Everyone’s Sore This Week. Is That OK?

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Muscle soreness is very common when you start a new exercise, or are coming off a period of rest
  • Most muscle soreness is manageable with simple steps such as active recovery, hydration, proper nutrition, massage, and rest
  • Seek professional medical evaluation for anything that you would describe as persistent pain

It seems this week that every young athlete coming in to the office is sore. Legs sore, arms sore, back sore, sore all over. What’s going on here? Is it okay to be sore and just play through the soreness? Is there anything that can be done to reduce the soreness? When is it time to stop and take a break? sore calf

First of all, you want to make sure it’s muscle soreness and not a joint issue, or a muscle tear. If there was a definite injury event (such as a hard tackle, fall to ground, etc.), if there was a feeling of a “pop”, if there was rapid onset of swelling, or if you are having what you would describe as significant pain then you’ll need a visit to a physician.

If none of those apply to you, and if you have generalized muscle soreness or fatigue you most likely have a common condition called Delayed Onset Muscle Soreness (DOMS).

DOMS happens when you subject your body to a new physical activity, one that your body wasn’t accustomed to doing. Essentially you’ve switched up your workout and surprised your body with something totally new. If you were taking a month off in July and then started aggressive two a day camp in August, your body is doing something new. If you’re an experienced runner who typically runs 3-5 miles on flat terrain and you switch to aggressive hill sprints you’re doing something new. The exact process behind DOMS is not completely understood, but from the athlete’s point of view you’re going to be sore.

Generally it will be okay to continue training through the soreness, as long as you’re not in significant pain and as long as your performance is reasonable. At this time of year many young athletes won’t have a good option- you’ll need to do what’s required of players trying out for a fall sport team.

But there are some things you can do to minimize the soreness. Pay close attention to hydration, proper nutrition, and get as much rest as possible. Massage can also help speed recovery time. If your coach is knowledgeable then he/she has likely put some active recovery time in to the preseason workouts. On those especially bothersome days it would be better to do a light run or stationary bike; something low intensity that will help with blood flow to the muscle and assist the muscle to recover.

At the end of the day you might not have many options, you’ll need to go along with the coach’s plan for the team. In a good program, you should be sore, and then not sore. And then you should be sore again if you add intensity or change up an exercise. In other words, constant pain does not necessarily equal maximum muscle gain. If you’re a young athlete and you’re in pain all the time I’d recommend that you seek professional evaluation from a sports medicine physician. Otherwise, do your best to hang in there. Eventually the two a days will be over!

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Establish a Preseason “Chain Of Command” About Youth Sports Injuries

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • A recent survey was published by Safe Kids Worldwide highlighting important aspects of the culture surrounding youth sports injuries
  • Youth coaches at club and high school levels must be properly educated in basic injury recognition
  • It’s very important to have a discussion with parents prior to the club season to establish a decision process for dealing with on-field injuries

There are some really great points exposed in this recent survey from Safe Kids Worldwide regarding the culture of youth sports injuries. Here are the most relevant points I took away from the survey: Screen Shot 2014-08-19 at 11.37.00 AM

  • Survey was comprised of 1,000 young athletes (seventh through 10th grade), 1,000 coaches and 1,000 parents
  • 42% of players report that they have hidden or downplayed an injury during a game so they could keep playing; 62% say they know someone else who has done so.
  • 54% say they have played injured and 70% of those kids say they told a coach or parent that they were hurt. Top reasons given for playing injured: it wasn’t that bad (18%); couldn’t let the team down (13%); didn’t want to be benched (12%).
  • 33% say they have been injured as a result of dirty play from an opponent; 28% agree that it is normal to commit hard fouls and play rough to “send a message” during a game.
  • 53% of coaches say they have felt pressure from a parent or player to put an athlete back in a game if the child has been injured.
  • 80% of parents favored their child’s youth sports coach receiving certification or at least training in injury recognition
  • But less than half of coaches responded that they had received any injury training

The numbers above are interesting but what I’d really like to point out to you are that the numbers of players with injuries dealt with on the field of play by the coach and parent who do not end up seeing a physician are staggeringly large. We know with good certainty that there are about 1.2 million visits annually to the Emergency Room for youth sports related injuries; we also know with good certainty that about another 2 million visits take place annually to the pediatrician or sports medicine specialist for youth sports injuries. But the real number that is underpublicized is that at least 3 times that number are dealt with each year by the coach without involving a physician. That’s about 10 million injury incidents annually.

Many of those 10 million are really minor bumps, bruises, etc. What if they’re not? And will you as a coach know if it’s something that should be looked at by a skilled professional?

In the preseason it’s really important for the coach and parents of club teams to have an open and honest discussion to lay down some ground rules, what I like to refer to as a “chain of command”. First, the coach must be educated in basic injury recognition. Then, there needs to be a clear understanding that if the coach feels a child should not return to play due to injury that the coach is backed on his/her decision without pressure from parents or players to have the child continue playing. At the high school level there needs to be an understanding that the ATC (or if available the team physician) has the last word on play or no play for injured athletes during a game, and the coach should not have authority to override the professional opinion of the ATC.

Injuries are going to happen. Let’s make sure we have the right education for the coaches and the processes in place to deal with the issues properly. Have the key discussions before the start of the season.

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Are You An Expert Performer? Radio CaptainU Interviews Joe Baker, Pioneering Canadian Researcher.

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Expert Performance refers to individuals that perform at the absolute highest levels
  • The most important factor in expert performance is training related, and more important than genetics according to Baker
  • Other interesting factors in expert performance are birthdate, being left handed, and emphasis on multiple sports or physical activities at the youngest ages

How does someone get to be the very best at something? These individuals are called “expert performers” by Canadian researcher and noted authority Joe Baker. Is someone just born this way, can it somehow be trained, is there a spectrum of performance through which someone can move from novice to expert?

Well it turns out that all of us can take heart, expert performers can be made and are not necessarily created that way from birth. Certainly there are genetic and environmental factors that will play a crucial role in performance but many individuals can dramatically improve their sports performance, regardless of genetics.

The number one factor in expert performers is training, a person’s ability to take on hard training seems to be a critical factor in success. So to a certain extent hard work, determination, and response to adversity are possibly more important than genetics. Specific training indicators are often age dependent. In the earliest age groups research supports sport enjoyment and basic skill acquisition in multiple sports or physical activity as a very important factor. Later on, emphasis shifts more to sport specificity and seeing results from the hard work.

Another factor they identified is birthdate, called the “relative age effect”. Essentially, when you are young and playing in age group sports, those kids born immediately after the cutoff date for the sport will have a definite advantage in the early going. This factor seems to become less prevalent in adolescence but it’s definitely a factor in the youngest age groups.

A very interesting finding was handedness, apparently a disproportionate number of expert performers are left handed.

Baker’s research is very interesting, but one caution I’d offer is that most of the research on expert performers is done retrospectively, meaning that the researchers identify expert performers and then generally look back in their past to find factors possibly responsible for their development. The problem with any of these retrospective studies is that they might not be predictive. In other words, it’s currently not possible to say to someone “if you do the things that these expert performers do then you’ll definitely become one yourself”. Certainly you’ll improve your performance by following the principles of expert performers so you probably have nothing to lose by trying these things. Go get to work!

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The Crucial Importance Of Good Football Helmet Fit

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Proper football helmet fitting is a very important step in reducing risk of injuries such as concussions, facial lacerations, and facial fractures
  • Many high school football players will release air from the air bladders in their helmets during the season to improve comfort, however, this leads to a loose helmet that protects poorly
  • Ideally, helmet fit needs to be checked weekly, especially for air bladder type helmets
  • Steps: if possible, select the best STAR rated helmet you can afford, next you need to follow the manufacturer’s fitting steps, and finally you need to maintain the fit at weekly intervals

This week’s post is short and sweet: make sure your football helmet is properly fitted and that you keep it that way throughout the season.

It’s a simple enough thing, at the start of the season get the best helmet you can and then make sure it’s properly fitted for you.  Following generally well accepted guidelines for helmet fitting will mean that your head does not move around within the helmet, and this will mean fewer chances to get a cut on the skin from excessive movement, it will protect better against facial injuries, and it will reduce the chance of a concussion. OLYMPUS DIGITAL CAMERA

I would recommend that if you have a choice of helmet, that you use the STAR ratings from Virginia Tech and choose the best rated helmet you can afford. Then, make sure the helmet is properly fitted. If you are purchasing from a retail store then the sales representative should be properly trained to fit you; if you are doing this with a team then one of your coaches will be trained to do this. As a parent it might be good to familiarize yourself with the fitting process. USA Football’s informational page is an excellent resource.

During the season many players will modify the helmet fit because they feel more comfortable with a looser fit. I will commonly see players release air from air bladders, excessively loosen chinstraps, or remove padding to loosen the fit. You might be tempted to do this but resist that temptation and keep the fit snug and correct! Consult your coach or athletic trainer regularly to check your helmet. It’s a small price to pay for a big improvement in safety.

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NCAA Concussion Statement Has Great Points For High School Athletes Too

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • The NCAA recently released a concussion guideline that presents clear definitions and processes for collegiate athletes in all sports
  • The vast majority of concussions will not have a loss of consciousness
  • In my opinion it would be helpful at the high school level for athletes to have preseason baseline concussion testing; suspected concussion in-season would be compared to the baseline
  • Return to classroom function can also require individual decision making, and students with pre-existing conditions such as ADHD, migraines, or depression may require extended assistance to successfully return to academics

I hope that someday soon we won’t have to write as many posts and articles about concussion. But for now we still need to improve awareness about recognition, treatment, and long term effects from concussion. girls soccer header

In an attempt to bring a comprehensive and clear set of processes around sport related concussion for men and women in all sports, the NCAA recently released their “Diagnosis and Management of Sport Related Concussion Guidelines”. There are a number of excellent points raised in the guideline, many of which bear repeating as they are applicable in youth sports too.

One of the most important points is that our current understanding of concussion is evolving based upon available scientific evidence and consensus statements authored by concussion experts. As we gain more knowledge it’s become clear that the vast majority of concussions occur in awake individuals who do not lose consciousness. Furthermore, the symptoms of concussion often clear up very rapidly. In fact at the high school level I find that most of our concussed athletes have returned to their baseline level of cognitive and neurologic function within about 15 minutes from the concussion event. At the high school level it would be very helpful for the head trainer to have a preseason discussion with the parents and coaching staff about this important point.

A second important point is that in the NCAA they will require baseline concussion testing in the preseason for all athletes.  The baseline testing could be computer based or paper based but the point is that the athlete with a suspected concussion would undergo the same testing as they had in the preseason and would be compared for differences, thus supporting the diagnosis of concussion. A return to baseline values on the testing would be required for the athlete to start a return to play process. This will be difficult to implement at the high school level due to cost and a number of logistical issues. However, I believe the rationale is clear and if a high school is able to have some form of preseason cognitive testing for their athletes then I believe they should do it.

Finally, the NCAA guidelines highlight the need for a stepwise progression not just for return to play, but also a return to academics. They refer to this as “return to learn”. Great phrase. Some students will have concurrent conditions such as ADHD, migraines, or depression that will contribute to a potentially slower recovery from concussion. The take home point here is that young athletes must have an individualized approach to return from concussion and that medical professionals may need to work with school administrators and counselors to ensure the best environment for the student to return to normal function.

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Hockey Helmet Ratings Coming Soon from Virginia Tech

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Independent and objective scientific analysis is adding to our knowledge of football helmet safety
  • The researchers at Virginia Tech will next analyze ice hockey helmets and then in the coming years look at baseball, softball, and lacrosse
  • I would predict that the evidence will be used by parents to demand the safest equipment for their kids

Whenever possible we like to base our medical decisions on high-quality scientific evidence.  The issue of concussion safety can become emotionally charged, which makes it even more necessary to seek out unbiased opinion when making recommendations on equipment, rules changes, sideline treatment of professional athletes, etc. 23HELMET-articleLarge

And so it is with helmet design. In football, we’ve come a very long way from the early days of leather “helmets”, and professional hockey in the relatively recent past didn’t even require helmets. Technical change requires buy-in from the players, who often have strong feelings about the traditions or culture of the game that may run counter to the proposed technical changes.

This is where objective analysis really helps. In football helmet design, the collaboration between Virginia Tech University and Wake Forest University School of Biomedical Engineering and Sciences has produced the Virginia Tech STAR Helmet Rating System. I find the testing methodology to be sound and well thought-out, utilizing linear and rotational testing. We will undoubtedly learn more about the exact risk factors for concussion but for now the Virginia Tech system is a big step in the right direction.

After football, one of the sports with the highest concussion risks is ice hockey. It is also a sport with a rapidly growing youth participation rate in the U.S., so it makes sense that science and industry take a close look at making the concussion risk as low as we possibly can. This article in the New York Times reports on a recent announcement by the researchers at Virginia Tech that they’ll be applying the STAR testing to hockey helmets. A hockey helmet rating will be published later this year.

Ideally, we should see similar testing by other independent researchers, and also look at external helmet padding such as the Shockstrip and Guardian Cap. The external padding makes some sense but in my opinion we simply don’t have the independent research to endorse use from the medical standpoint. The Virginia Tech researchers will look at baseball helmets, softball helmets, and lacrosse helmets using similar methodology over the next few years.

Design engineers have made enormous improvements in automobile safety over the last several years, and without question we can improve sports helmet safety too. My prediction is that the scientific evidence will compel parents to demand the best protection for their kids. It may take quite a bit of time and it may be expensive, but change is coming and all our young athletes will benefit.

 

 

Posted in Baseball, Concussions, Football, Hockey, Science | Leave a comment

Hamstring Injuries: What To Do, What To Expect, What’s On The Horizon

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Hamstring injuries can take a long time to fully heal, ranging from 3 to 8 weeks for most young athletes
  • See a physician soon after injury if you heard or felt a “pop”
  • Full recovery is needed before return to sports in order to lower your chance of reinjury

Hamstring injuries are common in any sport involving sprinting, jumping, or rapid change of direction. In young growing athletes hamstring injuries can involve pulling the bone off the pelvis (an “avulsion”). Once growth slows down or stops hamstring injuries are more often found in the muscle, or in the tendon at the upper or lower end.  These injuries generally have a high rate of return to play, but can often take a long time to recover and also have a risk of reinjury. Some new treatments are on the horizon which have the chance to improve healing times and lower reinjury rates. OLYMPUS DIGITAL CAMERA

What’s The Story?

Athletes with hamstring injuries will typically have a sudden onset of pain in the back of the thigh during a sprint.  This often causes them to stop the run, putting their hand on the back of the thigh.

If you heard or felt a “pop” at the time of the initial injury I would strongly recommend that you see a sports medicine physician for early evaluation and treatment.  The dreaded “pop” may mean that you had a bone injury in the pelvis, or it could mean a serious tear in the hamstring muscle or tendon.

Fortunately, most injuries involve the hamstring muscle rather than the bone or tendon. The reason that’s a good thing is that the muscle has a very good blood supply and that is essential for healing any injury. The blood carries cells and other repair factors to the injury and will allow the body to heal the injury.

Treatment Guidelines

Everyone will respond differently, so discuss your particular situation with your doctor. In general, hamstring injuries in young athletes will not require surgery. An exception could be a bone avulsion that is significantly pulled away from the bone. Most often, the initial treatment is rest from sports, ice, an Ace wrap for compression, anti-inflammatory medication, and physical therapy. Crutches might be needed early on for pain relief. In teenagers and young adults a cortisone injection is sometimes done, and has been shown to shorten return to play times in specific circumstances. Discuss this carefully with your doctor.

Proper rehabilitation is incredibly important. Before returning to practice or competition, the athlete will need to go through a gradual rehabilitation program involving range of motion, strength, agility, power, and speed. A physical therapist is skilled in these techniques and can greatly improve the chances for successful recovery. Very important: you want to be completely recovered before returning to play. If you are not completely recovered you have a high chance of getting another (and often more severe) injury.

On the horizon: new treatments

Keep an eye on the news for use of “platelet rich plasma” or “PRP” during the upcoming NFL season with hamstring injuries. This is a safe treatment involving an injection of concentrated products from the athlete’s own blood. PRP has the potential to accelerate healing and without any illegal substances used. I would predict that PRP will become common for most athletes over the coming years, once we gather widespread evidence of its benefits. Other treatments further down the line would include implantation of stem cells with the potential to truly heal the injury with normal tissue. Stem cell research for muscle injuries is progressing, but in the very early stages.

When Can I Return To Play?

Once again, everyone is different so you’ll want to get individual guidance from your doctor and physical therapist. But in general, I will typically see young athletes take about 3 weeks to return to play after a mild injury, and about 8 weeks to return after a more significant injury. It takes a surprisingly long time! Bone avulsions are a completely different story, often taking several months for successful return.  Whatever the injury severity, make sure you are fully recovered before you attempt a return to play.

 

 

 

 

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ACL Surgery In The Growing Athlete: Save The Growth Plates

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • A recent scientific study showed that young growing athletes with open growth plates can successfully undergo ACL surgery with no risk to bone growth, and high success rates for return to sports
  • Return to unrestricted sports took about 13 months on average in this study
  • I would encourage the young athlete to consider “all inside” ACL reconstruction to avoid possible damage to the growth plates

The ACL is a main stabilizing ligament in the knee, and most athletes with a torn ACL will require surgery to rebuild (otherwise known as “reconstruct”) the ACL if their goal is to return to jumping, cutting, sprinting, and pivoting sports. Unfortunately, we are seeing more ACL tears in very young athletes. While ACL surgery in adults is a fairly straightforward procedure with a high success rate, surgery in young athletes with open growth plates poses some challenges. Recent technical advances now make it possible for the surgeon to completely avoid the growth plates.gty_child_knee_injury_dm_111020_wmain

Let’s start with some definitions. Growth plates are areas of developing cartilage tissue near the ends of long bones. The growth plate regulates and helps determine the length and shape of the mature bone. The long bones of the body do not grow from the center outward. Instead, growth occurs at each end of the bone around the growth plate. When a child becomes full-grown, the growth plates harden into solid bone. The two main growth plates around the knee are in the upper tibia and lower femur. With commonly performed ACL surgery, the surgeon creates tunnels across these two main growth plates. The tunnels would then create risk of damaging the growth plates resulting in the potential for a change in length or angulation of the bone.

Over the last few years, technical advances in ACL surgery now make it possible for the surgeon to do the procedure without creating any tunnels across the open growth plates. This type of surgery is called an “all-inside ACL reconstruction”. A presentation at this week’s annual meeting of the American Orthopaedic Society for Sports Medicine showed excellent results with this type of surgery. The success rate in terms of stabilizing the knee and allowing unrestricted sport activity was very high, (93%), and there were no observed changes in bone growth.

This type of ACL surgery requires specialized surgeon training, and not all sports medicine surgeons will be skilled in the procedure. But I think it would be worth finding a surgeon trained in the procedure if you are considering the surgery for your growing son or daughter.

What Would I Do With My Son Or Daughter?

We are now at the point where it makes sense to perform all-inside surgery for the young athlete with open growth plates who needs ACL surgery. The main limiting factor is that there just aren’t many surgeons trained in the procedure. You’ll have the best chance of finding a surgeon trained in all-inside ACL reconstruction in children at sports medicine clinics run through major children’s hospitals in larger urban areas. If it were my son or daughter I would research a children’s hospital sports medicine clinic in a major metropolitan area and have the all-inside procedure from an experienced surgeon. Having said that, not everyone has access to these specialized centers. We also have many, many years of solid scientific evidence that it is possible to create tunnels across the growth plates with slight modifications to the standard adult operation, with very little risk to the growth plates. You’ll find those skilled surgeons all across the U.S. With a skilled surgeon and careful attention to rehabilitation, ACL reconstruction in young athletes with open growth plates should allow a very high chance of successful sports participation and minimal risk to bone growth.

 

 

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Sports Nutrition (Including The Wonders Of Chocolate Milk!) Radio CaptainU Interviews Nancy Clark, Internationally Renowned Sports Nutritionist.

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • For serious athletes at any age, nutrition is an often overlooked but incredibly important component of athletic performance
  • Each body will react differently to food and fluid recommendations, it’s best to do a bit of experimenting in the preseason
  • She’s as much of a believer in low-fat chocolate milk as a recovery drink as I am!
  • Her book provides outstanding practical advice in one source for all athletes

Nancy Clark is an internationally renowned sports nutritionist based in Boston. Over the course of her career, she has counseled athletes of all ages and levels of ability. Her substantial experience forms the basis of what I’m sure you’ll find interesting and practical in this Radio CaptainU episode.

If you are interested in maximizing your athletic performance (that goes for parents and coaches as well as young athletes) then her book is a great place to look. The book is organized in easy to read and practical sections, and is now in its Fifth Edition, titled: “Nancy Clark’s Sports Nutrition Guidebook”.

She bases her recommendations on science, and generally avoids the fad-of-the-day hype often found in many fitness magazines or other media sources. There are several points in the book that I found particularly useful:

  • Chapter 9: Fueling Before Exercise contains suggestions for pregame food based on the starting time of your event.
  • Suggestions are also based on the type of sport, e.g. endurance vs. power sport
  • Suggestions also given for weight-class sports
  • Chapter 10: Fueling During and After Exercise has outstanding recommendations for many different situations, including tournaments and back to back events
  • She is a believer in low-fat chocolate milk as an excellent post-event recovery drink.  I really like this and have recommended it for years.
  • Every body behaves differently so the young athlete should experiment with different food and fluid combinations in the preseason
  • Carbohydrates are important for the athlete! Low carb diets are generally ineffective for the competing athlete. A low carb diet might be good for a 50-year-old attempting to lose body fat and weight, but a high-energy athlete absolutely needs carbs for performance.

Have a listen to this very engaging interview with Ms. Clark!

Posted in CaptainU, Hydration, Nutrition | Leave a comment

Throw Like A Pro: Dr. James Andrews’ iOS App Hopes To Save Young Arms

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Renowned clinicians Dr. James Andrews and Dr. Kevin Wilk created an app called “Throw Like A Pro” to assist young pitchers in healthy pitching habits
  • Proper use of the app has the strong potential to correctly monitor pitching load across multiple teams and private training sessions, and reduce the chance for serious overuse injuries to the shoulder and elbow

This is heavy pitching season for a lot of talented young arms. In our part of the country, a number of outstanding Little League teams have fielded teams that have gone very deep into the annual Little League baseball championships. Not surprisingly, having at least one truly outstanding pitcher is a prerequisite for success.  Grant Lewis

Many of these young pitchers are talented for sure, but many also rely on multiple sources of coaching and game experience to advance quickly. It’s common for a player to be on an “official” Little League All-Star team and also take private pitching instruction. During the regular season there are likely travel teams too.

The result is often overpitching. We can have a Little League coach follow a pitch count and innings count, but that has no effect on the pitches thrown outside the coach’s watch.

For the player and the parents they find themselves in a tough situation. There is a feeling that success must be achieved as early as possible to have a chance at landing a pro contract or a college baseball offer, and if the young man doesn’t get that early success he’ll be left behind. “Everyone else is doing a league team, travel team, and private instruction, so I need to do it too.” Orthopedic surgeons often hear that explanation when a young pitcher sees us for an injured shoulder or elbow. From their side I can definitely see their point: the very best college programs are now recruiting in middle school.

But the toll extracted physically from the young pitcher can be substantial. We continue to see more serious shoulder and elbow injuries in young pitchers than we did 10 years ago and Dr. James Andrews estimates that 60% of those injuries are from overuse. And therefore they could be preventable.

Dr. Andrews believes very strongly in education for young athletes in hopes of preventing serious injury. He contributes his time, money, and expertise to the STOP Sports Injuries program and recently created an iOS app called “Throw Like A Pro” along with noted rehabilitation specialist Dr. Kevin Wilk.

If you’re the parent of a young pitcher I strongly encourage you to use the app. There are four components to the app: a pitch counter and rest calculator; pre-season prep guide including an exercise regimen; pre-game warmup; and educational component on pitching injuries. I find that the pitch counter and rest calculator are the most valuable parts. If a player and parent actually use this tool it will allow them to keep track of the arm reps across any number of teams or private coaching sessions.

I completely recognize that the pressures are higher than ever to perform better at younger ages. As a parent and young pitcher it might take some courage for you to take a close look and resist the trend to overpitching. But doing so has a very good chance of successfully enjoying the game and competing far longer than you otherwise might.

 

 

 

 

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