Let's Have A Ball This Summer!

Dr. Brianna is calling all youth baseball  players, parents, 
coaches and enthusiasts!

Happy Summer from your friends at LEAPS! Warmer weather means a few things to us… attending BBQs with friends and family, hittin’ the beach or swimming in the pool, and just generally spending more time outside. There seems to be an endless amount of activities that kids can get involved with in order to stay busy during their summer vacation. For kiddos that are regularly involved in sports, many families view this time as an opportunity to gain more experience and “hone in” on their craft before the new school year begins. This may include attending sport camps and clinics, joining summer leagues, and one-on-one training sessions with coaches and parents to work on particular skills. Due to the disruption of a child’s normal daily/weekly physical exercise routine, coupled with an increased focus on one skill or sport, we tend to see the development of abnormal body mechanics and overuse injuries during this time period. One population at increased risk are kids that play sports that involve overhead throwing, particularly baseball players. Experts in this field agree that some of the main contributors to shoulder and elbow pain in youth baseball players are throwing mechanics and pitch counts. This blog post will provide information and guidelines that parents and coaches should follow to prevent and minimize injuries and keep your kids safe and healthy during their off-season!

​Physiological Changes and Repetitive Throwing:
 
It is easy to understand how repetitive throwing can place an increased strain on the shoulder girdle and elbow joints of all athletes, and research suggests that these effects are often exacerbated in youth baseball players. Children and adolescents that participate in repetitive-throwing sports have an increased risk of becoming injured due to the immaturity of their musculoskeletal systems, and the rapid physiological changes that occur during growth spurts, puberty, etc.  Radiographic images indicate that 56% of youth baseball players displayed changes at the growth plate in their dominant throwing arm. This study also states that over half of these participants with boney changes never reported any symptoms like pain or arm fatigue. (Mair et al., 2008)  Another study suggests that after just one 12-week little league season, approximately 50% of players had elbow/shoulder abnormalities that were severe enough to be seen on MRI images. (Pytiak et al., 2017) Experienced medical professionals agree that although muscle soreness is normal and necessary in the development of a pitcher, complaints of joint pain is not. Therefore, shoulder and elbow pain should be considered a warning of the potential development of an overuse injury. (Manzi et al., 2022)


Proper Throwing Mechanics:
 
So, you’re asking yourself… what can we do about this?!? First things first, focus on proper throwing mechanics. This doesn’t just mean keep throwing that ball every day, over and over, until you can throw it faster and farther than anyone else on your team. Having an efficient and effective throw requires the engagement and strength of certain muscles, and proper flexibility and stability in others. Learning early on to engage your deeper core and abdominals to help stabilize your trunk, while also activating the larger muscles throughout your hips and legs for power, can help reduce the strain on your upper body and lead to less injury at your shoulder and elbow joints. Working with a local physical therapist or pitching coach can ensure that your kids maintain good all-around strength and global flexibility, in order to help minimize injury and reduce muscular strain or fatigue.

Pitch Count: Why it Matters


Pitch count is the number of throws performed by a pitcher within a certain amount of time. Numerous studies have been conducted that demonstrate the positive correlation between increased pitch counts and shoulder or elbow pain and injuries. Below you can find updated recommendations of these numbers based on a child’s age and pitching window:
 






It is important to understand that these players should not be allowed to exceed or bypass this “throwing max” by participating in more than one league/ team at a time, practicing with friends or parents, or even engaging in other sports that require a lot of throwing such as dodgeball or football. All organized throwing should be monitored closely by parents or coaches in order to ensure adherence to the suggested numbers. Not only does pitch count help reduce injuries, but it also can help players reduce the onset of developing fatigue. Sometimes it may be difficult for children or adolescents to explain what true muscular fatigue may feel like; this age group often described this as their arm feel “tired” or “off.” This can be a vital piece of information to further ensure their upper extremity health in years to come. Research states that a pitcher who regularly pitches despite feeling arm fatigue can be 36x more likely to develop a serious injury requiring shoulder or elbow surgery. Therefore, complaints of being tired should be taken seriously as they could indicate potential injuries in the future if ignored or played through.
 

In summary, children that engage in sports that involve a lot of over-head throwing and repetitive movements are more at risk for developing poor body mechanics and overuse injuries. Ignoring complaints of pain and fatigue places each child at an increased risk for developing serious injuries in the future, and potentially limiting their ability to participate in sports as they get older and enter into adolescence and adulthood. Ways to mitigate these risk factors include ensuring your child is using proper body mechanics while pitching and participating in sport, and paying close attention to the amount of throwing your child is doing overtime. For any further information or questions on this topic, please feel free to contact our office via our social media page or contact information below.
 
 
References:
1.     Mair, S. D., Uhl, T. L., Robbe, R. G., & Brindle, K. A. (2004). Physeal changes and range-of-motion differences in the dominant shoulders of skeletally immature baseball players. Journal of Shoulder and Elbow Surgery, 13(5), 487–491. https://doi.org/10.1016/j.jse.2004.02.008
2.     Pytiak, A. V., Stearns, P., Bastrom, T. P., Dwek, J., Kruk, P., Roocroft, J. H., & Pennock, A. T. (2017). Are the current Little League pitching guidelines adequate? A single-season prospective MRI study. Orthopaedic Journal of Sports Medicine, 5(5), 232596711770485. https://doi.org/10.1177/2325967117704851
3.     Manzi, J. E., Kunze, K. N., Estrada, J. A., Dowling, B., McElheny, K. D., Dines, J. S., & Carr, J. B. (2022). Variability in pitch count limits and rest day requirements by state: Implications of season-long pitch counts in high school baseball pitchers. The American Journal of Sports Medicine, 50(10), 2797–2804. https://doi.org/10.1177/03635465221111098
4.     Safety Tips for young baseball pitchers: HSS sports rehab. Hospital for Special Surgery. (n.d.). https://www.hss.edu/conditions_tips-for-young-baseball-pitchers.asp 

---