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SSports ports TTrauma and rauma and OOveruse veruse PPrevention revention
STOP Elbow Injuries
Elbow Injuries
• Why are we so concerned about elbow injuries?• Because elbow injuries are…
– Common: >50-75% of youth baseball players– Increasing: Elbow surgery has increased 50% in
high school pitchers in the past 5 years.– Preventable: Fewer pitches = Longer Career
• Only 4 Little League World Series pitchers have made it to the MLB
• Why? Overuse injuries & Early burnout!
Common Elbow Conditions
• Ligament & Tendon Injuries– UCL (Ulnar Collateral Ligament)
• Tommy John
– Medial & Lateral Epicondylitis
• Bone & Growth Plate Injuries– Occur in Growing children– Medial Apophysitis
• “Little Leaguer’s Elbow”
Risk Factors for Elbow Injuries
• Number of Pitches– Pitch Count: #1 Risk Factor for Elbow Injuries– Year round baseball, Multiple teams
• Pitch Types– Fast Ball should be mastered first– ?Breaking pitches should be taught later (>14 yrs)
• Mechanics– Strength supports form, form supports speed– Fatigue leads to poor mechanics
-Lyman, AJSM 2002
Pitch Counts & Rest
Age Pitches/Game
7-8 509-10 75
11-12 8513-16 9517-18 105
Pitch Counts
Age 7-16
Age 17-18
# Rest Days
61+ 76+ 341-60 51-75 221-40 26-50 11-20 1-25 0
Rest Days
-USA Baseball Medical and Safety Advisory Committee
When To Throw What
• Fastball First• Change-up Second• Breaking Pitches
– Curveball, Slider– After age 14?
• Learn one pitch at a time
Pitch AgeFastball 8±2
Change-up 10±3Curveball 14±2
Knuckleball 15±3Slider 16±2
Forkball 16±2Screwball 17±2
-USA Baseball Medical and Safety Advisory Committee
Diagnosing Elbow Overuse
• Pain is NOT a sign of a strength deficit.• Common Symptoms
– Loss of form, accuracy, or velocity– Takes longer to loosen up– Early Fatigue– Pain– Stiffness– Swelling
-USA Baseball Medical and Safety Advisory Committee
Treating Elbow Overuse
• Prevention is the best treatment!
• Initial Treatment– Rest, Ice, Gentle stretching
• Involve your coach early• When to see a doctor…
– Pain that lasts more than a few days
– Swelling or stiffness in the joint
Preventing Elbow Injuries
• Watch pitch counts and rest days!• Always warm up & cool down• Learn proper mechanics• Don’t forget strength &
conditioning• No year round play• Avoid multiple teams• Don’t pitch through pain or fatigue
Summary
• Elbow injuries are common & preventable.• Pitch counts are the #1 risk factor for elbow
injuries.• Prevention is the key and rest is the cure.
• Charles Carroll