2006 Spring Coaches Clinic Sports Medicine

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2006 Spring Coaches ClinicSports Medicine

• Sponsored by

Heritage Family Care
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Guest Speakers
Dr. Scott Konopka Heritage Family Care Dr.
Konopka is a board-certified family practitioner
with a special interest in sports medicine.  Dr.
Konopka received his medical degree at East
Carolina University School of Medicine and
completed his internship and residency at Wake
Forest University, Bowman-Gray School of Medicine
at Baptist Hospital.
Dr. Mark Galland Orthopaedic Specialists of North
Carolina Dr. Galland is an Orthopedic Surgeon
with a special interest in sports medicine.  Dr.
Galland received his medical degree at Tulane
University and completed his internship and
residency at Tulane as well.
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Prevention of Injuries in Youth Baseball

• Scott E. Konopka, M.D.
• Heritage Family Care
• 570-3090

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Benefits of Regular Exercise

• Youth athletic programs provide opportunities to
  
• Improve self esteem
• Acquire leadership skills and self-discipline
• Develop general fitness and motor skills
• Engage in peer socialization
• However participation is not without injury risk

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Kids Activities Intensify

• More than 35 million youths between the age 6-21
  participate in sports
• Baseball is one of the most popular sports for
  children
• Each year more than 500,000 baseball injuries
• Recent study shows 40 injury incidence among
  9-12 y/o pitchers over 1 year
• Upwards of 50 of all injuries in sports are due
  to overuse injuries

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Common Types of Injuries

• Acute Injuries
• Occur suddenly and are usually related to trauma
• Usually involve minor bruises, sprains and
  strains
• More severe acute injuries
• Eye injuries scratched retinas, etc
• Broken bones or ligament injuries
• Brain injuries concussions, etc
• Normally due to inadequate equipment
• for example sliding into immobile bases

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Avoid Injuries

• Wear protective gear
• Protective eyewear especially important for all
  functionally one-eyed individuals and for
  athletes with prior eye surgery or trauma
• Properly fitted helmets (sports specific)
• AAOS wear helmet at bat, when waiting a turn at
  bat, and running the bases
• Properly fitted footwear
• Hats and sunscreen to prevent sunburn
• Sports specific pads
• Catchers should wear helmet, face mask, throat
  guard, long model chest protector, shin guards

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Avoid Injuries II

• Maintenance and Appropriateness of playing
  surfaces
• Check to be sure playing fields are not full of
  holes and ruts or foreign objects
• Break away bases

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Common types of Injuries II

• Overuse Injuries
• Occur from repetitive actions that put too much
  stress on bones and muscles
• Problematic in children as they may effect bone
  growth
• The more time spent in sports, the more likely to
  occur

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Common Types of Overuse Injuries

• Anterior Knee pain
• Front of knee under knee cap
• Caused by muscle tightness of hamstrings and
  quadriceps
• Little league elbow
• Medial elbow pain
• Repetitive throwing
• Shin splints

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Factors contributing to Overuse Injury

• Intrinsic
• Growth
• Prior injury
• Inadequate conditioning
• Anatomic malalignment
• psychological
• Extrinsic
• Too-rapid training progression/ inadequate rest
• Inadequate equipment
• Adult or peer pressure

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Little league Elbow
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Injury Mechanism

• Overhand throwing subjects the elbow to forces of
  tension, compression, shear, and torsion
• Two main stages are acceleration, and follow
  through

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Common Stages of Injury
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Physis changes
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Elbow Injuries in Young throwing Athletes

• Anterior Compartment
• Anterior capsular stretching
• Bicipital tendonitis
• Biceps weakness
• Osteochondritis dissecans
• Lateral Compartment
• Supinator muscle strain
• Lateral apophysitis
• Anconeus muscle stain
• Suprachondral fracture
• Posterior compartment
• Olecranon tip impingement
• Olecranon apophysitis
• Triceps tendonitis
• Medial Compartment
• Ulnar collateral ligament strain
• Flexor muscle strain
• Medial apophysitis
• Ulner nerve neuritis

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Typical history

• Medial elbow and proximal forearm pain occurring
  a few days after throwing to first base from
  third or shortstop or after pitching.
• Pain abates with rest but returns with throwing
• Usually best skill player

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Preventing Overuse

• Must have healthy participant preparticipation
  physicals
• Daily stretching and conditioning
• Distance running and sprinting included
• Age appropriate strength training
• Coaches should teach the proper mechanics of
  pitching and throwing
• Youth league regulations limit the innings
  pitched per week

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Pitch Count

• 9-10 year olds
• 50 pitches per game
• 75/ week
• 1000/ season and 2000/ year
• 11-12 year olds
• 75 / game
• 100/ week
• 1000/ season and 3000/ year
• 13-14 year olds
• 75 / game
• 125/ week
• 1000/ season and 3000 / year

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Preventing Overuse Injuries

• No breaking pitches in competition until bones
  are mature 13 y/o (curveball, slider)
• Do not pitch for more than 1 team in a given
  season
• Pitch for only 9 months out of the year

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Heat and Hydration

• Children perspire less than adults
• Can be fatal
• Heat related illnesses include
• Dehydration
• Heat exhaustion
• Heat stroke

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Playing safe in the heat

• Recognize the dangers
• Respond quickly if injury occurs
• Schedule regular fluid breaks during practice and
  games
• Drinking water is the best choice, others include
  fruit juices and sports drinks
• Kids need to drink 8 oz of fluid every 20 minutes
• Make player substitutions more frequently in the
  heat
• Wear light colored clothing, hats
• Use misting body sprays on the body to keep cool

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How to prevent sports injuries

• Be in proper physical condition to play the sport
• Know and abide by the rules of the sport
• Wear appropriate protective gear
• Know how to use athletic equipment
• Always warm up before playing
• Avoid playing when very tired or in pain
• Get a preseason physical
• Make sure there is adequate water or other
  liquids to maintain proper hydration

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• Mark W. Galland, MD
• Orthopaedic Specialists of NC

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ORTHOPAEDIC CONSULTANT

• CAROLINA MUDCATS
• RALEIGH REBELS
• LOUISBURG COLLEGE

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ELBOW INJURIES IN YOUTH BASEBALL
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ELBOW ANATOMY

• MCL/UCL
• TOMMY JOHN
• 30 DEGREES FLEX

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SKELETALLY IMMATURE ELBOW
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PITCHING SEQUENCE
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PLAYERS MOST AT RISK

• PITCHERS
• 3RD BASEMAN
• SHORTSTOP

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INJURY TYPES

• FRACTURES
• STRAINS
• INFLAMMATION
• NERVE INJURY

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LITTLE LEAGUERS ELBOW

• MEDIAL EPICONDYLE
• APOPHYSITIS

• SWELLING
• PAIN
• LOSS OF MOTION

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TYPICAL HISTORY

• FATIGUE
• PAIN
• CONTROL

• TIGHT
• THROWING ONLY
• VELOCITY

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TREATMENT

• REST
• REST
• REST

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TREATMENT

• NSAIDS
• ICE
• REHAB

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• LOSS OF SEASON

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SURGICAL TREATMENT
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INTERVAL THOWING PROGRAM

• LONG TOSS
• BULLPEN
• FULL EFFORT

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RETURN TO PLAY

• GOOD CONTROL
• PAIN FREE
• FULL VELOCITY

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PREVENTION

• FREQUENCY OF PLAY
• TRAVEL TEAMS

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PREVENTION

• PITCH COUNT
• THROW COUNT

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PITCH/THROW COUNTS

• 50-75 PER GAME
• 2-3 DAYS REST (PITCHERS)

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PREVENTION

• VELOCITY
• THROWING MECHANICS
• AGE

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THE BREAKING BALL

• NEVER BEFORE
• AGE 13

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CHANGE UP

• HITTING IS TIMING. PITCHING IS UPSETTING
  TIMING
• --WARREN SPAHN

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INJURY PREVENTION

• RESPONSIBILITY OF ALL INVOLVED IN YOUTH BASEBALL

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Tom Shipman

• President, GWFABC

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USA Baseball Medical Safety Advisory Committee
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