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Young arms face risk of premature wear

According to medical professionals, children today face short-term and long-term injuries

Posted: August 8, 2009 8:03 p.m.
Updated: August 9, 2009 4:55 a.m.

According to medical professionals, children today face short-term and long-term injuries due to year-round play.

 
As the influence of sports spreads, the pressure placed on young athletes has increased in kind.

So has playing time.

Between league play, travel ball, extra training sessions and early specialization, athletics have become a full-time job before the age of 10.

And like many jobs, there is tremendous risk involved.

When young athletes get injured, worker’s compensation is not an option and the effects can be long-term.

“We know that over the last 20 to 30 years, we are seeing more in the way of overuse injuries as more and more pressure is put on kids to perform in sports,” says Dr. Paul Horowitz of Discovery Pediatrics in Valencia.

Ailments such as Little League elbow and Little League shoulder have become common, both of which are the direct result of overtraining.

The injuries stem from repetitive throwing that irritates the growth plates.

One of the foremost experts on overuse is Dr. Lyle Micheli, the director and co-founder of the sports medicine clinic at Children’s Hospital Boston, the primary pediatric medical facility for Harvard Medical School.

He has seen both aforementioned injuries among myriad other overuse injuries.

“The most basic reason (for the increase) is more and more children are being put into organized sports programs,” Micheli says.

And the dangers can range from immediate pain, to arthritis later in life, Micheli says.

As participation has increased, the number of overuse injuries has also risen as a result of repetitive motion and a lack of time off.

Of the 600 patients Micheli says the hospital sees each week, 60 percent to 70 percent are the direct result of overuse injuries.

When the clinic first opened in 1974, he says the figure was 20 percent to 30 percent.

The facility has even expanded to include 21 doctors specific to the field of sports medicine.

The Santa Clarita Valley is no different.

“We see it a lot,” says Horowitz of the patient-load he sees on a daily basis. “I feel like often it’s because their body was not given a chance to rest.”

Since the body is in a “constant state of stress and repair,” it is essential that team staff and parents give their athletes a break, Horowitz says.

This can be a difficult proposition for many families in regards to baseball.

After all, the level of baseball talent coming out of the valley is translating to professional levels, and it is starting young.

According to Paul Silveri, director of the William S. Hart PONY League, there are approximately 2,000 athletes spanning six age groups in baseball and five age groups for softball.

From a league standpoint, the coaches and official scorekeepers keep track of innings pitched, appearances in a week and pitch counts starting with Pinto League players, which are 7 to 8 years old, Silveri says.

Pinto is the first age group where the players pitch.

Then add travel ball during the league offseasons and many preteens are rarely stepping off the diamond.

“They are taking all the abuse in the arm year-round. I don’t think it is necessary,” Silveri says.

But with the potential of oversight and an excessive drive to win, it ultimately comes down to the parents, Silveri says.

“It is the parent’s responsibility to step up as parents and look out for their kids,” he says. “So many parents see their kids as being able to play at the high school and college level. A lot of people see their kids as being the star so they defer to the coach, and the coach wants to win.”

Canyon Country Little League follows similar policies in regards to pitching limitations.

Score keepers fill out a “Pitching Affidavit,” complete with number of pitches, innings pitched, the players’ name and age and a field for the umpire’s signature.

There is also a log, which allows the scorekeeper to cross off each pitch as it happens.

But as Silveri points out, no matter the organization, the most effective form of enforcement is self-policing.

If a team possesses a dominant pitcher, opposing teams are not going to want to face him or her.

Therefore, knowledge of the pitching schedule can even become an competitive advantage and keep the ace off the mound or out of the circle.

But what if the athlete doesn’t want to admit to his or her pain?

Dr. Mininder S. Kocher, whose areas of expertise include throwing injuries of the shoulder and elbow in young athletes for Children’s Hospital Boston says the issue of silence is just one of the factors leading to the growing trend.

“I think the result is that we are seeing a tremendous amount of throwing injuries,” Kocher says. “It used to be unheard of to have high school kids — throwers — having shoulder and elbow surgery, and now it is the norm.”

But in terms of the local pulse, Hart High head baseball coach Jim Ozella says the number of overuse injuries is decreasing.

“What I kind of think is that we are starting to see less (injuries) and better conditioned athletes,” he says. “Let’s not kid ourselves. Kids are bigger and stronger than they were 10 years ago.”

Heading into his 10th year with the program, Ozella has nearly 30 years of coaching experience.

“I kind of see less of the sore arms,” he says. “Every once in a while we have to shut a guy down for a bit. I also think coaches are doing a better job of having more common sense, not throwing a pitcher longer.

“Look at the short term and long term. Short term, are you going to win today or lose today? Long term, what is this guy going to have for his career?”

Micheli recommends that aside from pursuing national certifications for coaching, trainers and coaches should only increase the amount of training intensity 10 percent per week so that the body can more easily adapt.

One local training professional agrees, but also notes that the longer athletes wait to specialize in one sport, the better off they will be.

Adam Johnson, director of sports performance at Velocity Sports Performance in Valencia is the former strength and conditioning coach at Wayne State University and possessed two national certifications in the field of strength and conditioning.

“In my personal and professional belief, an athlete that is playing multiple sports is going to be a better athlete in their one chosen sport when they finally get down the road ... than the athlete that has concentrated on one sport since they were 8 years old.”

They might stay healthier too.

“You used to see three- and four-sport athletes and now by middle school, if someone is very good, they tend to specialize into one sport,” Kocher says. “That is a big part of the injury pattern we are seeing because if you were doing baseball in spring, basketball in winter and say football in the fall, you are doing different patterns, you are putting different forces on your body, you are giving certain parts more time to rest and you are getting some cross training that can help prevent injuries.”

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