Keep spring from being a season of injured pitchers
n the Bay Area, some days it feels as if spring is already here. While the breeze still has a chill to it, sunny days are signaling to baseball players of all ages that winter is finally fading away and it will soon be time to line the fields with chalk and oil the leather gloves for baseball season. Soon the crack of bats, slapping of leather gloves and non-stop chatter will be heard from every direction. Unfortunately, so will the moans of pain as young athletes are hurt in the phenomenon known as “Little League Elbow,” and medically as, medial epicondylitis. Medial epicondylitis —it can also be referred to as “Golfer’s Elbow,” — is an easily preventable injury caused by overuse of the flexor and/or pronator muscle groups of the forearm. It is essentially a strain, which is a stretch or small tearing of the muscle fibers, tendon or tendon sheath. In this case, it is the repeated forceful flexion of the wrist and valgus elbow (elbow-in) forces that are causing microtears in the muscles of young arms. In the bodies of children and young adults who are still growing, the repetitive stress may cause the apophysis, the un-hardened bony attachment of the tendon at the elbow condyle, to become irritated. And in severe cases, it can pull a piece of the bone off. This condition is called apophysitis. The most common symptoms for little league elbow is localized swelling, point tenderness, and muscle weakness or dysfunction. It may become difficult for you to grip a baseball, bend your elbow or flex your wrist. It is important to note that this is a chronic trauma injury that occurs from throwing and not by pitch type. Simply overthrowing, throwing too many pitches without proper rest, fatigue or lack of conditioning are contributors to the injury. During play, beware of signs of fatigue such as loss of control or pitch speed, needing more time between
pitches, or poor mechanics like leaning, pulling the head to the side, or dropping your arm angle. These are red flags for a repetitive trauma injury. Typically, athletic trainers may treat a mild injury with a combination of rest, ice, and a forearm strap and then help you work on more efficient mechanics. However, the best thing you can do is to prevent arm injuries is by adhering to recommendations for pitch counts and rest periods. While 17- and 18-year olds can throw 105 pitches per day, teenagers 16 and younger should only throw 95 maximum. The 11-12 year old ballplayers can throw 85 daily pitches and 9-10 year olds 75. Kids younger than this should not throw more than 50 pitches in a day. Little League baseball requires rest periods for pitchers once they reach 20 pitches in a game. Throwing 21-35 balls equals a day of rest, 36-50 pitches equals two days, and so on every 15 pitches. If you suspect this injury, have your coach or athletic trainer refer you to a qualified sports medicine specialist or orthopedic professional for an evaluation. Overall, conservative treatments are preferred. Rest, NSAIDs (non-steroidal anti-inflammatory drugs), proper strength and conditioning. Also, flexibility programs are usually prescribed. You must be fully healed before returning to play or risk making the injury worse, perhaps even season-ending. For the “Boys of Summer,” that would be as much a tragedy as a long winter. ✪
Health Watch Mikel Jackson
Mikel Jackson is an athletic trainer for the staff of Sports Medicine For Young Athletes, a division of Children’s Hospital Oakland with a facility also located in Walnut Creek. If you have questions or comments regarding the “Health Watch” column, write the Sports Medicine For Young Athletes staff at Health@SportStarsMag.com.
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February 10, 2011