow, does it hurt?” keeps slipping out. But the note’s argument is that the waiting period is not empty time. A child who cannot throw is also a child under stress, and that stress is measurable.
What parents can do while the throwing stops
The concrete suggestion from Ishibashi is to build “what can be done now” into the sidelined period. At the next medical appointment, he advised, parents should ask the doctor which parts of the body besides the elbow are safe to move. Running is one option; training muscle groups away from the injured area is another, tailored to the individual child.
The logic, as Ishibashi put it: if a child has something he can still do, he can feel he is moving forward toward a return even while he cannot throw.
Ishibashi’s path from the Carp to the Red Sox to Holos Baseball Clinic
He spent 15 years, from 1987 to 2002, as a first-team training coach for the Hiroshima Toyo Carp, and went to the Boston Red Sox as a coach in 1997.
Through Holos Baseball Clinic, launched in November 2022, he supports young ballplayers’ development, and he has also worked as a private coach with athletes and professional musicians on training and conditioning.
Questions parents ask after a baseball elbow diagnosis
If my child says the elbow no longer hurts, can he start throwing again? Not on that answer alone. Ishibashi’s example shows a boy who said the pain was gone the next day but still showed a clear problem in a game. Treatment should follow the hospital’s instructions first.
What exactly did the Kato study find? Among 223 Japanese high school pitchers surveyed in 2016, those whose elbow pain was severe enough to prevent playing were more likely to show moderate or higher psychological stress on the SRS-18 scale. The study was cross-sectional, so it did not determine whether pain caused the stress or the reverse.
Can stress really make a young athlete more likely to get hurt? Ishibashi cited research cited in the note indicating that stress can stiffen muscles and make movement awkward, which can raise injury risk — the basis for treating mental care as part of injury care.
What can a child actually do while he cannot throw? Ask the doctor which body parts are safe to move, then build a plan — running, or strength work away from the elbow — with a trainer, using a structured return-to-play protocol such as the one adapted at Holos Baseball Clinic.
Who is Hideyuki Ishibashi?
The open question the research leaves behind is causal: the Kato study shows pain and stress moving together in sidelined pitchers, not which one drives the other. What it does establish is that during the weeks a young pitcher cannot throw, the elbow is not the only thing that needs attention — the note’s closing point is that the mind deserves care too, and that parents can start by asking what their child can still do today.
