Submitted by Pediatric Othopedic Surgeon Mark Moran, MD, Presence Saint Joseph Medical Center
It may seem odd, with a few snowflakes falling, but professional pitchers and catchers have already reported to Spring Training.
Many local youth teams are already working out and practicing indoors. Parents and their little leaguers are getting excited about starting a new season. Growing children often improve dramatically from season to season due to their rapid growth, adding to the excitement.
Unfortunately, this also contributes to an increase in injuries to the throwing arm. Pitchers, in particular, are susceptible to serious injuries that, for the most part, can be prevented. Young pitchers’ arms are not fully developed, and the repetitive motion of pitching takes a greater toll on their immature elbows and shoulders. Children are not just small adults. They have growth plates that are still open, making their bones significantly weaker than adult bone. Their muscles and ligaments are also not strong enough to support these joints. Injuries to these undeveloped joints can have lasting effects on function. That is why prevention of these type of injuries is critical.
The primary cause of injury in the young pitcher is throwing too much, too hard, too soon, and without adequate rest. These are usually errors of enthusiasm on the part of the child and their parents. Little League Baseball has published charts showing “Maximum Pitch Count” for age groups, “Rest Period Required” for age groups and “number of pitches”, as well as a mandatory three months of downtime for young pitchers. (www.littleleague.org) Dr. James Andrews has developed recommendations for when young pitchers can start to throw various breaking pitches.
The problem is that these guidelines often are not followed. A coach can adhere to these limits for an individual player under his care, but if that player pitches on a second team, goes to private pitching lessons, and throws to friends or family at home, there is little the coach can do to help prevent injury.
Parents have to make prevention a priority to protect their child to ensure they will be able to reach their full potential, whatever that may be. Basic prevention means getting loose and warming up to allow muscles to stretch out and better absorb the repetitive stress of pitching. Similarly, emphasizing control, accuracy and good mechanics over strike-outs is important. But by far, the main cause of injury is simply throwing too much.
If a child has pain in the arm the day after pitching or there is stiffness or restricted movement compared to the opposite arm, attention is needed. The first treatment is rest and avoidance of the activity that caused the pain (pitching). Ice and anti-inflammatories such as ibuprofen are also helpful. If the symptoms persist, it is essential that a physician be contacted to assess the injury. Simply ‘resting’ will usually not be enough. While the symptoms may subside, it also causes a loss of muscle bulk, tone and endurance. Once the pain is gone and motion is restored, a throwing rehabilitation program should start.
We all love the exuberance of the young pitcher and their parents, but we warn them that unless they want to use their baseball cleats to play soccer, they have to avoid overuse and possible permanent injury to the pitching arm.