For many of us, playing baseball or softball is the first true sign of spring. Children and adults across the country anxiously anticipate the first chance to play catch, hit a few balls or play pickle at the old ball field.

While it may seem gentle when compared to some “contact and collision” sports, baseball can be a demanding sport on the body. Swinging bats, running the bases and hurling balls at high speeds inevitably leads to some scrapes, bumps and bruises along the way.

Many of the accidental injuries that occur while playing baseball are just that, accidents; an errant pitch hitting a batter, turning an ankle on a base or a grounder taking a bad hop. These unfortunate events should be treated properly and immediately to minimize the players’ discomfort. (Think RICE: rest, ice, compression and elevation.)

There are, however, some injuries that can be avoided to keep you and your children in the game. These involve various muscle pulls, shoulder problems and elbow sprains.

The most common baseball injury that I see in my practice involves the rotator cuff -- a collection of four muscles surrounding the shoulder that function to maintain the correct biomechanics of the shoulder.

Tendonitis (inflammation) of the cuff occurs when the tendon is overused, often as a result of repetitive overhand throwing and underdeveloped muscular strength. Pitchers and catchers are most susceptible to rotator cuff injuries because of the amount of throwing involved in those positions, but outfielders and other players can also be affected.

Plan

To help prevent these injuries, all players are encouraged to develop a regimen of warm-ups and stretching before throwing, as well as to learn proper throwing mechanics. Unfortunately, because children are often less aware of their physical limitations and sometimes put increased pressure on themselves, it is critical that parents and coaches pay close attention to their child’s play and be aware when his or her performance may have changed for the worse.

For example, a pitcher who throws in control for the first few innings and then starts to throw wild pitches may actually be showing signs of fatigue or early injury to the rotator cuff. To avoid potential injury, this child should be removed from the game as performance begins to deteriorate.

During the game, players are also encouraged to look after themselves by observing the following habits:

*Stay warm: Keep a jacket on between innings;

*Stay loose: Jog out to your position on the field at the change of innings;

*Stay in the game: Keep moving between pitches.

If a shoulder, elbow or hamstring does begin to hurt, it is important to talk to your family doctor or sports medicine physician to properly diagnose the problem. They will help develop a plan for resting and then strengthening the trouble spot.

For easy reference, I have provided a few Web resources that describe some simple, effective strength exercises specifically targeting the rotator cuff and elbow. While lifting heavy weights will strengthen the large muscles in your body, the only way to strengthen the underlying tendons is through these very specific exercises that target smaller muscles of the rotator cuff. Often, the only resistance needed is a piece of elastic tubing.

Timing

The Baseball’s Safety Advisory Committee recommends that the first pitch introduced to Little Leaguers should be the fast ball at 8 years old, followed by the change-up at 10, the curve at 14, the knuckle ball at 15, and the slider and fork ball at 16. Following these guidelines will allow the arm muscles to develop properly to meet the physical demands of each pitch and avoid “Little League Elbow,” a chronic inflammation of the growth plate in the elbow joint.

It is also important to note that throwing fast or far is not purely a result of arm strength. Velocity comes from developing good mechanics and strengthening of the trunk, legs and hips. The stronger you can make these parts of your body, the less stress you will put on your arm.

Lastly, although it may seem like many of the players we see take the field at Hadlock or Fenway simply jump off the bus and hit the field ready to go, nothing could be further from the truth. Professional players often reach the park four to five hours before game time and have done two hours of warm-ups and stretching before even taking batting practice.

Take a page out of their book and give yourself enough time to warm up.

Dr. Heinz specializes in the diagnosis and treatment of sports-related musculoskeletal injuries at Orthopaedic Associates of Portland. He is also the team physician for the Portland Sea Dogs, Deering High School and a team physician for U.S. Soccer.

 

http://orthoinfo.aaos.org  - American Academy of Orthopaedic Surgeons

http://www.apta.org - American Physical Therapy Association

http://www.orthoassociates.com/shoulderRCD.htm  - OA Rotator Cuff Treatment

http://www.littleleague.org  - Little League Baseball and Softball

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