What is a Parent to Do?

Young male and female athletes are taking to the baseball and softball fields for the start of a new season, signaling a return of spring and invariably arm injuries related to throwing. Often these young athletes have little or no preparation during the winter months to get themselves physically ready for the season, then they step onto the field and try to emulate their favorite major league player. In addition, players have the availability to practically play baseball and softball almost year round, leaving little time for rest and recovery. Often some of these young athletes will play on several teams at the same time-on the school team, a local team, or even on a select travel team. When their bodies and arms do not get the proper recovery time, injuries occur. When an athlete plays on several teams at the same time, coaches cannot accurately keep track of the amount and type of throwing an athlete is performing while playing for these different teams. The athletes can often pitch for two different teams in the same week without taking into account the recommended pitch limitations and days of rest between pitching. Sometimes coaches also are not properly prepared for the upcoming season and ask a young athlete to try some pitches that the young athletes are not prepared to perform, such as throwing when they have not warmed up or performing pitches that they are not physically mature enough to perform.

What does this all add up to?

Increased throwing arm injuries in youth baseball and softball programs. The incidence of throwing injuries has grown so much that in 2007, Little League Baseball adopted new rules to limit the number of pitches a pitcher can throw in a game and how many days rest in between pitching appearances based upon age. In the clinical setting, we are seeing younger and younger players coming in for surgeries related to throwing injuries. Tommy John surgery (repair of the ulnar collateral ligament of the elbow) is now frequently seen in kids as young as 14 years of age. This type of surgery used to be seen only in players towards that latter stage of their careers and now this is not the case. The types of injuries that most commonly occur are strains or tears in the elbow or shoulder. The structures most commonly injured are the joint capsule, ligaments, rotator cuff, or the labrum of the shoulder (a cartilage ring in the shoulder). Joint laxity in the shoulder can develop which can lead to an impingement syndrome during which the rotator cuff tendons get pinched as the athlete goes through the throwing motion. The more the athlete tries to push through the pain, more damage and inflammation occurs. In addition, injuries can occur to the growth plates in the bones of growing, young athletes. Luckily, not all throwing athletes who develop elbow or shoulder pain will require surgery. Many can recover with a proper rest, rehab to strengthen the elbow or shoulder and modification of the throwing activity. The recovery can take several days, several weeks, or several months depending upon the extent of the injury. Early recognition of the problem is key to correcting a potential season or career ending injury or perhaps preventing the need for surgery to correct the problem. For pitchers under the age of 14, it is recommended that they concentrate on fast ball and change up pitches and avoid the use of curve ball pitches.

So what is a parent to do? Here are some items to keep in mind.

-Have your son or daughter warm up before pitching -Follow pitch count and recovery guidelines-monitor your kid's pitch count -Make sure your child is physically fit to pitch by building up their throwing intensity and pitch volume prior to the season -Monitor your child's well being by asking them how they are feeling -Teach your child that it is okay to back down if pain is occurring -Stretch after pitching -Ice and rest if pain develops If your child does develop arm pain that does not seem to be resolving, have them see an orthopaedic doctor or physical therapist to be evaluated. Prevention is always the best cure.