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Bush League

By Scott Hamilton, MD
September 3, 2021
Hamilton Blog Headshot Updated 12.21.21

It was a scene right out of the movie “Parenthood.” The pop fly was headed for right field where my nine-year-old son stood, his glove up, everyone holding their breath. When he caught it, the stands went wild and my anxiety of him dropping it evaporated. I could hear the mom from the movie telling a fretting Steve Martin: “You threw him a million pop-ups in the backyard. You cut the odds (of him missing it) considerably.”

Lots of parents want their kids to succeed in sports. Many of them, like me, had lackluster childhood baseball careers. You could count my little league hits on one hand, even if you'd lost several fingers in a bandsaw mishap. Fortunately, my boy loved baseball, even practicing hitting and throwing. But too much can lead to overuse injuries.

Getting good requires lots of repetitive movement. In baseball it’s throwing over and over and over. Too much practice strains small elbows, which are still growing and have weak spots that more mature ones don't. Pitchers particularly are at risk for “little league elbow,” where a “growth plate” in the joint, where new bone is made, starts to crack open. Kids begin to have pain at the end of throwing sessions, and progress to pain with any movement. Keeping kids’ “pitch counts” below a certain number helps prevent this, but is the coach counting throws at home or warm-ups?

The best way to avoid overuse injuries is mixing up activities. Most professionals were in multiple sports as kids, doing different drills for each discipline. While many think specializing in one sport makes a kid good, multiple different sports and activities (including bike riding, tree climbing, tag) keeps the whole body good. And is much more fun.

The Lafayette little league team was recently in the Little League World Series. When my wife announced that watching it on TV was our Saturday evening activity, I was pretty stoked. College and other nonprofessional baseball and softball games are lots more fun to watch than the majors. The games go faster, and the higher risk of errors spices things up. Major league ball drags on and is too slick. I was also happy for the excuse to finally have beer and peanuts with a game too. Beer and little league? Sure!

Like we said above, becoming a little league phenom takes lots of practice, which can strain growing bodies. Throw after throw takes a toll on young arms. So, what do you do if kids start complaining about pain? Or have more sudden injuries?

If the pain comes on gradually, time to cut back. During the Little League World Series, part of the suspense was: could a pitcher get through crucial innings before coming out because of his pitch count limit? If kids start getting sore elbows, they need to stop throwing to let things heal. One or two weeks without throwing should do it, and then gradually start back. Ice is great for inflammation. Ibuprofen and acetaminophen help if kids can't sleep due to pain.

If your child has a more sudden injury, where to go? If you’re considering a walk-in clinic, call first. Do they have an x-ray? Are they comfortable with kids? I see many children in the Emergency Department whose parents drove from one clinic to another, only to be turned away because of a kid's age. It's best to go to your kid's own doctor, who can order x-rays, follow the healing progress and access orthopedic consults if necessary. If the practice also served beer and peanuts, they’d be truly perfect.

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