Injury Prevention: Little League Pitch Counts and Rest

© sherrie smith | Dreamstime Stock Photos

We have discussed pitch counts and injury prevention for our young athletes in the past, but with baseball season upon us, it is important to remind parents and athletes of the guidelines. Young athletes feel invincible and feel injury "won't happen to them". As a physician with over 20 years of experience in sports medicine, I can assure you that injuries can and do happen. Luckily, some simple precautions can help minimize injury risk.

It is important to mention that while the old adage “practice makes perfect” is true, our youth need guidance in order to prevent injury. Overuse injuries in school aged athletes are on the rise. The incidence of shoulder and elbow injuries among youth baseball and softball players is five times greater than it was in the year 2000.[i]

Many of these baseball injuries are preventable. In recent years, Little League Baseball has released guidelines and enforced regulations to help prevent injury in young athletes (see charts below). The league has put limits on pitch counts during games and also enforced required rest periods. All the guidelines are based on the age of the athlete.

While the guidelines from Little League Baseball are important, there are additional steps that can be taken at practices and off the field.

Here are some tips:
1. Always warm up – stretch, jog and begin with some easy, gradual throwing
2. Try different positions – different positions require the use of various muscle groups
3. REST – don’t play year round and allow rest between games
4. Focus on your form, accuracy and control
5. If you have shoulder or elbow pain, do not pitch
6. Talk to your parents and coaches about any pain – do not play through the pain!

Getting kids involved in sports at an early age is a great idea, but it is important to remember an injury can end their baseball career too soon. By following the suggestions outlined here, injury can be avoided and a lifelong love of baseball and activity can be built!

Common Baseball and Softball Injuries: Glenohumeral Internal Rotation Disorder (GIRD)

Shoulder injuries are common in baseball and other sports involving overhead activites. Prevention is possible and the first step in prevention is knowledge. In this post, we will examine a common shoulder condition of the glenohumeral joint called Glenohumeral Internal Rotation Disorder or GIRD. 

The genohumeral joint is what most people think of as the “ball and socket” of the shoulder. Clinically, it is the joint that connects the humerus and scapula. This important joint is what allows the arm to move in a circular motion. 

Baseball pitchers rely on the Glenohumeral Joint for throwing. The strain that pitchers put on this joint by repetitively throwing can lead to GIRD. GIRD is an injury that develops over time as a result of overuse and is not typically an acute injury. 

GIRD is defined as a 20⁰or greater loss of internal rotation of the throwing shoulder. Other symptoms include: 

• Vague pain in the shoulder with overhead pain
• Decrease in throwing performance (control and velocity)
• Occasionally, a decrease in motion
• Increased range of external rotation and decreased internal rotation vs. non-dominant shoulder

Normally, GIRD is treated using non-invasive methods. Surgery is not normally required to treat this condition.  A common treatment plan could include the following:

•  Rest from throwing for a period of 3-6 months
• Physical Therapy that includes various stretches for the posterior and inferior capsules

In rare cases where rest and physical therapy does not work, arthroscopic surgery may be performed to restore range of motion. However, most cases of GIRD can be treated non-surgically. If you suspect you suffer from GIRD or another shoulder injury, make an appointment to see Dr. Vitolo or your orthopedic surgeon.

Preventing Overuse Injuries in Young Athletes this Baseball Season

Baseball season is here! Young athletes are ready to start training. While the old adage “practice makes perfect” is true, our youth need guidance in order to prevent injury.

Overuse injuries in school aged athletes are on the rise. The incidence of shoulder and elbow injuries among youth baseball and softball players is five times greater than it was in the year 2000.[i] Many of these baseball injuries are preventable.

In recent years, Little League Baseball has released guidelines and enforced regulations to help prevent injury in young athletes (see charts below). The league has put limits on pitch counts during games and also enforced required rest periods. All the guidelines are based on the age of the athlete.

While the guidelines from Little League Baseball are important, there are additional steps that can be taken at practices and off the field. Here are some tips:

1.  Always warm up – stretch, jog and begin with some easy, gradual throwing
2. Try different positions – different positions require the use of various muscle groups
3. REST – don’t play year round and allow rest between games
4. Focus on your form, accuracy and control
5. If you have shoulder or elbow pain, do not pitch
6. Talk to your parents and coaches about any pain – do not play through the pain!

Getting kids involved in sports at an early age is a great idea, but it is important to remember an injury can end their baseball career too soon. By following the suggestions outlined here, injury can be avoided and a lifelong love of baseball and activity can be built!

---

[i] http://www.stopsportsinjuries.org/media/statistics.aspx

Maximum Pitch Counts and Required Rest Periods courtesy of Little League Baseball

Baseball Season: Protect your Shoulder

Spring is in the air!  It is baseball season; time to get out and enjoy this classic American sport.  Many kids and adults play the game and probably give little thought to the impact playing can have on the shoulder.  It is important to be aware of the potential injuries that can occur so that a small strain does not evolve into a serious problem. 

Bursitis, rotator cuff weakness and rotator cuff tears are all possible complications from the constant throwing, batting and diving that are involved in the wonderful sport of baseball.   What are injuries should you be aware of and how are they caused? 

Rotator Cuff Weakness:  Rotator cuff weakness can be caused by a constant throwing motion.  Weakness occurs when the rotator cuff tendons become inflamed and may get pinched under the shoulder blade. 

Tendonitis/Bursitis:  Tendonitis occurs when the rotator cuff tendons and/or the bursa become irritated and inflamed.  Symptoms include extreme pain or weakness, especially when the shoulder is in motion.   These conditions often occur in conjunction with each other, but pain associated with Bursitis tends to be located just under the joint capsule. 

Rotator Cuff Tear:  Here we have the ‘worst case scenario’.   Rotator cuff tears occur when the tendon is ripped off the bone.  Symptoms include:  limited motion, decreased shoulder strength and aching and weakness when you lift your arm above your head.  Surgery is often required to fix a rotator cuff tear. 

The big question is:  how do you avoid these injuries and stay in the game? 

One great way to prevent injuries of the shoulder is Strength Training.  Around the shoulder blade (also called the scapula) are a series of muscles that together with the rotator cuff, allow a dynamic, fluid motion seen with throwing. Many athletes perform exercises that strengthen the large muscles of the shoulder, such as the pectoralis major and deltoid muscle, but ignore the rotator cuff and smaller muscles surrounding the shoulder blade.  Failure to strengthen these smaller muscles, called the parascapular muscles and rotator cuff muscles, can result in pain while throwing, and issues with shoulder function.   

Examples of rotator cuff exercises are resisted external and internal rotation exercises of the shoulder, reverse flies and seated rows (look for future posts for more details on these exercises).  All of these exercises should be performed with an emphasis on squeezing your shoulder blades together while doing each repetition.  These muscles are small in relation to other muscles in the body and do not require a significant amount of resistance.  A few pounds of weight or a light resistance band is usually adequate for strengthening. 



As a reminder, prior to performing any of these exercises it is important to see your orthopedic surgeon if you are unable to lift your arm, or if you are unable to perform these exercises due to pain or discomfort.

Prevention of these injuries is often possible.  In addition to the strength training mentioned above, here are some additional tips from STOP Sports Injuries (www.stopsportsinjuries.org):

• Warm up & stretch -  it is important to  stretch out  the shoulder and start with a few “softer” throws.
• Play various positions - this is especially important for the younger athletes.  Switching positions and using different body parts/muscles is an important component to preventing injury.  
•  DON’T play through the pain!  If pain persists, see a doctor. 
• Take time to rest.  If you are a pitcher, try to take a day or two off between games. 
• Concentrate on control, form and accuracy when throwing or pitching. 

If you suspect you or your child has a shoulder injury, we are here to help.  Skyview Orthopedic Associates is an excellent resource.  Our staff is focused on individualized, state of the art patient care and is led by John Vitolo, MD.  Dr. Vitolo specializes in injuries and disorders on the shoulder and knee.  He is board certified in orthopedic surgery and sports medicine.  Dr. Vitolo was also recently named to the NJ Top Doc list.   For additional information, visit www.skyvieworthopedic.com or call 973-300-1553.