RETURN TO SEASONAL SPORTS FOR YOUTH: Reversing Overuse Injury in youth

Ever have one of those weeks where random events seem to conspire to send the same message?

Wondering what the hell am I talking about here?

Well, the other evening I was driving by the local Youth Baseball/Softball Stadium, when I noticed there was a Youth Baseball Tournament with what looked to be 10-11 year old boys going on….IN NOVEMBER! I know you can guess what my thoughts were on young athletes playing baseball at night during FOOTBALL SEASON.

The next morning, I was listening to a radio interview with the shortstop of the World Champion S.F. Giants, Brandon Crawford. Crawford told how, despite the pressures to play baseball year round, he played Football and Basketball throughout his high school years.

He told the interviewer that he felt his body needed the rest/break from baseball; especially his arm. He felt other sport movements allowed him an opportunity to improve his overall athleticism while not exposing him to “overuse” injuries common to baseball. Without playing other sports through high school, he felt he might have been injured before, or during his collegiate years at UCLA.

That same afternoon I read a paper from a prominent Sports Medicine Doctor’s group that recommended keeping youth baseball players to under a 100 pitch per week count. What bothered me about that was the fact that I see young athletes aged 10-14 playing YEAR ROUND BASEBALL. Even limiting hard throwing or pitching to 100 per week seems TOO MUCH. Imagine 40 weeks (out of 52 in year) x 100 hard throws (4,00) from age 10 to 14 (20,00 hard throws or pitches).  More than 20,000 hard tosses or pitches BEFORE High School?

That very same evening I happened to get to Chapter 5 in Mark McCluskey’s “Faster, Higher, Stronger” book. Below are some of the informational highlights of this Chapter (The Fast Track to Greatness).

“…the more important difference between the fast and slow developing athletes is how much and when they came to their primary sport. The fast developers played many more sports before they started their main sport, when they started much later in life---around seventeen years old. Although they had spent their childhoods trying out various sports, once they found the one that clicked, the great fit between athlete and sport allowed for their very quick progress.”

“The huge popularity of the 10,000 hour theory has led to some real changes in how parents are managing their kids’ athletic careers….While studies like we’ve just examined (above paragraph) undercut this position, there are still lots of parents who bet that the 10,000 hour theory is the best possible way they can help their kids become great athletes. The popularity of the theory has caused a shift away from the more fluid model of sports participation we saw a generation ago toward a world where kids pick a single sport at a young age and focus on it to the exclusion of others.”

“You can see the results of that focus almost everywhere you look in youth sports. The number of ligament repair surgeries done on teenage baseball players has mushroomed as they pitch more and more innings. Overall, more than 3.5 million kids under the age of fourteen are injured annually playing sports. Nearly half those injuries are caused by overuse, according to statistics from the American Orthopaedic Society for Sports Medicine.”

“A recent study by doctors at Loyola University suggested that a good rule of thumb is that young athletes shouldn’t spend more hours per week than his or her age playing one sport. So, if you are 12 years old, you should spend 12 or FEWER hours playing a particular sport. Athletes who exceeded this guideline were 70 percent more likely to suffer overuse injuries…”

Alluding to a study of elite Australian athletes…”the majority of those elite Australian athletes played lots of different sports as a kid, rather than focusing on one. The longer the wait before specializing in one sport, the better chance that a young athlete will find a sport that he’s not only best suited for but also enjoys the most.” A German study showed similar statistics. In this recent German study over 1.500 German National Team Athletes were sampled.  “A larger proportion of the world class athletes reported to have changed their main sport during their career and the proportion of world class performers was highest when athletes had experienced more sports.”

This type of information IS HARDLY new but seems to get washed over by parents who believe their children, either because they matured earlier or started earlier, HAVE THAT SPECIAL TALENT in THAT ONE sport that will keep them at the top of the talent pool throughout their high school careers and beyond…DESPITE all the evidence showing a minuscule percentage of athletes who succeed with this process.

Here are specific factors concerning ages at which aptitudes for various athletic performance factors, such as strength, power, endurance and specific movement types are best suited to the child’s maturation level.

Ages 2-5: Children may have difficulty catching, throwing, and hitting because the brain’s vision centers aren’t fully developed. TBALL make a good entry sport and free play can help develop fundamental skills of hopping, skipping and jumping.

Ages 6-9: This is a time of significant development of visual and balance skills. Most activities at basic levels are good; such as swimming, martial arts and soccer.

Ages 10-12: Visual judgment, balance and strength improve. Children can better play sports requiring memory strategies and rapid decision making, such as football and basketball.

Ages 11-15 >Puberty depending on gender: Rapid physical growth may bring a temporary decline in balance skills and body control and improved performance in aerobic activities.

Ages 16-19: Endurance conditioning and strength training can improve aerobic and strength performance, but heavy weights should be avoided until the skeleton fully matures.

I urge you to read the article below for further evidence that seems to grow each year that young athletes flock to Year Round, Single Sport participation and the Industry that now flourishes is providing traveling teams and private coaching to parents who want to nurture their child’s talent and/or provide a head start towards a college athletic scholarship.  In addition, check out the article at the top of list on the PAGES COLUMN TO THE RIGHT OF THIS POST. ----BRING BACK SEASONAL SPORTS FOR KIDS!!!

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Arm pain in young baseball players common, preventable

November 6, 2014

Columbia University Medical Center

Arm pain is common among supposedly healthy young baseball players and nearly half have been encouraged to keep playing despite arm pain, the most in-depth survey of its kind has found. The findings suggest that more detailed and individualized screening is needed to prevent overuse injury in young ballplayers.

The most in-depth survey of its kind found that arm pain is common among supposedly healthy young baseball players and nearly half have been encouraged to keep playing despite arm pain. The findings suggest that more detailed and individualized screening is needed to prevent overuse injury in young ballplayers. The study, led by Columbia University Medical Center (CUMC) researchers, was published this week in the online edition of the American Journal of Sports Medicine.

"Both nationally and internationally, we're witnessing a troubling increase of elbow and shoulder injuries in young baseball players," said study leader Christopher S. Ahmad, MD, chief of sports medicine and professor of orthopedic surgery at NewYork-Presbyterian/Columbia and head team physician for the New York Yankees. "The likely explanation is that they're throwing too much, too early, putting increasing demands on their bodies that their bodies are not ready for. Despite current guidelines and precautions--for example, limiting pitch counts and emphasizing off-season rest--many players are still sustaining overuse injury to their throwing arm. Thus, it's vital that we develop better ways for coaches, parents, and clinicians to identify players at risk so we can prevent irreversible injury and season-ending surgery."

As a first step toward this goal, Dr. Ahmad and his colleagues designed a questionnaire to learn more about the frequency, severity, and psychosocial effects of arm pain among active adolescent baseball payers. The questionnaire was completed by 203 players from New York and New Jersey between the ages of 8 and 18. All of the surveys were completed without input from parents or coaches.
Among the survey's findings was that 74 percent of players reported having arm pain while throwing (answering that they "always," "often," "sometimes," or "rarely" experienced arm pain). Just 26 percent said they "never" had arm pain while throwing.
The study also found that:

• 80 percent reported having arm pain the day after throwing.
• 82 percent reported arm fatigue during a game or practice.
• 54 percent reported that arm pain limited the number of innings they could play.
• 75 percent reported that arm pain limited how hard they could throw.
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Pitchers, compared with infielders and outfielders, were especially likely to have played with pain. One-quarter of pitchers reported that they "often" or "always" had pain the day after throwing. "These pitchers likely represent one of the higher-risk groups for incurring a future overuse injury and thus warrant particularly high monitoring," said Dr. Ahmad.

Almost half (47 percent) of players reported that they had been encouraged to continue playing in a practice or game even though they were having pain. One in eight players, aged 17 to 18 reported that they "always" felt encouraged to continue playing despite having arm pain. A majority of players reported that arm pain caused them to experience less enjoyment while playing and that it was responsible for holding them back from being a better player.

"It's alarming that so many young baseball players are encouraged to play with pain," said Dr. Ahmad. "Years ago, prior to concussion protocols, we observed something similar in football, where players who suffered a concussion were routinely sent back into the game after 'recovering' for a few minutes. The initial concussion lowered the threshold for another concussion, and the repeated concussions put the player at risk for permanent damage. I think we're seeing a similar problem in baseball, where playing with arm pain is setting the stage for more serious injury."

Dr. Ahmad suspects that this phenomenon has contributed to the recent rise in "Tommy John" surgeries among college and professional baseball players. ("Tommy John" surgery is the colloquial name for reconstruction of the elbow's ulnar collateral ligament. The procedure was named after the former Los Angeles Dodgers pitcher, who was the first to undergo this repair in 1974.)

According to Dr. Ahmad, current precautions and guidelines are inadequate for preventing injury. "It's not enough to set pitch counts based on a player's age," he said. "While some 14 year olds are already quite mature, in terms of their skeletal structure, others haven't even started their growth spurt yet. We need to come up with more individualized throwing programs and better ways to detect which players are at risk for injury." Dr. Ahmad is currently investigating the use of ultrasound for correlating arm pain with tissue damage.