MIAMI BEACH — Throwing a baseball too many times and throwing the wrong kinds of pitches can predispose a child athlete to shoulder and elbow injuries, Dr. Jordan D. Metzl said.
If pain limits the child's ability to participate or worsens over time, further evaluation of the injury is warranted. “We know sports are great for kids, but they can experience sports-related injuries,” he said at a pediatric update sponsored by Miami Children's Hospital.
It is important to be extra careful with children, especially about getting them back into activity, Dr. Metzl said. Advise child athletes not to throw a ball until they are pain free.
“'Play through the pain' is terrible advice. Their bones are developing and some of the injuries can have negative, long-lasting consequences,” said Dr. Metzl, cofounder of the Sports Medicine Institute for Young Athletes and a pediatrician at the Hospital for Special Surgery in New York City.
The epiphysis in children is made of cartilage. If children who are baseball pitchers complain of shoulder pain, they might be pulling on their growth plate. Clinical consequences include a growth problem with that bone, or more seriously, the potential for the shoulder growth plate to split apart.
“The same thing can happen in the elbow,” he said. Children have an open growth plate near the ulnar collateral ligament “and can pull it off.”
An x-ray is recommended for initial evaluation. If available, a biomechanical assessment aids diagnosis of these sports injuries. It can illustrate how the pitch of one child athlete varies from another, and in some cases identify the etiology of the injury. “We know how you throw makes a difference, and the number of pitches makes a difference,” Dr. Metzl said.
He uses multiple cameras to observe the biomechanics of an individual patient's throwing. Every position in the pitching motion is assessed, including the stride and balance point (the position at which a baseball player raises one foot and rests on the other during a windup). Biomechanics also can reveal any flaws in the child's form that might cause an injury in the future.
Other injury prevention strategies include warming up for 5–10 minutes and performing strengthening exercises, Dr. Metzl said. Also, because a high frequency of pitching increases the risk of injury substantially, consider using pitch counts to set a maximum number of throws during practice, warm-up, and/or a game.
Disclosures: Dr. Metzl said he had no relevant financial conflicts to disclose.
The pitching motion and the number of pitches can affect the chance of injury.
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