Play ball — but protect young athletes from overuse injuries

The rates of injury for baseball and softball are relatively low compared to other sports, but the degree of injury severity is relatively high.

To protect young athletes, the American Academy of Pediatrics recommends that qualified adults instruct kids on proper throwing mechanics, training and conditioning.

Adults need to encourage athletes to stop playing and seek treatment when signs of overuse injuries arise.

Dr. Mike Perlstein, AzAAP board of directors member, says that over the past 20 years, the range of sports available through schools and through city recreational departments for children of all ages to participate in has grown.

But as the opportunities for playing sports has increased, so has the perceived competitive level.  Often, says Perlstein, the difference between a select or competitive team and the corresponding recreational team has been blurred.

And as the competitive nature of sports has heated up, the pressure applied by coaches and/or parents to succeed can be stifling.

In reality, an extremely small percentage of student athletes continue participating in competitive sports through high school, college, and beyond, Perlstein says.

So, parents should take a step back and think about what else young athletes can learn from participating in sports. “ I feel the lessons involved in competition are important for kids to learn,” he adds, “but should be secondary to the more important in lessons of having fun and exercising.

Perlstein, who practices at  Palo Verde Pediatrics in Gilbert, recommends that patients and their families avoid hyper specializing in any given sport until at least age 12.  “Experiencing a broad range of sporting activities, and developing different skill sets focusing on different muscle groups, is very important.”

Perlstein says that helps kids to develop in to well-rounded athletes and avoid overuse injuries. Which is important at any age — but especially in those younger athletes who have not yet reached puberty.

Overuse injuries, by definition, are almost all preventable, according to Perlstein. And the list of significant injuries documented in today’s young athletes continues to grow.

That is a source of frustration, he adds, because many of these injuries could be minimized or prevented with appropriate training strategies.

“Physical stresses on the pre-pubertal body need to be managed differently than in an athlete with a fully mature body,” he says. “For example, I do not recommend weight training with free weights until the student athlete is well into pubertal development.”

Repetitive activities, especially in relation to the upper arm, such as involved in tennis, swimming, and baseball/softball  need to be managed closely.  “Student athletes, their coaches, and their families all need to listen to the student athlete and for potential signs or symptoms of possible evolving overuse injuries.”

Have a young athlete with a single sport interest? Here are Perlstein’s recommendations:

  • Make sure the child continues to enjoy the activity, and is not simply feeling the pressure to continue.
  •  Spend intermittent time away from the sport to allow their body time to heal and to “re-charge their battery”.
  • Follow up with a sports medicine trained staff to watch for evidence of physical stress or imbalance in their flexibility or strength to avoid overuse injuries.

Not everyone may know exactly when an athlete begins to show signs of overuse, says Stephen Rice, MD, FAAP, a co-author of the AAP policy statement. “But it is important to know to never pitch when one’s arm is tired or sore. Athletes must respect the limits imposed on throwing, including pitch counts and rest periods.”

Additional AAP recommendations for young athletes include:

  • All players should wear appropriate protective gear to avoid injury. Polycarbonate eye protection or metal cages on helmets should be worn when batting.
  • Coaches should be prepared to call 911 and have rapid access to an automated external defibrillator if a player experiences cardiac arrest or related medical condition.
  • All coaches and officials should be aware of extreme weather conditions (heat, lightning) and postpone or cancel games if conditions worsen and players are at risk.
  • Not all children will develop at the same rate, so repeated instruction and practice are essential for young baseball and softball players to acquire basic skills when learning the fundamentals of the game.

RAK Archives:

Strength training for teens

Twitter chat with Cardon Children’s Medical Center sports medicine specialist Udall Hunt, MD

What you can learn from training the best: A conversation with veteran strength and conditioning coach Tim McClellan

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