March 14, 2008

With baseball season approaching, area physicians anticipate seeing an increase in shoulder and elbow injuries in young athletes. "Overuse injuries are a very common problem for young athletes, particularly throwing athletes," explained orthopedic surgeon and sports medicine specialist Gregory Primus, MD, of Advocate South Suburban Hospital in Hazel Crest, Ill. "Athletes, parents, and coaches can take steps to prevent over-use injuries by recognizing the symptoms and understanding the importance of proper technique."

Overuse injuries can occur in any sport, but are particularly common in young baseball pitchers whose bodies are still developing. "Pitching is not a natural movement for the arm and forces stress on both the elbow and shoulder," Primus explains. "Throwing a high pitch count that is unregulated can cause damage and inflammation to the growth plates in the arm. This is known as little leaguer’s elbow or shoulder."

According to the American Academy of Orthopedic Surgeons (AAOS) this condition occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow or shoulder. Continued pulling can stress the ligament and tendons attachments to bone resulting in abnormal bone growth, small tears, or at worst deformity.

"When little league elbow occurs, there is pain on the inside of the elbow," Primus explains. "At the first sign of pain or any restriction in the range of motion, the player should consult a sports medicine physician. Another symptom to note is if the child’s elbow joint locks when he or she throws."

In rare cases, it may be necessary to discontinue pitching for a short period in order to prevent further damage and start the healing process. "Over-use injuries can be serious if the condition is not addressed early," Primus says. "If the child does not take a break from throwing, his or her future ability to play the sport may be jeopardized. Serious complications can arise if the arm is not rested and treated."

In most cases, over-use injuries can be treated with rest and icing of the affected area. "The athlete must not resume the activity until the pain is entirely gone," Primus says. "Apply an ice pack to the affected area for 15 to 20 minutes, four to five times a day until the pain dissipates."

A physical therapy plan will aid healing and get the child back in the game. "The child should work with his or her doctor to develop a plan with both strengthening and range of motion exercises," Primus says. "When returning to throwing, the child must ease into the activity. The coach should be involved with developing a plan to gradually increase the numbers of pitches the player can make." In extreme cases, some children may require surgery to repair damage. "Prevention is really key in avoiding over-use injuries," Primus says. "Young athletes need to be trained in proper technique and form. They should always warm-up and stretch their muscles before pitching in practice or a game."

Pitchers must limit the number of pitches that are thrown in a week. While there are not nationally standardized limits, most club leagues have set guidelines. "Coaches need to carefully track of the number of pitches thrown by young players," Primus explains.

Primus also wants to remind young athletes to play for fun and not let competitiveness get in the way of safety. "Club sports are very competitive and some athletes might not speak up if they are feeling pain because they don’t want to miss playing time," Primus says. "What they have to remember is that the longer they wait to treat an injury, the more serious it will become. In the end, this is going to lead to even more missed playing time."

Source: Medical News Today