Hitting All Of The Bases: Uncovering Overuse Injuries In Youth Baseball

As MLB’s spring training begins mid-February, you may be wondering why our young athletes are expected to report even sooner than the professionals. Is it because they want to become the best players they can be? Is it because of a lack of universal regulation, unlike the major league? Is it a social and societal pressure that influences teams to get a headstart on their opponents? In a sense, all of those reasons can impact the way teams and organizations run. Each year youth baseball players are seemingly expected to report earlier and earlier for spring training, but at what cost?

Youth Leagues & Their Inconsistencies

Organization-specific regulations are implemented as a means of keeping games safe and fair for all players to have a fun and competitive experience. However, not all organizations are built the same -- many leagues utilize different rules and regulations to best serve its players. Due to the differences, there is a lack of widespread consistency when it comes to how these young players train and compete with one another.

Typically, a young athlete with a specialization in baseball will not only play in the spring but will also play summer and fall ball on top of that. Leagues such as the USABL league runs 7-8 weeks in the spring starting March 29th, then hold 5 weeks in the summer and have playoffs from October to November. Other leagues such as Perfect Game start as early as January 7th for their National Indoor League Session in Cedar Rapids or January 8th for their Select Off-Season Training in Iowa. Other leagues may opt for a combination of early report dates as well as late playoffs leaving these boys to be in essentially in-season for over two-thirds of a calendar year.

While frequent play and practice time may make for well-seasoned athletes, it’s important to identify potential drawbacks and ensure that your athlete has not become a victim of any of them. Fatigue and overuse injuries are by far one of the greatest risks a young baseball player might face during their career.

Luckily, certain leagues such as USA Baseball and Perfect Game implement educational programs such as Pitch Smart and USA Baseball utilizes Long-Term Athletic Development Plans (LTAD’s) to encourage kids not to burn-out early on. Pitch Smart, “is a series of practical, age-appropriate guidelines to help parents, players and coaches avoid overuse injuries and foster long, healthy careers for youth pitchers.”

They understand injury prevalence of and ensure that their athletes are taking the steps they need to stay off the bench and in the game. LTAD’s, on the other hand, are development programs that help players, parents, and coaches understand how the athletes should be progressing during their developmental stages. By emphasizing growth via progress and player health and safety, LTAD’s increase participation, aid in performance, and enhance enjoyment across the sport of baseball.

Overuse Injuries

However, the youth baseball organizations that push their athletes hard without proper rest and recovery are a major cause of overuse injuries.

The players at the highest risk of injury are pitchers and catchers due to the repetitive throwing motion. On average, 50% of high school pitchers are injured to some extent and the Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review helped analyze why. This study found direct ties to overuse injuries and throwing while fatigued or in pain. They found that pitchers were at a 4 to 36 times greater risk of injury due to overuse and fatigue when pitching with pain or fatigue and that regularly throwing with arm fatigue also increases the chances of needing surgery. In the study, pitchers were also 3 to 7 times more likely to develop shoulder or elbow pain if they threw more than 75 pitches per game, played catcher when they weren’t pitching or threw more than 600 pitches per year.

If the player were to throw more than 80 pitches a game, throw more than 100 innings per year, or throw more than 8 months per year, they were 2 to 5 times at greater risk for needing shoulder or elbow surgery to continue their baseball career.

One of the more common procedures available is the Tommy John surgery. This procedure was coined in 1974 when Dr. Frank Jobe performed the experimental surgery on Tommy John, a pitcher on the Los Angeles Dodgers. Once they found that they can successfully replace the damaged tendon with another from elsewhere in the player’s body, what would’ve been a career-ending injury turned into hope for other major league players with the same issues. Ironically, what used to be a procedure saved for the professional players has become increasingly common among young baseball players. Dr. Jeffrey Dugas of Andrews Sports Medicine and Orthopaedic Center in Birmingham, Alabama explained: “When I started my practice 17 years ago, Tommy John surgery was really a college and pro phenomenon, with a couple of high school athletes.” But now more than 55% of his Tommy John surgery patients are high school athletes, a significant increase in younger and younger patients.

Despite the risk, increased chances of injuries have not dissuaded players and parents from getting seriously involved with the sport on an almost year-round basis. At present, Dr. Tommy John, Tommy John’s son works to inform parents about the dangers of overuse and how to better manage baseball specialization. He is concerned that parents are being pressured into making potentially harmful decisions for their child's development. Parents can get into a mindset of competing with other parents, and worry about their child falling behind from his competitors. To combat those concerns, they enroll their sons in more and more baseball, but if they’re not careful they can put their child at risk for injury.

Injury Prevention

Since enrolling young baseball players for the majority of the year has become increasingly common, it’s extremely important to put more emphasis on injury prevention and active recovery to maintain their levels of activity. A major difference between MLB players and youth players is the extent to which they take care of themselves. While professional players have trainers, nutritionists, and staff dedicated to their well-being, children don’t have that same support. That’s why parents and coaches need to educate their players on how to best rest and recover so they can stay in play.

Focusing on strength and conditioning during spring training is one method that has a significant impact on injury prevention. By starting with the basics and ensuring that the players are using the correct form when lifting or throwing can ultimately give them the correct foundation to build on. It’s also important to pay attention to signs of fatigue and adjust their regimen accordingly. The American Sports Medicine Institute suggests that young players should not pitch for more than 100 games during a calendar year, no overhead throwing of any kind for at least 2 to 3 months per year, and no competitive baseball pitching for at least 4 months per year.

Another key way to ensure that young players aren’t falling victim to overuse injuries is engaging in active recovery. Most people assume that rest is the equivalent of recovery and while rest aids in the body’s natural healing process, rest is limited when your son plays year-round baseball. State of the art treatments like cryotherapy and NormaTec Compression Sleeves can decrease recovery time, heal faster and prevent injury in people of all ages.

Localized cryotherapy is beneficial to target specific areas in need of recovery including shoulders, biceps, elbows, wrists, knees, ankles and more. It uses vaporized nitrogen at negative 220-230 degrees to stimulate the body’s natural responses and increase blood flow to the targeted areas to protect them from the cold. Full body cyrotherapy encompasses the exposure of the entire body to vaporized nitrogen. The benefits of cryotherapy include reduced recovery time, reduced inflammation and increased collagen production.

NormaTec Compression Sleeves are also beneficial to target areas within the extremities. Compression sleeves can be placed over the arms and legs and are broken into segments that inflate and deflate in specific patterns producing an increased blood flow to those areas. For example, the leg sleeves are geared to intermittently squeeze the chambers from your feet to the calves, to the ankles, knees, quads, and finally hips.

Since our extremities get the poorest circulation, the healing process takes longer than somewhere on your torso. So the appeal of the compression sleeves is to reduce recovery time, reduce inflammation, increase circulation back to the heart, stimulate mitochondria production, antioxidant activity, and blood vessel dilation, increase flexibility, and enhance muscular performance. Practicing active recovery from an early age not only helps inspires good, healthy habits, but also aids in injury prevention and ultimately supports their long term development.