Mukilteo Little League Safety Clinic 2018
Joe Gizzi, DPT Physical Therapist 12121 Harbour Reach Dr., Suite 100 Mukilteo, WA 98275 (425) 493-8313
MLL Safety Clinic • Review the most common issues that affect safety in little league baseball and softball. • Updates from Little League Baseball
Disclaimer • This is a review of basic first aid management. It is not a substitute for First Aid Certification. • CPR/AED/SCA/Concussion Awareness (additional training) • The Safety Manual may give basic guidelines for CPR/AED but it is not a substitute for certification
I. Developmental Issues and Safety
Developmental Issues - Highlights A child can not learn specific skills until they are ready. It is normal for same aged children to be at different skill levels. Children are not adults. There is no research that shows you can groom a toddler to be an elite athlete. A child with advanced motor skills may not have advanced learning skills.
Developmental Issues - Highlights • Ages 10 – 12, during pubertal growth, you can see a decline in coordination and balance. • Be cautious not to interpret this as a lack of effort and/or talent. • 13 – 15 y/o rampant growth spurts occur – setting stage for injury. • Lots of “aches and pains” – be cautious about dismissing them as growing pains.
II. Safety in Baseball
Is baseball safe?? As with any sport there are safety concerns-Compared to other sports baseball is considered a relatively safe sport.
Baseball is safe; however … In general, youth baseball is a safe sport with a relatively low injury rate including severe injuries. Little League International has been very proactive in making changes to ensure the safety of the players. Pitch counts; concussion guidelines; break away bases; and the USA baseball certified bats, etc.
Safety Equipment Discussion • All equipment will be inspected by the League’s Equipment Manager prior to distribution • All managers, coaches, and umpires will check questionable equipment to ensure it meets safety guidelines.
Causes of Injuries • Overuse is the leading cause of 30 – 50% of all pediatric sports injuries. • One study reports 20-40% reported elbow pain in 9-12 year old baseball players – annual incidence. • A young pitcher has 5-10% chance of developing a serious arm injury within 10 years • Improper warm-up, lack of conditioning , and ignoring early signs and symptoms leads to overuse injury, and much more likely to reoccur if not promptly treated.
Causes • For pitchers, the major cause of injury: - improper technique , -too many pitches thrown , and -too advanced pitches for the athlete’s developing muscles and bones.
III. Safety Issues and Pitching
Pitchers and Injuries Statements from ASMI Injuries in Baseball Conference • A recent 5 year study, concluded that overuse and cummulative stress , were the primary cause of injury in pitchers versus the type of pitch • Up to approximately age 12 (onset of puberty), growth plates in the elbow and shoulder are still developing and are more susceptible to injury. • Important for coaches and parents to understand the long term effects of cumulative stress and overuse. • In general, youth baseball pitchers pitch too much . Pitch count rules are helping reduce cumulative overuse injuries.
Pitchers and Injuries • Study that followed Little League pitchers (8 – 13 y/o) for 4 years; High School pitchers; and College pitchers: – Previous HX of injury predisposed young athlete to 5x greater risk of injury – Avg. number of innings pitched was risk factor – Pitch count reduced risk in Little League baseball by 50% – Increased risk of elbow/shoulder injury with those who also pitch in select programs.
Pitchers and Injuries • To help reduce the risk of injury in the young pitcher, training should focus on: Control – proper mechanics Command – placing the pitch in different areas of the strike zone Speed/Velocity – emphasizing proper mechanics Movement – breaking pitches at 14 y/o and above.
American Sports Medicine Institute Recommendations Age Guidelines for Pitch Types Fastball ……………….. 8 y/o Change Up …………… 10 y/o Curve ………………….. 14 y/o Knuckle ……………….. 15 y/o Slider ………………….. 16 y/o Forkball ……………….. 16 y/o Splitter ………………… 16 y/o Screwball ……………… 17 y/o
Little League International Pitch Count Rule ( “The Pitch Count Regulation Guide for Parents, Coaches and League Officials” at www.littleleague.org) 7 – 8 y/o ………………………… 50 pitches/day 9 - 10 y/o ..……………………… 75 pitches/day 11- 12 y/o ………………………. 85 pitches/day 13 -16 y/o ………………………. 95 pitches/day 17 -18 y/o ………………………. 105 pitches/day The pitcher may continue beyond the maximum until the batter reaches base, is put out, or the third out is completed. If pitching over 40 pitches in a game, the player may not play catcher the remainder of the day.
Little League International Pitch Count Rule League age 14 and younger: 66+ pitches …………………………. Four (4) calendar days of rest 51 – 65 pitches ……………………..Three (3) calendar days of rest 36-50 pitches ……………………..Two (2 ) calendar days of rest 21-35 pitches……………………….One (1) calendar day of rest 1 – 20 pitches ……………………….No (0) calendar days of rest
Recommendations • Throwers should have 2-3 months off from throwing each year. No year round baseball • Be cautious with high velocity throwers, and catchers • Softball pitchers (Currently 12 innings in a day max, over 7 requires 1 day of rest) • Coaches and parents need to understand: » Need for rest » Maximum pitch counts » Importance of proper warm-up » Guidelines for when to start breaking pitches (14 y/o)
Other Recommendations • No more than 100 innings per year • 1000 pitches per season • 2000/yr (9-10) 3000/yr (11-14 year old) • Never throw when fatigued • Refer to MLB/USA Baseball Pitch Smart Program ( www.littleleague.org website link)
IV. Little League Elbow and Shoulder The most common sites of injury in baseball – elbow and shoulder. The primary cause - OVERUSE Not just Little League- “Should be called youth thrower’s shoulder or Elbow”
“Little League Elbow” Pain in the elbow from the throwing motion, usually at the growth plate (multiple sites) • The throwing motion: – Traction/separation stress on the medial elbow. – Compression stress on the lateral elbow.
“Little League Elbow” • • Typical complaints: Injuries at the elbow: – – Pain at the inside of the Micro tears/strains of the forearm musculature elbow with throwing – – Gradual onset – no specific Medial ligament damage (Ulnar Collateral injury Ligament) – Increase in soreness with – Avulsion fractures harder and farther throws – – Pain lasting longer than 24 Ulnar nerve inflammation hours – Loose fragments in the – “Tight” elbow – difficulty elbow loosening up – Osteochondritis dissecans – “Clicking” with throwing
“Little League Shoulder” Pain at the shoulder from throwing stresses • Injuries at the shoulder: • Typical complaints: – Shoulder Impingement – Pain at the proximal shoulder with throwing – Tendonitis/Bursitis – Gradual onset – no specific – Sprains – AC joint injury – Rotator Cuff Tears – Increase in soreness as – Labral Tears velocity and duration increases – Loss of velocity and control of pitches noticed
“Little League Elbow and Shoulder” Safety Guidelines • “Listen” (watch/observe) to your athlete. • Athlete must report pain or soreness early. • Athlete should never pitch, throw, or play through pain. • Monitor pitch type and count. • Necessary that athletes use good mechanics and proper technique.
“Little League Elbow and Shoulder” Safety Guidelines • Pain during a game (especially pitchers) is cause for immediate removal. • Rest (if severe – up to 6 -12 weeks), ice, range of motion, and gradual return to throwing. • If pain persists for more than 3-4 days or increases with throwing/pitching, athletes need to see a physician. (X-ray, anti-inflammatories, splint) • Early intervention is key to prevention !!!
V. Baseball Injury Recognition and Basic First Aid Management
Common Injuries in Baseball • Sprains • Strains • Contusions/Impact Injuries • Dislocations/Fractures • Eye/Dental Injuries • Simple Wounds and Nose Bleeds • Insect Bites/Stings • Heat Illness • Concussions
Not so common but possible…….. Sudden Cardiac Arrest
Injury Assessment • History - Make sure you know how the injury happened. • Observation – Look for deformity, swelling, and or discoloration. • Palpation – Palpate around the injury to identify the injured area. • First Aid - Apply first aid as indicated.
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