The Number-one Risk of Arm Injuries Continues to be Year-round Play
By Dr. James Andrews
If baseball is to continue to be “America’s Pastime”, we need to make sure that prevention of injury becomes a number one priority. There is no question that Little League® International is working hard to keep our young athletics healthy. From my perspective, there is no youth baseball league that has done more to promote youth baseball as a safe and healthy sport, particularly Little League’s executive staff, along with the rest of the Little League International Directors.
For years, the arm injury rates in youth baseball has been on the rise. Due to this trend, several years ago, dramatic steps were taken by Little League Baseball® to make youth baseball a safer and healthier sport. This effort has been successful in curtailing many of traumatic injuries due to overuse. However, there is much more work to be done.
The initial step taken at Little League to decrease arm injuries was the development of the pitch count rules, which everyone reading The Parent Connection needs to be familiar with. The pitch count rules were generated after long periods of study and research at USA Baseball and the American Sports Medicine Institute (ASMI).
In regards to overuse injuries that occur in youth baseball, “FATIGUE” continues to be the driving factor. Research work done at ASMI in Birmingham, Alabama and from the Andrews Research and Education Institute (AREI) in Gulf Breeze, Fla., has proven that if a young baseball player plays with fatigue, there is a 36 to 1 increased incidence that they can injure their throwing shoulder and/or elbow.
Fatigue can be defined in three different ways.
Event Fatigue – too many pitches in a game.
Seasonal Fatigue – too many pitches and/or innings in a season.
Year Round Fatigue – playing youth baseball year-round.
Like football, baseball has an ugly epidemic on its hands.
But unlike the dementia dilemma slowly sacking football, baseball’s Achilles heel — the soaring rate of Tommy John elbow surgeries — can be moderated with common-sense measures.
Youth league officials and coaches must better enforce strict guidelines for pitching and throwing, while parents must employ logic by shutting down their children from touching a baseball for at least four months out of the year and not allowing them to pitch simultaneously for multiple teams.
Major League Baseball and USA Baseball — the governing body for amateur baseball — have established pitching guidelines and valuable resources for youth and high school players at the website Pitch Smart. But there remains an opportunity for MLB’s new Commissioner Rob Manfred to take a holistic approach in investigating the circumstances that cause the need for Tommy John surgery.
Until the late 1990s, talented youth athletes typically enjoyed the luxury of playing multiple sports. The rash of Tommy John surgeries at the professional level is likely a repercussion of the wear and tear athletes have suffered due to the specialization of youth sports. Too many boys are playing way too much baseball.
It used to be that kids’ sports were just plain fun. Now, they’re considered a portal to bigger and better things, such as athletic scholarships and bursaries, an Olympic berth or a pro contract.
To be fair, that’s not what most parents are thinking when they first enrol their child in a sports program. But if that child shows promise early, it’s not long before he or she is practising four to five nights a week during a season that never seems to end.
By early adolescence, that commitment has blossomed into a six-day-a-week schedule of training and competition that spans 11 months a year.
And then there’s the so-called off season, where kids are enrolled in sport-specific camps or working out with a personal trainer to build the muscle, speed and agility needed to maximize performance.
“More young athletes are training year-round,” said Erika Persson, a pediatric sport medicine physician whose practice is based out of the Glen Sather Sports Medicine Clinic in Edmonton. “They’re also specializing in sports at an earlier age.”
Children’s bodies respond to training differently from adults. Growth plates in the knees, feet and shoulders make these body parts particularly vulnerable to overuse. And then there’s the awkwardness and lack of body awareness and control that is prevalent in growing children, all of which increases the risk of injury among young athletes.
This vulnerability to injury runs contrary to the repetition considered necessary to develop skill in young athletes. So, while coaches demand that athletes repeat the same movement patterns over and over again, health-care officials warn of the dangers associated with overuse.
Persson says, despite the call for coaches and sports organizations to put limits on how often kids train, there is very little conclusive research to suggest just how much is too much. Statistics from a variety of sources suggest that about 50 per cent of sports-related injuries in youth are the result of overuse, yet there are few child- and sport-specific guidelines regarding prevention.
One of the few sports where extensive research has been done into youth injuries is Little League Baseball. Researchers monitored the arm health of pitchers with respect to pitch counts, types of pitches and quality of mechanics. What they found was that the number of pitches thrown was the most significant contributor to arm injuries in young baseball players.
In 2007, a pitch-count rule was put into effect for players from age seven to 18 with specific limits for each game, based on age. The amount of rest between pitching assignments was also regulated, based on the number of pitches delivered in the previous game.