Baseball safety

Pitching and throwing can lead to overuse injuries in the arms, elbows and shoulders. Tissue such as bone, cartilage or tendon can become damaged by repetitive motion activities. Without adequate time for recovery, the tissue cannot adapt to the demands placed on it.

The damage caused by repetitive stress leads to tissue inflammation that causes pain. Symptoms of overuse injuries, also considered chronic sports injuries, include:

• Pain when performing the activity or sport

• Intermittent swelling

• Decreasing performance

• Dull pain even at rest

• Inability to straighten the elbow

If the symptoms persist, take your child to see a pediatrician or a pediatric sports medicine physician. In each consecutive season, repetitive maneuvers by certain body parts can lead to fatigue and long-term damage.

In young players, bones have not finished growing. Repetitive motion can cause muscles and tendons to pull on the bones at these growth sites where they are most vulnerable. This can cause pain and discomfort, and with continued activity, can cause a fragment to pull away from the bone on the inner side of the elbow. Rest is the primary treatment. Prevention by following pitch count recommendations is most important. A good reference for the most up-to-date information on pitch counts is available on the Little League Web site.

A secondary symptom of this type of overuse is pain on the outside of the elbow from the compression of the two bones at that point. With continued activity, damage to the bone, much like a pothole in the street, can leave the soft covering of the bone vulnerable for injury. This may require surgery to remove pieces of the soft covering if it becomes loose.

Elbow pain should not be ignored. Rest is recommended to allow for sufficient recovery. If symptoms persist after two weeks of forced rest, a visit to a pediatric orthopedic surgeon or sports medicine specialist is recommended. Delayed treatment of these problems can make a significant impact on future participation in throwing sports.

A concussion is a brain injury usually caused by a sudden jolt or a blow to the head or neck that disrupts normal brain function. This can occur in baseball from a pitch that hits the batter’s head or a collision at home plate. An athlete does not need to be knocked out or have memory loss to have suffered a concussion. In fact, most athletes who suffer a sports-related concussion DO NOT lose consciousness.

You may observe that an athlete with a concussion:

• Appears dazed or stunned

• Is confused

• Forgets plays

• Is unsure of game, score or opponent

• Exhibits unsteadiness

• Moves clumsily

• Answers questions slowly

• Has behavior or personality changes

• Can’t recall events either before or after hit

• Loses consciousness

An athlete with a concussion may have:

• Headache

• Nausea

• Balance problems or dizziness

• Sensitivity to light or noise

• Concentration or memory problems

• Double or fuzzy vision

• Confusion

• Feelings of being “in a fog”

An athlete with signs of a concussion should be removed from play immediately and not allowed to return until evaluated by a doctor. Do not leave an athlete alone after a concussion.

Call for immediate medical help if your child displays:

• A headache that gets worse, lasts for a long time or is severe

• Confusion, extreme sleepiness or trouble waking up

• Vomiting (more than once)

• Seizures (arm and legs jerk uncontrollably)

• Trouble walking or talking

• Weak or numb arms and/or legs

• Any other sudden change in thinking or behavior

Most athletes with a concussion will recover completely within a few weeks of the initial injury. Returning to play before completely recovering puts the athlete at risk for a more serious injury, long-term damage and even death.

Baseball players are at risk of dehydration if they don’t get enough fluid to replace what is lost through the skin as sweat and through the lungs while breathing. It is important to drink plenty of fluids before, during and after a workout or game. An athlete’s performance can be impacted by even mild dehydration.

Athletes should take a water bottle to school and drink between classes and during breaks so that they are well-hydrated before their workout. In addition:

• Water should be readily available when working out

• Athletes should drink often – ideally every 15 to 30 minutes

• Sports drinks are recommended for activities lasting longer than one hour.

Early signs of dehydration can be non-specific and include:

• Fatigue

• Decreased athletic performance

• Headache

• Thirst

• Apathy

• Irritability

• Nausea

Signs of advanced dehydration include:

• Dark urine

• Dry lips and mouth

• Disorientation

• Decrease in reaction time

Athletes with any of these signs should rest and drink water or sports drinks. If athletes don’t improve, feel dizzy or faint, or have not had much urine output, they should be seen by a doctor. Seek emergency treatment if the athlete is disoriented, unable to drink or has pale skin.

The most common injury in sports is a lateral ankle sprain. In baseball, this injury is caused by rolling the ankle over the outside of the foot. This often occurs when the foot rolls over the edge of a base or when stepping on another player’s foot. A lateral ankle sprain causes damage to the ligaments just below the bone on the outside of the ankle. In some cases, a “pop” is felt or heard by the athlete.

Treatment recommendations vary with the severity of the injury:

• Mild sprains require rest but not necessarily medical treatment (follow the PRICE formula plan shown here)

• Persistent swelling, pain or any deformity should be seen by a physician.

These can affect all areas of the body. Recommended treatment is the PRICE formula:

• Protect the area with a sling or crutches, if necessary.

• Rest the injured area.

• Ice the injury for 20 minutes at a time. Do not apply the ice directly to the skin.

• Compress the injured area with a wrap. Do not pull tightly, as this can cut off circulation.

• Elevate the injured area above the heart, if possible.

Athletes should see a pediatrician or pediatric sports medicine physician if any of these symptoms are present:

• Deformity

• Limping that lasts more than 48 hours

• Soft tissue swelling that gets worse the next day despite ice and over-the-counter anti-inflammatory medication such as Motrin®

• Effusion – mobile soft tissue swelling on both sides of a joint, often the knee or ankle

• Pain that returns quickly with activity or is not gone after two weeks of forced rest.