Little League days and nights have arrived once again. The signs are all there: The smell of hot dogs in steamed buns, the sight of arrow straight lines marking off the baseball diamond, fresh cut grass, “Batter up!”
It’s a great time of year in communities across the country, as local boys and girls learn about “America’s Pastime,” and more importantly, what’s it’s like to be part of a team.
Yet baseball and softball, like most sports, are competitive. Both coaches and players often are focused on winning. In some cases, parents want to see the son or daughter win even more than the child does.
Safety is also a primary concern for parents as players hit the diamond. A common question I often hear from moms and dads is how can we keep our young players safe, especially our pitchers? A regular summer condition that many physicians see in young pitchers is something known as Little League elbow.
According to HealthyChildren.org, Little League elbow is a common overuse injury associated with throwing. It’s most common among pitchers, but can occur with any player. It’s the result of repetitive stress to the growth plate inside the elbow caused by the throwing motion.
Growing bones in young athletes can be easily injured because the growth plate is much weaker than the ligaments and muscles that attach to it. Once the growth plates fuse, athletes are likely to injure ligaments and tendons.
In my practice, I see many adolescent players with arm problems. About 90 percent of the time injuries can be linked to some sort of a sudden change in the intensity or duration of the activity. Most commonly, young pitchers are either throwing too hard, too often or trying to build up their endurance too quickly.
Increased pitching time can result when a player decides suddenly that baseball is going to be his or her main sport. The young athlete may start playing for two summer teams.
Excess strain on young elbows can also come from changes in the distance or elevation from the pitcher’s mound to home plate — or having a new, more intense coach.
According to a study published by Safe Kids International, young baseball pitchers face a number challenges.
Whatever the cause, soreness, some swelling and pain when the player throws the ball usually come on gradually – and diminish when the arm is rested. Rest and icing the area are keys to treating these injuries.
Typical recovery time from this type of injury is six weeks or so for minor problems. For more significant problems, recovery can be as much as three months.
Pre-high school players age 10 to 15 tend to be the most prone to problems, with those 12 to 14 especially vulnerable.
So what can we as parents and coaches do to help combat this issue facing our young ballplayer? It’s simple: limit the number of pitches players throw.
Most physicians, including myself, believe the first line of defense is to limit the pitches or number of innings young pitchers throw. Coaches, players and parents should be monitoring pitch counts.
Youth baseball pitchers can throw more than 100 pitches per game. This pace is over-loading kids’ elbows and shoulders.
Kids sometimes sacrifice mechanics for a few strong innings of baseball each season.
Coaches also occasionally keep kids on the mound when they should be taken off to “get that last out.” Once a child’s arm is fatigued, fundamental throwing mechanics go out the window. That’s when many injuries occur.
Guidelines have changed over the past few years. Generally, seven and eight year old hurlers should throw no more than 50 pitches per outing. If they do throw 50 pitches, then they should have at least two days rest between games.
As kids get older, pitch count can increase — marginally. 17-18 year olds can throw over 100 pitches per outing, but if they do exceed 90-100 pitches, they should have three days of rest between starts. As you may expect, the more they throw, the more rest is required.
If a player’s arm gets sore during the season, it needs to be evaluated if the pain doesn’t subside after rest, ice and activity modification.
Keep a close eye on young pitchers. In my experience, the first sign of fatigue is loss of control on the mound.
For example, if your pitchers are generally finding the ball near the strike zone early in the game, and then a few innings later they’re having difficulty getting a strike, a likely culprit is arm fatigue.
Little League arm health is one of the most important items to monitor while allowing our children enjoy “America’s Game.” The responsibility for safety falls on the shoulders of the adults, including coaches, trainers, players and parents.
If we monitor pitch counts closely and watch for warning signs of arm fatigue in our kids, we can make the game better for everyone, creating lasting memories of summer at the diamond we can all cherish.