Dr. Andrews Offers Some Advice to Baseball

If you are a coach or the parent of a pitcher, here's an important article with some words of wisdom from Dr. James Andrews, considered by many to be the leading orthopedic surgeon in the world. Here are some highlights of what he has to say:

• Radar guns should be outlawed. Trying to throw harder increases the chance of injury.

• Young pitchers throwing at high velocities are putting too much stress on their elbow.

• Year-round baseball should be banned. Ligaments need rest to develop.

• Pitchers should never pitch on consecutive days.

• Pitchers should never finish an inning when they are tired or sore.

• Playing on multiple teams is a risk factor, especially when the coaches do not communicate.

Dynamic Stretching for Baseball and Softball

Unless we seek out new information, youth coaches tend to do things the same way it was done "back in the day." Passing down the knowledge we have gained from years of experience is often beneficial to our players.

But a large part of instructing youth baseball and softball players is based on health and science. And when it comes to health and science, you don't want to be passing down information that is decades old.

One aspect of youth sports that has changed since we were playing is stretching. Doctors and researchers say there's more to it now than just tugging at a particular muscle for 20 seconds (static stretching). These days, dynamic stretching, or stretching while moving, is considered to be more beneficial for athletes preparing to play while reducing the risk of injury.

Here are a couple of good articles on dynamic stretching:

First is a Mom's Team article about the proper way to warm up for athletic competition - light aerobic exercise followed by dynamic stretching. The article goes on to say that static stretching is not only without benefit, but can also weaken muscles.

And here is an article by Yankees strength and conditioning coach, Dana Cavalea, about the goal of dynamic stretching - to get moving and activate the nervous system and muscle groups, not only single muscles.

To see some dynamic stretching in action, below is a video of the 2009 Wake Forest baseball team preparing to play. This was actually followed by another clip of the same team going through a static stretching routine. So they have not abandoned it altogether.

Nutrition for Youth Ball Players

The postgame snack schedules are just about set now. Team Moms across the league probably know who is responsible for every game of the season. But take time to consider what types of food we should be giving out to our kids at the park.

Here is one article on nutrition for youth ball players. It lists five basic nutritional facts to teach our young athletes:

1. Protein allows the body to build muscle and enhance strength.
2. Carbohydrates provide energy. Complex carbohydrates are best for longer lasting energy.
3. Certain types of foods provide more protein.
4. Processed foods are generally less healthy than unprocessed, fresh foods.
5. Eating more, but smaller meals, is considered by many to be healthier.

Sometimes the right choices don't come in individual snack bags. And consider also how much energy is required to play a T-Ball game. Sometimes the calories after the game might outweigh the ones burned during the game.

How to Protect Pitchers from Injury

I came across an important article from last year by Eric Cressey: Understanding Elbow Pain - Part 4: Protecting Pitchers. Cressey is a expert in the field of physical training for amateur and professional athletes. He works with a lot of baseball players and knows what he's talking about. He has a useful blog that I read occasionally, which our high school pitchers might also be interested in.

The article is wordy, but here are essentially Cressey's four primary ways to protect pitchers at any level:

1. Good Mechanics. No two pitchers are alike, but there are certain angles and timing issues to avoid, which exert more stress on the elbow. Visit my Lessons page for additional info on learning proper mechanics at a young age.

2. Avoiding Overuse. This has been discussed by about everyone. See the post below.

3. Long Term Physical Preparation. I think flexibility is most important for youth pitchers, but strength training is beneficial as well.

4. Short Term Physical Preparation. Pitchers should warm up their bodies first, then their arms. And don't forget the stretching and cool down period afterwords.

There's much more in the article, including some good links in each section.

Five Ways to Prevent Overuse Injuries

Here is a link to a timely article at Mom's Team on how to prevent overuse injuries. According to the National Athletic Trainers Association, 50% of youth sports injuries are caused by overuse / repetitive stress. Their top five ways to prevent such injuries are:

1. Education and supervision;
2. Pre-participation physical exams;
3. Participation limits;
4. Training and conditioning; and
5. Delayed specialization.

Check out the article for all the details.

Specialization vs. Sampling

Here's a link to an article by Dr. Sharon Chirban, a psychology professor at Harvard Medical School, about the popular debate regarding what is better for youth athletes - specializing year-round in one sport at a young age, or sampling a variety of different sports. Chirban says it is healthier for kids to play different sports, both physically and mentally. The interesting thing about this debate is that we never seem to see the other side of the argument presented.

Another Study on Youth Pitching

The results of a 10-year study on youth pitching have been published by The American Journal of Sports Medicine. This one, which began in 1999 before pitch counts were the norm in youth baseball, used innings pitched as the primary risk factor to be measured. The study also looked at pitchers who played the position of catcher and those who threw curveballs before the age of 13.

The study found that youth pitchers throwing more than 100 innings per calendar year were 3.5 times more likely to experience a serious arm injury. It found a small increase in injuries for those pitchers also playing catcher. But it was unable to find a correlation between curveballs and injuries.

The details of this study, as well as a good summary on youth pitching and previous research on the subject, are in the AJSM publication. This is not exactly new information - we know quite a lot more about overuse injuries than we did in 1999. But it is further confirmation and another reminder of how careful we need to be about the number of pitches our boys throw, how fatigued they get when pitching, and how much rest they get between outings. Taking these precautions, which are mostly mandated by Little League rules, and teaching proper mechanics will go a long way toward keeping our pitchers safe.

Book Review: Until It Hurts by Mark Hyman

There has been plenty of talk nationally about Mark Hyman's latest book, Until It Hurts, since its release about a year ago. And a couple of parents in our own league have mentioned it to me. So I decided to give it a read and report back.

Hyman's book is essentially about what he calls the "hostile takeover" of youth sports by adults. As he says in his introduction, "adults rule youth sports." It isn't a new trend. It has gone on for decades.

Hyman uses anecdotes and statistics to show the disturbing patterns of behavior among many misguided and ultra-competitive parents and coaches throughout various sports, both team and individual. One story is that of his own family and what led to his son's Tommy John Surgery.

Throughout the book, Hyman examines a number of things considered wrong with today's youth sports culture:

- The big business it has become, including national TV broadcasts;

- Parents who relentlessly pursue athletic success for their kids, over-scheduling them to the point of exhaustion, with hopes of rare college scholarships, even more rare million dollar contracts, or just the social status of having raised an elite athlete;

- Early sport specialization and adults who push athletes to be the best, no matter the toll it takes on their minds and bodies, sometimes working them to the point of injury; and

- The focus on winning over fun, fairness and health.

Hyman is an advocate for organizations designed with fun and the best interests of the kids in mind. He says we should be listening to doctors' advice, and to what the kids themselves have to say about what they want to pursue and how they want their athletic experiences to be.

He's done a good job of painting an honest picture of what youth sports in America has become, although some of the anecdotes could be considered extreme cases. This book is an important look into what is best for kids and what we, the parents and coaches of young athletes should keep in mind as we guide them.

Until It Hurts by Mark Hyman is currently available at Amazon for around $10.

How Much Exercise Does Your Practice Provide?

It is widely accepted that youth sports are beneficial for general health and obesity prevention. Experts recommend an hour of moderate to rigorous physical activity per day. But a new study conducted by San Diego State University and UC-San Diego suggests what we may have suspected about organized team sports practices.

Researchers placed accelerometers on 200 young soccer, baseball and softball players aged 7-14 to measure how much activity they were getting in practice. The findings show that overall, only 24% of participants met the one hour recommendation during their team's practice. Baseball, and especially softball players, got significantly less physical activity. Check out the study for all the details.

This tells us that (1) team sports aren't enough - school PE and neighborhood recreation are very important to the health of our nation's youth, and (2) our practices could probably include more exercise.

How can we get our players moving more in practice? Here are some ideas. If you have other suggestions, please leave a comment below.

- Have the team run a couple of warm-up laps before starting. This, followed by stretching, also helps prevent injuries.

- Practice baserunning often. Baserunning is a quarter of the game (pitching, hitting, fielding and baserunning) and often gets neglected.

- Utilize stations to keep the players engaged and minimize standing around waiting. Use the nets and batting cages for hitting stations like tees, soft toss and BP.

- After your instruction periods, reward the team with an intrasquad scrimmage or quick game of Pull-the-Trigger. This not only gets the players moving, but it's fun and sends them home wanting more.

Strength Training for Kids

A recent NY Times article takes a look at a study regarding the safety and potential benefits of youth strength training.

There has been a long-held belief that kids could not gain strength from any kind of weight training, and that it could even stunt their growth or cause growth plate damage. But the latest research indicates that kids actually benefit from such exercise, not by bulking up, but by creating more efficient interaction between the nervous system and muscles.

Doctors do not advocate putting kids in the weight room, but do encourage other types of fun strength training activities that get kids away from the computer screen or tv and will prepare their bodies for the sports they play. This makes a lot of sense, especially for baseball and softball, those activities that develop core and leg strength - something our more serious ballplayers might want to consider this offseason.

Arm Care and Velocity Development Clinic

Tickets for the 2nd annual Arm Care and Velocity Development Clinic are on sale at the South Charlotte Sports Report. This clinic is led by Alan Tyson of Architech Sports & Physical Therapy. Tyson is considered one of the leading arm care specialists in the region.

This clinic is highly recommended by many baseball people in the area. It is for serious pitchers, age 12-18. It is a non-throwing event, since many pitchers have shut down their arms for the winter. But the information provided by Tyson and the other speakers is said to be extremely beneficial.

The event is on Saturday, December 4th from 8:00 am to 12:00 pm at Ardrey Kell High School. The cost is $90 per player-parent combo. Visit the South Charlotte Sports Report website for more information.

Article on Overuse Injuries

Tommy John, then of the Los Angeles Dodgers, was the first to undergo ulnar collateral ligament (UCL) replacement surgery. Since that initial procedure performed by Dr. Frank Jobe in 1974, Tommy John Surgery has become a common fix for serious elbow injuries. And as previously mentioned in this blog, it has become far too common in young pitchers.

Here is a link to another article about overuse, or "repetitive stress" injuries in young athletes. Amanda Schoenberg writes in the Albuquerque Journal about author Mark Hyman's experience with his own son's injury, and his book on the subject, "Until It Hurts."

I am currently reading the book and will comment on it later. But for now, there is some useful information on overuse injuries in this article. The more informed we are, the better.

Rhymer Fitness Seminar

Rhymer Fitness, an MPTLL sponsor, is hosting a free nutrition and mental toughness seminar on Monday, November 1 at 6:30pm at B&B Batting Center in Indian Trail. The seminar will cover topics such as supplements, protein, carbohydrates, fish oil, the dangers of performance enhancing drugs, proper hydration and more. For more info, visit B&B Batting Center.

What's Causing the Arm Injuries?

This guy on the left is not the only one having significant arm trouble these days. He's just the most prominent. Stephen Strasburg of the Washington Nationals was the #1 overall pick in the 2009 MLB Draft. His college and pro coaches were careful with him because he was widely considered to be the best pitching prospect in years, if not decades. But apparently it was too late. Perhaps the damage was done before he even got to college.

Strasburg is one of many elite pitchers having to undergo surgery and take months off these days due to UCL or shoulder injuries. But the trend is not limited to the best in the world. Youth pitchers are blowing out their arms at a high rate too. But why? Is it flawed mechanics? Curveballs? High pitch counts? According to the doctors and the studies, there are several factors.

Gregg Doyel of CBS Sports blames it on youth coaches and parents. His article from August 26, 2010 may be on to something. Doyel is no expert when it comes to arm care, but he can connect the dots based on what the experts say. Among the primary experts are Dr. James Andrews and Dr. Glenn Fleisig of the American Sports Medicine Institute (ASMI), among other credits.

ASMI conducted a study with some important conclusions - mainly that while arm injuries often do not rear their ugly heads until high school or college (or later), they can begin in youth leagues. How do they begin in youth leagues? Overuse at a young age. Not a new term - that's why we have pitch counts. The study says that arm fatigue is the primary factor involved: "When regularly pitching despite arm fatigue, the risk for injury requiring surgery increased 3600%." That's almost a guarantee.