Quad Cities, IL/IA

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Throwing and Overuse Injuries


By Andrew Bries, MD, ORA Orthopedics

Baseball is a relatively
simple sport for kids to play, and used to be predominantly perfected in
the sandlot. However, between travel teams, local little leagues, and
sessions with pitching and batting coaches, kids now seem to have little
time to play pickup ball. Although the idea of organized sports has
been wonderful, since we are getting our kids off the couch and giving
them a break from the video games, our current “more is better” approach
has potentially created the opposite effect. An increase in overuse
injuries is now forcing them to sit on the couch for an entirely
different reason — to recover.

It is not getting hit by a pitch or
breaking a bone sliding into home that concerns most of the sports
medicine specialists It is actually the vicious act of throwing the ball
that threatens our young athletes’ skeletons. It may seem
counterintuitive, but the act of throwing the ball overhead is not a
natural motion. Baseball puts tremendous stress on the shoulder and
elbow. The forces that act on the shoulder and elbow can exceed what the
ligaments (stabilizing tissues) can normally withstand. There are a lot
of things that have to happen in perfect synchronization to make a
pitch happen, and, if one of them breaks down, it can lead to
catastrophic shoulder and elbow injuries in a young athlete. As more
athletes play more throwing sports at younger ages, sports medicine
specialists are seeing more elbow and shoulder injuries.

Two common
conditions seen in young throwers are little leaguer’s shoulder and
elbow. Both of these conditions are caused by a young person placing too
much repetitive stress on their joint and thus putting too much force
across their growth plates. These repetitive forces can eventually
weaken the growth plate, causing further injury and even fracture. In
the case of the elbow, if the growth plate fractures, the joint can
become unstable, usually necessitating a trip to the operating room to
avoid a permanent problem with the elbow. Persistent pain or pain that
gets progressively worse in the shoulder or elbow should be evaluated by
a sports medicine specialist. For the most part, treatment of little
leaguer’s shoulder and elbow is simple when caught early. Rest, a little
physical therapy, and a supervised throwing program are all that is

A few simple tips can go a long way at preventing injury and
potential lifelong deformity in the throwing athlete. The basics of this
program include good mechanics to avoid over stressing any particular
area, age-appropriate pitch counts, a variety of pitches to prevent
overuse, and extended periods of rest to allow for normal development
and healing. More information and the complete set of guidelines can be
found at www.stopsportsinjuries.org.

When taking care of throwers and
their injuries, knowledge of baseball and the mechanics of pitching
help to develop an individualized treatment program to get athletes
safely back to play. The sports medicine specialists at ORA Orthopedics
have experience working with athletes of all levels, from the little
leaguer to the professional athlete.

To learn more about Andrew
Bries, M.D. and ORA Orthopedics, visit qcora.com. Like us on
facebook.com/oraorthopedics and follow us on Twitter/oraorthopedics.