Injury Prevention: Little League Pitch Counts and Rest

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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!

What is Swimmer’s Shoulder?

Swimming is one of the few, if not only, sports that utilizes the upper body and shoulders to move the entire body forward. Swimmers, both male and female, tend to be very flexible and have more range of motion in their shoulders than the average athlete. Swimming is also unique because the water gives resistance that the air does not. The reliance on the upper body, coupled with the resistance of the water and repetitive use of the shoulder can lead to a spectrum of overuse injures termed “swimmer’s shoulder”. 

Swimmer’s shoulder rarely results in permanent injury requiring surgical intervention. The most common swimmer’s injury found on MRIs of the shoulder is tendonitis. Tears of the rotator cuff or labrum are much less common. 

Anatomy

In order to better understand swimmer’s shoulder, we need to review the anatomy of the shoulder. The key muscle group of the shoulder is the rotator cuff, which consists of the subscapularis, supraspinatus, infraspinatus, and teres minor. The primary role of the rotator cuff is to function as the dynamic and functional stabilizer of the glenohumeral joint.

The muscles and the attached tendons of the rotator cuff can be overused and injured in shoulder dominant activities such as swimming. The most commonly injured portion of the cuff is the supraspinatus. On the other hand, the "power muscles" of the shoulders, including the latissimus dorsi, pectoralis, and deltoid, are responsible for moving the arm through space or water, but rarely sustain significant injury.

Treatment

Treatment protocol for swimmer’s shoulder is as follows:

• Oral anti-inflammatories to decrease inflammation of the shoulder
• Strength training of the shoulder and rotator cuff
• Maintaining range of motion in the shoulder

The above is normally achieved with physical therapy or a physician directed home exercise program. It is important to consult a physician before adopting a treatment plan. Without guidance, one can potentially make the injury worse. 

Prevention

Swimmer’s shoulder may be avoided with a regimented dry land program in the off-season. Training programs should focus on strength training and flexibility of the rotator cuff and other shoulder blade muscles.  

For more information on shoulder injuries and conditions, please visit our website, www.advocaredoctors.com/orthosportsmed