5 months ago
Gaithersburg, Md. (WUSA) -- As kids return to a new school year, a new season of sports participation has begun.
For some kids, participation in competitive sports at earlier ages, along with intense practices schedules can lead to some young athletes pushing themselves too hard.
For 14-year-old Joshua Neal, his favorite part of baseball is when he steps on that mound.
"I was playing just about every day and when I wasn't playing, I was either practicing or in the batting cage," explains Joshua.
Joshua was pitching nearly 40 innings a season.
Then last summer, the teen from Gaithersburg felt a sharp pain in his right shoulder when he pitched. The pain last long after the game was over and he ended up in the office of orthopedist Dr. Craig Miller.
Dr. Craig Miller specializes in sports medicine and arthroscopic surgery with Shady Grove Orthopaedic Associates. He says an X-ray revealed Joshua suffered from an injury dubbed "little leaguer's shoulder."
Dr. Miller explains, "His growth plate was showing signs of being pulled apart."
The growth plate is cartilage at the end of long bones, including those in the the arm and shoulder. It is where rapid growth occurs in childhood. Growth plates are weaker than surrounding bone and more susceptible to damage, including an overuse like Joshua's.
"Potentially, this could have completely pulled apart, and he could have ended up with a fracture, or it could have done permanent damage where this would not grow normally," explains Dr. Miller.
Josh had to stop playing baseball for 6 weeks altogether then ease back into his favorite sport. He and his parents decided his pitching days are behind him. Today, he's an infielder.
Josh says, "You have to listen to your body and make sure you do what you know is right. If you are sore, you need to tell your parents immediately so you don't end up with life-long injuries."
For more specific prevention and treatment advice from Dr. Miller, please see his answers to commonly asked questions below:
- Why does it seem that youth injuries are on the rise?
- These types of injuries are increasing for a variety of reasons, but most notably "overuse syndromes". Children are participating in one sport year round as opposed to a variety of activities. Many young athletes are being pushed too hard or are being thrown into intense athletic activities without the proper conditioning and supervision. Additionally, kids are now playing coached sports at a much younger age than in previous generations, often playing on several organized teams at the same time resulting in extended practice hours and a level of intensity that may exceed what some young bodies can handle.
- Why are children more prone to these injuries than adults?
- Young athletes are not merely small adults. Children's bones, muscles, tendons and ligaments are still growing making them more susceptible to injury. Growth plates - the areas of developing cartilage where bone growth occurs in youngsters - are weaker than the nearby ligaments and tendons. What is often a bruise, sprain or strain in an adult can be a potentially serious growth plate injury in a young athlete that can have life long consequences. Furthermore, some children are exposed to an unhealthy level of stress to "win at all costs" which can easily overload them physically and psychologically. We already discussed how children's bodies are not physically mature enough to deal with the stress of unhealthy competition but people often overlook the fact that many children are not mature enough emotionally to handle internal stresses (expectations of one's self) and external stresses (peers, coaches and parents) of competition.
- Young athletes are not merely small adults. Children's bones, muscles, tendons and ligaments are still growing making them more susceptible to injury. Growth plates - the areas of developing cartilage where bone growth occurs in youngsters - are weaker than the nearby ligaments and tendons. What is often a bruise, sprain or strain in an adult can be a potentially serious growth plate injury in a young athlete that can have life long consequences. Furthermore, some children are exposed to an unhealthy level of stress to "win at all costs" which can easily overload them physically and psychologically. We already discussed how children's bodies are not physically mature enough to deal with the stress of unhealthy competition but people often overlook the fact that many children are not mature enough emotionally to handle internal stresses (expectations of one's self) and external stresses (peers, coaches and parents) of competition.
- What are some different types of youth sports injuries and how frequently do they occur?
- We have found that many of the injuries that children get are indeed preventable. About 95% of sports injuries are classified as "soft tissue" injuries due to minor trauma involving the soft tissues - bruises, muscle pulls, sprains (ligaments), strains (muscles), and cuts or abrasions.
- Little sports time is lost from these injuries as most of these injuries respond well to conservative care involving the commonly used acronym of RICE - rest or removal from athletics, ice, compression and elevation. Typically these injuries resolve within a couple of weeks and the child may resume activities once they have regained full and pain free motion of the involved limb or joint. Any complaints of severe pain, joint swelling, limping or loss of motion or function should prompt a visit to the pediatrician or a sports medicine specialist.
- We have found that many of the injuries that children get are indeed preventable. About 95% of sports injuries are classified as "soft tissue" injuries due to minor trauma involving the soft tissues - bruises, muscle pulls, sprains (ligaments), strains (muscles), and cuts or abrasions.
- What are some recommendations to help minimize injuries among youth baseball players?
- Baseball is a culprit of many overuse injuries. Kids can get "Little Leaguer's Shoulder or Elbow" injuries from poor throwing mechanics, or form, and from repetitive strain. While there is no concrete guideline for the number of pitches allowed, reasonable limits are 80 - 100 pitches thrown in a game, or 30 - 40 pitches thrown in a single practice session, depending on the child's skeletal maturity, muscle strength and pitching techniques. For example, coaches should limit the pitch count to 60 - 80 pitches for younger children and use resources available online to assist in setting appropriate limits for their athletes' age range. Other important points are that young pitchers should avoid throwing breaking pitches, such as curves or sliders, and instead focus on fastballs, change-ups and pitch control. They should be prohibited from playing on more than one team per season and for at least 3 months per year they should not play any baseball or perform throwing drills or participate in any overhead activity for that matter, this includes swimming, playing football quarterback or any sports that require a throwing motion.
- Baseball is a culprit of many overuse injuries. Kids can get "Little Leaguer's Shoulder or Elbow" injuries from poor throwing mechanics, or form, and from repetitive strain. While there is no concrete guideline for the number of pitches allowed, reasonable limits are 80 - 100 pitches thrown in a game, or 30 - 40 pitches thrown in a single practice session, depending on the child's skeletal maturity, muscle strength and pitching techniques. For example, coaches should limit the pitch count to 60 - 80 pitches for younger children and use resources available online to assist in setting appropriate limits for their athletes' age range. Other important points are that young pitchers should avoid throwing breaking pitches, such as curves or sliders, and instead focus on fastballs, change-ups and pitch control. They should be prohibited from playing on more than one team per season and for at least 3 months per year they should not play any baseball or perform throwing drills or participate in any overhead activity for that matter, this includes swimming, playing football quarterback or any sports that require a throwing motion.
- How can parents and coaches prevent injuries in children involved in sports?
- In addition to what we have talked about parents and coaches must recognize that every child is different in term's of their body's ability to adapt to the demands of sports and physical activity, especially at higher levels of training and competition. Each child should have an annual pre-participation physical examination by their primary care physician to be sure they are physically fit for play. They should participate at an age appropriate and developmental appropriate level, especially when it comes to contact sports. Safe participation requires year round conditioning and activity, ideally in a variety od sports and activities. Finally, parents need to be vigilant and observe for signs of psychological burn-out, physical overuse or the development of injuries, which should always be taken seriously and be properly evaluated as our young athlete's parents did in this piece. A good philosophy to follow with young athletes is, "when in doubt, keep them out."
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