upper valley sports education foundation - baseball clinic

7/28/2019 Upper Valley Sports Education Foundation - Baseball Clinic

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Sports MedicineSports MedicineSports Medicine

Baseball InjuriesKeith J. Loud, MD, FAAP

Sports PediatricianMarch 20, 2013


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Sports Medicine

An overuse injury is microtraumatic damage toa bone, muscle, or tendon that has been

subjected to repetitive stress without sufficient

time to heal or undergo the natural reparative

process.

Overuse Injury


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Sports Medicine

(1) pain in the affected area after activity

(2) pain during the activity, without restricting

performance

(3) pain during the activity that restrictsperformance

(4) chronic, unremitting pain even at rest

Classification


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Sports Medicine

Unique Injuries inthe Skeletally Immature

Physeal Injuries

Epiphyseal Injuries

Apophyseal Injuries


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Sports Medicine

Rotator cuff tendinopathy/multi-directional

instability

Little Leaguers Shoulder and Elbow

Patellofemoral pain

Osgood-Schlatters /Sinding-Larsen-Johansson Osteochondritis dessicans

Severs calcaneal apophysitis

Types of Injury


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Sports Medicine

Anatomy


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Sports Medicine

Proximal humeral physis stress injury

Symptoms:

Shoulder pain

Easy fatigability

Decreased velocity/accuracy/performance

Little League Shoulder


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Sports Medicine

Widening of Physis


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Sports Medicine

Medial epicondyle apophysitis Avulsion in severe cases

Symptoms:

Elbow pain with/after throwing

Decreased velocity/accuracy/performance

Little League Elbow


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Sports Medicine

Anatomy/Pathology


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Sports Medicine

Rest At least 6 weeks, up to 6 months

No throwing for at least 3 months

Good structured rehab to return safely to

throwing

Treatment


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Sports Medicine

Injury surveillance (eg, incidence, prevalence)

Identification of risk factors for injury

Preparticipation physical examinations (PPEs)

Proper supervision and education(coaching and medical)

Sport alterations

Training and conditioning programs

Delayed specialization

Prevention???


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Sports Medicine

Arm pain and fatigue for young throwers

Decrease pitch counts

Consider

Generalized hypermobility Genu valgus

Midfoot hyperpronation

Leg length discrepancies

Identification of risk factors


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Sports Medicine

Educate participants (and providers)

Certification/credentialing of youth sport

coaches

Available medical supervision (certified athletictrainers)

Proper supervision and

education


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Sports Medicine

Sport Modification


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Sports Medicine

1. Watch and respond to signs of fatigue (such as decreased ball velocity,decreased accuracy, upright trunk during pitching, dropped elbow duringpitching, or increased time between pitches). If a youth pitcher complains offatigue or looks fatigued, let him rest from pitching and other throwing.

2. No overhead throwing of any kind for at least 2-3 months per year (4 months ispreferred). No competitive baseball pitching for at least 4 months per year.

3. Do not pitch more than 100 innings in games in any calendar year.

4. Follow limits for pitch counts and days rest.

5. Avoid pitching on multiple teams with overlapping seasons.

6. Learn good throwing mechanics as soon as possible. The first steps should beto learn, in order: 1) basic throwing, 2) fastball pitching, 3) change-uppitching.

7. Avoid using radar guns.

8. A pitcher should not also be a catcher for his team. The pitcher-catchercombination results in many throws and may increase the risk of injury.

9. If a pitcher complains of pain in his elbow or shoulder, discontinue pitchinguntil evaluated by a sports medicine physician.

Position Statement for Youth Baseball Pitchers,

American Sports Medicine Institute, June 2012


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Sports Medicine

Baseball Pitch Counts


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Sports Medicine

1-2 days/week totally off

Increase volume by no more than 10% each week

2-3 month break from every sport Only 1 competitive team per season

Special precautions for younger athletesparticipating in compressed multigametournaments

Delayed specialization


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Sports Medicine

Delaying

specialization, taking a

break

CLIN PEDIATR 2010 49: 731

originally published online 22

March 2010

Overuse Injuries in High School

Athletes


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Sports Medicine

2

Parent/AthleteSurveyRiskFactorsComparing

AcuteVersusOveruseInjuryCategories

Sleeping 6 or fewer

hours the night

before the injury

was associated with

all the fatigue-

related injuries (p =

0.028)


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Sports Medicine

Overtraining syndrome = a series ofpsychological, physiologic, and hormonal

changes that result in decreased sports

performance.

Burnout


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Sports Medicine

Adult

Chronic muscle or joint

pain

Personality changes

Elevated resting heartrate

Decreased sports

performance

Pediatric

Fatigue

Lack of enthusiasm about

practice or competition

Difficulty with successfullycompleting usual routines

Recognition of Burnout


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upper valley sports education foundation - baseball clinic

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