I recall that as a kid, I participated in sports based on the season. In spring and summer, it was baseball and basketball; in fall, it was football; and in winter, it was ice hockey. Nowadays, an increasing number of kids focus on one sport at an early age and compete in it year-round. Some even attend special camps to pursue that single sport.
Young athletes need to vary their training just like pros do. All pros have an offseason during which they change their training routine and rest more. They still specialize in one sport, but they adjust their seasonal training to allow complete recovery. No one can go 100 percent in a sport year-round without risking injury or reduced performance.1
According to Dr. James Andrews, he sees four times as many overuse injuries in youth sports now compared to five years ago, and more kids are having surgery for chronic sports injuries. "Complicating the issue with many of these young athletes is their immature bones, poor biomechanics, a lack of knowledgeable coaching, and inadequate conditioning."2
Table 1: Recommended Pitch Counts by Age | |
Age (Years) | Max. Number of Pitches (Per Start) |
7-8 | 50 |
9-10 | 75 |
11-12 | 85 |
13-16 | 95 |
17-18 | 105 |
Baseball, especially pitching, is a prime example of the problem, although any sport based on the domination of particular movements can be at fault. The one-sport baseball pitcher uses their pitching arm year-round, leading to an increased risk of overuse injury. In fact, it is estimated that more than 50 percent of all injuries suffered by middle- and high-school athletes are caused by overuse.
Table 2: Days of Rest Required Based on Pitch Count | ||
Pitch Count (Ages 7-16) | Pitch Count (Ages 17-18) | Days of Rest Required After Pitching |
1-20 | 1-25 | 0 |
21-40 | 26-50 | 1 |
41-60 | 51-75 | 2 |
61 or more | 76 or more | 3 |
Amazingly, the Tommy John operation for a torn ulnar collateral ligament is increasingly being performed on young baseball players. Originally, this procedure was reserved for professional players, but of late, high-school students are undergoing these procedures at alarming rates. This is definitely related to overuse. The Andrews Sports Medicine Center attributes the increase in this surgery to year-round throwing, inadequate rest between starts, throwing more than 80 miles per hour (probably because these are the kids who get asked to throw a lot by their coaches), and pitching in showcases.
Table 3: Age to Start Throwing Specific Pitches | |
Type of Pitch | Starting Age |
Fastball | 8 +-2 |
Change-up | 10 +-2 |
Curveball | 14 +-2 |
Knuckleball | 15 +-3 |
Forkball | 16 +-2 |
Slider | 16 +-2 |
Screwball | 17 +-2 |
The only way to reduce the injury rate beyond these guidelines is through education: public-service announcements, posters, DVDs, brochures and lectures, especially to parents, children and coaches. Doctors dealing with these conditions should be educating their patients and their families. Below is a sports safety checklist for parents that may help ensure a safe and healthy playing environment for their children who participate in organized sports:4
- Is there a scheduled warm-up and cooldown at games and practices?
- Does your child receive guidelines and recommendations about proper safety equipment? Is safety equipment required for play?
- Are children allowed adequate rest between games and practices?
- Is sportsmanship and fair play a core value of the program and the coach?
- Does the coach have First Aid training and an emergency action plan? Is a First-Aid kit always on hand?
- Is there a safety policy regarding injury, illness and inclement weather?
- Does the coach have your emergency contact information? Do you have contact information for the coach?
- Do players have adequate water/hydration available at all practices and games?
References
- Quin E. Youth Sports and Overuse Injuries. About.com, Sports Medicine; updated Sept. 8, 2009.
- Hill DE, Andrews JR. Stopping sports injuries in young athletes. Clin Sports Med, 2011;30(4):841-849.
- Safe Kids USA Campaign: Preventing Injuries at Home, at Play and on the Way. Safety Fact Sheets. Available at www.safekids.org/our-work/research/fact-sheets/.
- Quinn E. Youth Sports Safety Tips for Parents. A Parent's Checklist for Kids Who Play Youth Sports. About.com, Sports Medicine; updated Sept. 5, 2009.
Click here for previous articles by Warren Hammer, MS, DC, DABCO.