From the Spring 2017 issue of AtlanticView Kids:
With more than 60 million children participating in youth sports across the United States, injuries are bound to happen. But for kids who play throwing games, such as baseball and softball, the risk is even greater.
A Growing Problem
Overuse injuries are among the most common injuries to affect baseball and softball players. This type of injury impacts the ulnar collateral ligament (UCL), the primary stabilizer of the elbow in the pitching motion.
“We’ve seen a tremendous increase in those overuse injuries in this adolescent population over the last 10 to 15 years,” says Damion Martins, MD, director of orthopedics and sports medicine for Atlantic Health System, and team physician for the New York Jets.
Michelle Sirak, MD, director of pediatric physiatry for Goryeb Children’s Hospital, says this increase in overuse injuries is due to year-round playing, particularly among pitchers. “Playing in one single position makes the shoulder and elbow very vulnerable,” she says. “We have young kids who are not fully developed that are doing this repetitive motion – not only during a single season but year-round in sports clinics.”
In overuse injuries, the ligaments and tissues get stretched out and damaged over time, says Dr. Martins. “When the muscles get fatigued, they can’t protect those ligaments and eventually they tear,” he says. “We’ll see some kids by the age of 18 who have had two or three surgeries to repair ligaments. This is why our program takes a comprehensive approach to musculoskeletal injuries in an attempt to prevent kids from developing chronic rotator cuff problems, weakness in the shoulder, and arthritis in the elbow. We are one-stop shopping for the athlete, from education, prevention, diagnosis and treatment.”
While surgery is required in extreme cases, Dr. Sirak says most injuries are related to inflammation or tendonitis. Atlantic Sports Health physical therapists work with players to decrease the initial injury and monitor the arm’s form and function. “We try to get kids to decrease activity and frequency and get them into physical therapy,” she says. “No one should be playing through pain, so you limit them to non-pain control.”
Overuse injuries could be avoided if coaches and parents followed the guidelines from organizations such as the Centers for Disease Control and Prevention and Little League Baseball.
“The guidelines focus on three areas,” says Dr. Martins. “First is maximum pitch count by age. So if you’re seven years old, you shouldn’t be pitching more than 50 throws. They also look at rest periods. If you’re in the 10-year-old age group and you’re pitching 50 throws, you don’t want to play for two days. The third component includes various pitches and what age you can start throwing different types of pitches. I can’t tell you how many kids come into our office complaining of elbow pain who are 12 or 14, and they’re throwing knuckleballs and screwballs that aren’t age-appropriate.”