Little League coach talks with pitcher and catcher
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
The U.S. Men’s National Soccer Team forward Jozy Altidore suffered a left hamstring strain in USA’s 2-0 victory against Jamaica on June 19, leaving him on the sideline for the next 4-6 weeks. This injury can cause problems for the U.S. due to specific CONCACAF Gold Cup Tournament rules prohibiting replacing a player on the roster during competition.
A hamstring strain is caused by a tear in one or many of the upper leg muscles. There are three different grades of strains, which also come with their own pain levels. The first consists of minor tears in muscle, the second is a partial tear, and the third is a full rupture or rigorous tear in the muscle. There are many ways to treat this type of strain including active release technique, a patented soft tissue manual therapy technique which re-aligns the muscle fibers, stretching, and functional exercises. A physical therapist can also provide one with stretches and exercises to prevent a pulled muscle.
Here’s a short video on how to properly stretch your hamstrings to help prevent injury:
Throughout the summer, people have a tendency to become more active outside due to the nice warm weather, allowing them to exercise while enjoying the outdoors. What people tend to forget is that they must prepare their bodies for the excess heat they don’t face during the winter and colder days of spring. This excess heat can be avoided and prevented if simple actions are taken before and after exercises. First, it is important to understand what can happen to you and what to look for if you don’t prepare your body for the heat.
If preparation for outdoor activities isn’t taken, there could be consequences such as heat exhaustion and heat stroke. It is important to know and understand the signs of these consequences so if they do occur, you can take the proper actions to avoid these concerns. Signs of heat exhaustion include general fatigue, weakness, nausea, dizziness, muscle cramps, and an increase in body temperature. Signs of heat stroke can include an inability to sweat, temperatures above 104, acute respiratory distress and loss of consciousness. Keep in mind that everyone is different, and it is your job to know when your body is being over used to the point where it can become dangerous to your health.
While there are signs to warn you that your body is being affected by the heat, there are precautions to take before exercising in the heat that can prevent damage to your body:
• The biggest concern about summer exercise is keeping your body hydrated. Water is the best fluid to drink to maintain hydration. Drinking 20 ounces of water two hours before exercising, 8 ounces right before going out into the heat, and gulps every 15-20 minutes should preserve your bodie’s hydration.
• Become accustomed to the heat before putting your body through vigorous exercise. Getting your body used to the heat by going outside regularly allows you to be familiar with the heat, putting less stress on your body.
• Be aware of the temperature outside. If it is hotter then you are used to, don’t feel the need to push yourself as if it was a cooler day. Slow down your pace if necessary, there’s nothing wrong with finishing a little later than usual.
• Proper clothing is also very important when preparing for exercise in the heat. Light colors to reflect the sun and lightweight, breathable fabrics that wick away sweat are best for exercising in heat. Applying sunscreen to exposed areas helps as well.
• Exercising early or late in the day can also help with keeping your body temperature down. Before 7 a.m. and after 6 p.m. are the best times to exercise outside because those time frames are the cooler parts of the day.
• Altering your exercise route to keep you in the shade and out of the sun can also help keep your body cool.
• Exercising with a partner is also a good idea because they can monitor your performance, so if you seem to be lagging behind or struggling they can inform you to slow down and/or rest.
• Stretching is also vital before exercising. Preparing your muscles for strenuous activity can prevent injury.
There are always different ways to make exercising more enjoyable. If you follow these tips for exercising in the heat, being out in the sun won’t affect your performance.
Spring is here which means spring cleaning, gardening and the urge to get fit for summer. Because of these activities, spring can also mean back pain. Eighty percent of Americans will suffer from back pain in their lifetime and according to the North American Spine Society, back pain costs Americans $80 billion annually!
Don039#t become a statistic: Poor posture, tight muscles and decreased motion of your spine can all be contributing factors to back pain, but the good news is that stretching and exercises designed to improve your posture can prevent the onset.
Work these simple stretches/exercises into your daily routine and you can land in the elite 20% who never suffer from back pain!
A wet snow, such as we had to deal with yesterday, can certainly put people's backs in a world of hurt. Excel's Physical Therapist, Cam McCormack was featured last night on the 5:00 evening news sharing his tips for early treatment for back pain from shoveling and ways to prevent it in the future.
More Cam Tips
Below are tips which may have ended up on the cutting room floor, however we think it is great information for you to know!
Questions from Ali Gorman, ABC Healthcheck Reporter
Answers from Cam McCormack, PT
If people are experiencing pain after shoveling, what can they do to help relieve the pain?
Medication questions should be discussed with your primary care doctor. Often a quick phone call can help. But from a movement perspective, a few stretches and good positioning can help. Given that most shoveling involves repeated forward bending with a load (ie – the snow), restoring the opposite extension pattern can help. Maintaining a nice upright posture in standing is good, but most people benefit from a few minutes lying on their stomachs. One can either lay flat or prop themselves up on their elbows. After 10-15 minutes there, a few press-ups and hip flexor stretches are a good next step. Keep in mind that theses are the most general guidelines and may not be good for those dealing with current injuries.
Is it better to lie in bed or do something to keep moving?
Nine times out of ten, its always better to keep moving. Bed rest and lack of movement can often worsen a condition, especially if done for days at a time. Walking upright is great, as are other upright forms of exercise. Sitting to ride a bike or doing a lot of crunches should be avoided.
Any stretches that may help
Prone press-ups and the hip flexor stretches as mention before are helpful. More detailed or individual stretches should not be attempted until you have be screened or checked out by a Physical Therapist. Some stretches may be great for one person, but not so good for someone else. Your therapist can help you determine what you should do or not do.
What are some signs the pain may be more than just soreness?
A big thing to watch out for is buttock or leg pain, rather than just local back pain. Along the same line, numbness or tingling in the
legs/toes, while not necessarily painful, can indicate a more involved disc or nerve problem. It's also not uncommon to experience stiffness or muscle pain up to two days after strenuous lifting.
Do PTs see more people complaining of back pain, shoulder pain, neck pain during the winter snow months? What is the most common problem related to shoveling?
Immediately after snowfalls, we tend to see quite a bit of back problems. However most are mild and we can often get them fixed up and back to normal in a week or two. Neck and shoulder problems do exist, but not to the degree of low back issues.
In the future (if it snows again) how can you prevent back pain?
This is really the question to ask. Almost all over-use injuries can be prevented by clean movement and proper body mechanics. Learning to move and lift properly with the hips is paramount to good health. And that good health goes beyond just being able to shovel snow. Too many people use their backs or knees when they can spare themselves the agony by
using the hips well. Then, to supplement good hip movement, a well-designed exercise program can help 'bullet-proof’ one from common aches and pains. Excel PT & F uses the Functional Movement Screen to identify individual imbalances that can be addressed through exercise. The results of the Functional Movement Screen are used to guide exercise program design. After all, preventing a problem is a whole lot easier than fixing something after its broken!
It039#s patients like this that make me glad I chose to become a physical therapist. I039#m talking about Jordan Burnham. It was just another day at the PT clinic in the fall of 2008 when I went to the waiting room to start another new patient evaluation. Little did I know, this patient would have a very powerful impact on my attitude towards life. I met Jordan and his parents, and he proceeded to tell me a story of his long-term battle with depression, which led to his suicide attempt that left him with several traumatic injuries. Jordan, then 18 years old, fell nine stories from his bedroom window, leaving him with several broken bones on the left side of his body. Needless to say, Jordan needed extensive physical therapy to regain his functional mobility. For nearly 2 years, I had the pleasure of working with Jordan as his physical therapist. During this time, Jordan039#s change of attitude towards life was incredibly inspiring. He became involved with public speaking to spread his message about living and coping with depression. Currently, Jordan is traveling all over the country to high schools and college universities, spreading the news of his powerful story and inspiring others to speak out and learn to cope with depression, rather than deny it or be ashamed of it. I had the distinguished honor of working with Jordan in physical therapy. I helped him regain his mobility, strength, and endurance. I helped him learn to walk with a walker, then crutches, then a cane, and eventually without an assistive device. However, Jordan also helped me. He inspired me to cherish the positive things in my life. He educated me on the disease of depression, and to understand that it is something that people can and should be vocal about. Jordan039#s story has inspired me in many ways, and I hope this blog can give you a small appreciation of my experience.
RecentlyJordan Burnham, a past patient of Excel's own John Guillama was interviewed on ESPN's “Outside the Lines”. Jordan's incredible story touched many who have been battling and coping with depression.
After-Hamstring-Injury.aspx
Throughout the summer, people have a tendency to become more active outside due to the nice warm weather, allowing them to exercise while enjoying the outdoors. What people tend to forget is that they must prepare their bodies for the excess heat they don’t face during the winter and colder days of spring. This excess heat can be avoided and prevented if simple actions are taken before and after exercises. First, it is important to understand what can happen to you and what to look for if you don’t prepare your body for the heat.
lightweight, breathable fabrics that wick away sweat are best for exercising in heat. Applying sunscreen to exposed areas helps as well.
• Altering your exercise route to keep you in the shade and out of the sun can also help keep your body cool.
