Minimizing the Risk of Injury in Little League Players

It’s that special time of the summer again when young players flock to Williamsport, Pennsylvania in search of the Little League World Series Championship. Watching the games on television, you can’t help but notice the young pitchers and pay attention to how many pitches they throw and the types of pitches they throw. At the youth level, it seems that the pitchers who excel are the ones who are able to learn to throw a breaking ball. At that age, it is difficult for the hitter to recognize and hit that pitch. So, often the pitcher uses the curveball or slider frequently. Recently, in the media, there has been a lot of discussion regarding overuse injuries of the youth pitcher. The conventional wisdom was that throwing the curveball at too early an age would lead to injury in the young pitcher. However, research done by several authors in the past couple of years contradicts that idea.

A couple of studies done by The American Sports Medicine Institute (Birmingham, AL) and Connecticut Children’s Medical Center (Farmington, CT) were done to evaluate and compare the biomechanical differences between the fastball, curveball, and change-up pitches. Both studies demonstrated that the stresses to the shoulder and elbow joint were greatest when throwing a fastball as compared to the other types of pitches. The authors concluded that throwing the curveball may not be responsible for the rising injury toll in young pitchers.

So, if it’s not the type of pitch, then what is responsible for what seems like an epidemic of shoulder and elbow injuries in the young baseball athlete? The answer, yet again, may come from research done at ASMI in Birmingham, Alabama. Three main risk factors seem to be more responsible for contributing to a young pitcher’s development of pain and injury: Improper Mechanics, Fatigue, and Overuse.

Improper Mechanics

I’ve wrote about this area in many of my articles and blogs, but it bears repeating again. The overhead pitching motion is a fine-tuned sequence of movements in body segments originating from the lower extremities and pelvis, progressing through the trunk, and culminating in the smaller, less powerful upper extremity structures. The better and more efficient the thrower’s mechanics, the better the chances of reducing stresses on the shoulder and elbow. Mechanical faults that alter the timing of the sequencing of events or place the body in an improper position can result in increased upper extremity forces and torques. These increases in joint stresses can lead to an increase in subsequent risk of injury. Even though the curveball, by evidence of research, is less stress full on the elbow and shoulder than the fastball, the pitch should still be taught by a qualified pitching instructor. Too often, a volunteer coach or parent attempts to introduce the breaking ball to a young pitcher. Without proper knowledge of the pitching motion and the specific grips and key teaching points, the athlete may learn incorrect technique which may surely elevate his risk of potential problems.

Fatigue

The ASMI study notes that young athletes who pitch with arm fatigue or throw more than 85 pitches per game are more likely to require elbow surgery. Younger, less experienced pitchers are unable to maintain their accuracy or level of performance as they become fatigued. The fine-tuned chain of events necessary to execute the throwing motion is altered and creates timing delays and compensations in movement and muscle activation patterns which may ultimately result in an increased risk of injury. Fortunately, many youth baseball programs have adopted limits on pitch counts per outing and mandated specific lengths of rest prior to returning to the mound.

Overuse

Along with the number of pitches per outing, the length of a young player’s “season” also impacts his risk of potential shoulder or elbow injury. Adolescents who pitch more than 8 months out of the year are also several more times likely to require arm surgery. 8 months out of the year?! This seems absurd to me. The Major League Regular Season is only 7 months long and these are mature, seasoned, developed, and conditioned pitchers. If you enjoy playing baseball, that is fantastic! It is a great game. But as a youngster, go out and play other sports too. Learn how to move, run, cut, jump. Develop your overall athleticism. As you get older, then you can begin to focus on a sport that best suits your talents. If it’s baseball and pitching, then having a better foundation of athleticism can only help you.

The moral of the story is that if your son is going to throw the curveball, he should learn how to throw it correctly. It is important to learn how to identify when he is beginning to tire and be sure to allow for adequate rest and recovery between outings. Finally, avoid overuse by allowing your young player to become a multi-sport athlete. This will allow the body physically and mentally rest from the repetitive stresses of baseball and help to develop a better physical foundation for athletic performance.

David Yeager, ATC, CSCS
Co-Founder
BaseballStrengthCoaching.com

Energy Drinks: Healthy or Hazardous?

Energy drinks are the fastest growing segment of the beverage market today and in 2011 sales are expected to top $9 billion. These drinks are being marketed and sold to adolescents and young adults and are now being linked to causing serious health conditions in some people. Thirty to fifty percent of young adults and adolescents consume these wildly popular drinks that contain ingredients that claim to boost energy, performance, stamina, concentration and even weight loss. The big gun of energy drinks is caffeine---a stimulant that raises blood pressure, as well as heart rate. In small doses, around 300 milligrams, it has been shown to be a performance enhancer. In high doses it can cause irritability, increased heart rate, jitteriness, anxiety, insomnia, tremors, heart palpitations, upset stomach and nervousness. More caffeine is added in many of these products from other sources like guarana, kola nut, yerba mate, cocoa and tea. Other common ingredients you might see on the ingredient list are B vitamins, taurine, ginseng, yohimbine, L-Carnitine and tryptophan. Some of these additives may have potentially dangerous health effects and also interfere with prescription, as well as over the counter drugs, like aspirin.

Because energy drinks are classified as a dietary supplement, manufacturers can say just about anything they want about what they claim to do---even if they have no evidence to prove it. They are not regulated for safety, nor do they have any warnings on their labels. Therein lies the primary issue that I have with these drinks. In my opinion, consumers have a right to know exactly what is contained in any product that they choose to eat or drink. Recently, Consumer Lab ran a test on the 5 Hour energy shot that advertises it’s “no caffeine content” and found one shot contained 207 mg. of caffeine—more than an average cup of Joe from Starbucks! Because these drinks are unregulated, anyone choosing to drink them should exercise caution----know what you are putting into your body and think about how it might affect you. On February 14th, msnbc.com reported that an 18 year old high school senior had a seizure and was hospitalized for five days after drinking two large NOS energy drinks. Read the full article here: http://www.msnbc.msn.com/id/41577256
Most adults can tolerate modest amounts of caffeine (150-300 mg. per day) with no adverse effects, but its effects on children and adolescents, especially in high doses and in conjunction with other stimulants, have not been studied enough. The additive effects of many of these ingredients, along with over consumption, make the synergistic combination even more unpredictable. Simply put: the sum is more dangerous than its parts. Why then are these beverage makers not held to a limit on total caffeine dose like over-the-counter designated caffeine stimulants are (for instance, No Doz) or even soda?

Many countries are reviewing the reported adverse events associated with consuming these drinks and developing labeling regulations and other legal restrictions to protect the public’s health. In Norway, energy drinks can only be sold in pharmacies. Other countries have banned the sale of these drinks altogether……….what do you think the United States should do to regulate these drinks?

If you would like to learn more about the health effects of energy drinks on children, adolescents and young adults, log on to www.pediatrics.org for a recently published and comprehensive review article (February 15, 2011) by the American Academy of Pediatrics.

Kim Larson, RD, CD
Sports Nutrition Consultant
BaseballStrengthCoaching.com