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Are You Elite? Little League Pitching Speed And Injury Risk

The Little League World Series is well underway now, and it’s interesting to note the peak pitching speed of some of the athletes. This article notes that several pitchers are in the 65mph to 75mph range and one player actually hit 81mph on one of his pitches in this year’s tournament.

But at what cost? There is an interesting database that puts young pitchers into various categories based upon age, pitching speed, and maximum distance on the throw. An observational study published a few years ago suggests that pitchers in the three standard deviation range or higher on the accompanying chart are “elite” and at risk for arm injury.

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If You Have Knee Pain You Need BFR Training (Blood Flow Restriction)

Orthopedic surgeons will commonly recommend lower extremity strengthening for any of their patients with chronic painful conditions and almost everyone who’s had knee surgery. Strength gains and strength symmetry are necessary for proper function but individuals who have one of these conditions frequently report one common drawback: the exercises needed to increase muscle strength often lead to significant knee pain.

Blood flow restriction (BFR) training is becoming increasingly popular as a means of strengthening using low loads and without the same type of risk of increased joint pain found with traditional methods of strength training.

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Want To Play Pro Baseball? Play Multiple Sports.

Sports medicine specialists and team physicians want to see all of our athletes succeed to the best of each of their abilities. But we’re also in a position to see the many things that unfortunately go wrong for younger athletes, including overuse injuries, burnout, and psychological stress.

It’s believed that two of the main causative factors in the above problems are early sport specialization and high intensity training at a very young age. For the younger athletes it’s believed that sport specialization hampers the opportunity to develop proper neuromuscular skills and general fitness.

A recently published study showed that young athletes interested in a baseball career at the highest professional level can minimize the risk of overuse injuries and have the potential for greater future longevity by participating in multiple sports during high school.

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“Fortnite Shoulder”?

We are now about two weeks away from the start of the 2019 Little League World Series. There will be a lot of baseball, of course, but there’ll also be a lot of Fortnite and other video games being played. With that in mind I thought it would be interesting to take a look at an article published in 2018 showing a strong association between videogame playing and risk of shoulder and elbow injuries in baseball players.

Researchers from the Tohoku University School of Medicine in Japan found that players who spent three or more hours daily on videogames were 5.6 times more likely to have felt elbow or shoulder pain in the prior year than those who played videogames for less than an hour a day.

Could this possibly be real? Do we actually need to add extensive videogame playing to the list of risk factors for shoulder and elbow injuries amongst young baseball players?

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“Tommy John” Surgery Does Not Make You Throw Better Than You Did Before

We now have a solid understanding of the behaviors that place a thrower at risk for elbow injuries, but making inroads in changing that behavior remains a challenge. For example, 40% of youth pitchers report throwing in chronic elbow pain, and 25% of Major League Baseball pitchershad “Tommy John” surgery at some point in their career.

The reality is that surgery to reconstruct a torn ulnar collateral ligament (UCL) does not make the elbow stronger and better than it was before the injury. Many pitchers do successfully compete again after surgery but it’s likely due to extensive rehabilitation to correct underlying functional issues as much as it is to skillful surgery.

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This Hydration Strategy Should Work

Last week I provided an update on heat illness warning signs and in the post recommended that all individuals follow a good hydration strategy. Our bodies are made up of 70% water, so it makes sense that hydration should be a good component of overall health.

But there is a lot of noise out there on exactly the type of hydration strategy to follow. What should you drink? How much should you drink? When should you drink? Here’s an easy to remember hydration strategy that is gaining a lot of traction amongst healthcare professionals as well as athletic performance specialists: take half your body weight in pounds, and drink that amount in ounces of water every day.

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Heat Illness Warning Signs

This is the time of year we need to review some aspects of heat illness, and a potentially deadly form of heat injury called exertional heat stroke. A recently published study of NCAA athletesrevealed that heat illness is most common in preseason training, and that tackle football has the highest incidence but athletes in all sports are potentially at risk. I highly recommend this 2017 New York Times article by neurosurgeon Dr. Julian Bailes, in which he describes the effects of heat stroke and argues for banning football two-a-days at the high school level.  The NCAA Division 1 and the NFL have banned two-a-days.

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Are Calf Compression Socks Helpful Or Just A Fashion Statement?

Calf compression socks are reported to improve leg endurance during running, speed recovery after a long distance run, and possibly lead to better performance. Do they actually do these things or is something else happening?

A recent scientific study evaluated the pain levels, performance, and muscle architecture during a six-week training period prior to an ultramarathon and in the immediate period after the race. In this group of healthy experienced runners with no prior issues of leg pain, the study authors found no improvements in the compression sock group. In fact, their runners with compression socks actually reported more pain than the runners who trained and competed without the socks.

The conclusion in this well-performed study of healthy runners is that there is no benefit to wearing the compression socks. Still, I find there are good reasons to wear them, especially if you’re recovering from an injury.

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When Can I Play Again: Shoulder Separation

I’ve written recently about shoulder dislocation, a serious condition in which the ball portion of the shoulder (humerus) becomes completely dislodged from the socket. This week we’ll discuss a shoulder separation, another common shoulder injury. But first let’s clear up some terminology to avoid confusion.

A separated shoulder refers to an injury to the ligaments of the acromioclavicular joint (commonly known as the AC joint), which is the joint between the end of your collarbone and the upper part of your shoulder blade. It’s located near the point of the shoulder.

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Parents Have A Major Impact On Reducing Kids’ Overuse Injuries

Over the last several years there’s been a growing consensus that some sport behaviors place a young athlete at risk for overuse injury: single sport specialization before age 14, playing that sport in training and competition more hours per week than your age in years, and playing more than eight months out of the year. Sport specific recommendations such as PitchSmart have also emerged.

What was previously unknown was whether following these recommendations actually leads to reduced injury rates. Recently published research indicates that parents who are knowledgeable of the PitchSmart recommendations and follow them with their young pitchers show significantly reduced injury rates compared to parents who were unaware of those recommendations.

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