Spring training is here and the beginning of Little League baseball season is right around the corner. If you’re a proud parent and baseball fan like me, there will be plenty of trips to the ballpark for practices and games. And sometimes there will be injuries. One major concern for Little League pitchers is their arm health because most youth upper extremity injuries occur while pitching. In fact, the elbow is the most frequently reported area of overuse injury in child and adolescent baseball players. Here is the medical evidence to consider.
In a recent article for the American Academy of Orthopaedic Surgeons, Dr. Tetsuya Matsuura, reported that 25% of young players (age 8-12) experience elbow pain, with the highest rate of pain reported in pitchers. Specifically, Matsuura looked for osteochondral lesions, tears or fractures in the cartilage of bone covering the elbow joint.
Dr. Charles Metzger, an orthopaedic surgeon specializing in upper extremities, found that a simple stretch known as the posterior capsular stretch can help improve and prevent injury. “A posterior capsular stretch is done after play and since it is different from the general stretches players already know, it must be taught,” says Dr. Metzger. “Once learned, however, it is very simple, and takes only five minutes to complete. Nearly 97 percent of young players who perform the stretch properly and consistently report shoulder improvement.” Stretching exercises maintain good shoulder flexibility and reduce the risk of rotator cuff and other shoulder and elbow injuries to young pitchers. Without a stretching program, athletes tend to develop muscle imbalances through the season. The posterior capsular stretch is also known as the sleeper stretch. Click here for a video showing how to perform this stretch safely.
The good news is that Little League Baseball has taken steps to help limit the potential injury for today’s young pitcher by embracing the pitch count research and boldly altering their rules. Last year, I watched the Little League World Series in South Williamsport, PA and to my surprise, they had an outfield display for the pitch count of the pitcher.
In the February 6th issue of Sports Health, A Multidisciplinary Approach, Joseph J. Fazalare, et al published an article titled “Knowledge of and Compliance With Pitch Count Recommendations: A Survey of Youth Baseball Coaches.” The goal of the article was to see if coaches of youth baseball, in their region, were aware of the recommended guidelines and if they, in fact, followed these guidelines.
Their conclusions were that there was a deficiency in regard to knowing the guidelines set by the USA Baseball Medical and Safety Advisory Committee Pitching Guidelines. This led the authors to conclude that this may in fact put these young pitchers at increased risk for upper extremity pain and injuries.
Dr. George A. Paletta Jr., a surgeon at the Orthopedic Center of St. Louis and the team physician for the St. Louis Cardinals, firmly believes that sticking to the guidelines for playing baseball can significantly reduce injuries. “A young athlete should never throw through pain or continue to pitch when he or she is obviously fatigued,” said Paletta. He advises that parents should familiarize themselves with the recommended single game, weekly and season total pitch counts, suggested recovery times, and recommended ages for learning various pitches. Parents should insist that coaches and teams follow the Little League Baseball guidelines for the health and safety of young players.
For more information about reducing arm injuries for young pitchers, email Phillies Fan Joe Ruhl, PT.
- Contributed by: Joseh Ruhl, PT, ATC, Partner, E & A Physical Therapy