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

It Is Brutal Hot Outside Right Now!

Just a Friendly Reminder. . .

It is brutal hot outside right now.

CNN reports that the “heat index values” – how it feels outside – have been running over 125 degrees Fahrenheit in the worst areas. The heat index scale is designed to describe how intense heat feels, which includes factors such as humidity.

In working multiple camps this summer – the athletes have not been prepared for this heat. Most of you have already heard all of this, but now would be a nice time for a friendly reminder. As the athletic trainer for these camps, I am not nearly as active as the athletes. However, each day I have easily taken down a gallon of water and a few cups of some sports drink.

Here are some examples of stories that I have heard over the camps:

- Have you drank enough today? “I drank a lot of water. Two or three cups.”

- When’s the last time you have used the bathroom? “”First thing this morning.”

- Have you eaten anything? “I had a couple bananas.”

These are never good signs when it is six o’clock in the evening and people start cramping up during activity.

These are just a few symptoms for dehydration:

- Headache
- Fatigue
- Nausea
- Dizziness
- Decreases bathroom breaks
- Decreased sweating

If your body is telling you it is thirsty, you are already a little behind when it comes to hydration. Another great way to check your hydration levels is to check the color of your urine. Yes, it sounds pretty nasty, but it is an excellent way to take a quick measure of your hydration levels.

If your urine is pale like lemonade, that’s a sign of proper hydration. If it’s dark like apple sauce, you need more fluids. With proper hydration and a sound diet, most of the time, you will be in good shape.
Use a water bottle that you brought to be your guide through the process. For example – I carry around a half gallon container (yes I get made fun of) throughout the day. It serves as my reference for that days H20 intake. Plus, I would not always bank on water being in the dugout for every game in the summer.

This is information that you should have heard before this point in time. However, each year around this time, the athletes tend to struggle and need a little refresher.

Enjoy what is left of your summer and stay cool.

Chris Ham, MSA, ATC, CES
Athletic Trainer
Vanderbilt University Baseball

The Great Mask Debate

It doesn’t take much to see the public’s increased awareness about the dangers and long-term effects of concussions in sport. Just read the paper or search the web and you’ll see where a state legislature or local school district has passed a law or approved a new rule regarding testing and return to play guidelines following a mild traumatic brain injury.

Likewise, the sport of baseball has also updated with the times. This season, Major League Baseball implemented the 7-Day Disabled List to be used exclusively with those players diagnosed with a concussion. MLB has also tightened its diagnosis and return to play guidelines. Both a physical exam and neuro-psychological testing that must be submitted to the league’s medical director prior to a player’s clearance to return to play.

With all the increased awareness, one of the first lines of defense in the prevention of these injuries is still the protective equipment. The catcher in baseball is perhaps the most susceptible to repetitive trauma both from foul tips and the hitter’s backswing. There are typically two types of masks that that a catcher uses: the traditional cage and helmet, and the hockey-style.

Currently, there is no published study that distinguishes one mask as better than the other. Students in an Experimental Mechanics Class at Kettering University have been working to find an answer. After testing both mask styles for frontal impact (simulating a foul tip) and side impact (representing a backswing impact), the students concluded “Overall, the testing would support the theory that a traditional style catcher’s mask would protect better against a foul-tip and a hockey style catcher’s mask would protect better against a hitter’s backswing.”

As a sports medicine provider who works with the baseball athlete, it has been my experience that far more foul tips are experienced than backswings. Although the engineering students suggest that the traditional mask system needs to be improved in the area of the helmet, I would still recommend the traditional cage system over the hockey-style mask for the prevention of repetitive trauma to catchers and umpires.

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