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WESTCHESTER COUNTY, N.Y. Little League is not all home runs, hot dogs and Cracker Jacks. It is also about injuries, and young players are paying the price.
Some 6 million children under age 18 are involved in baseball leagues, while 13 million more play Americas pastime on their own, says the Consumer Product Safety Commission. Although baseball is a noncontact sport, most serious injuries come from contact with a ball, a bat or another player.
And while it is generally considered safe, the rate of serious injury is notable.
From 1994 to 2006, more than 1.5 million children were injured seriously enough to be treated in emergency rooms, said Dr. Victor Khabie, a specialist in sports medicine with Somers Orthopaedic Surgery & Sports Medicine Group.
Most of the injuries were minor muscle pulls (strains), ligament injuries (sprains), cuts and bruises. But, Khabie said, 24,350 required hospitalization, mostly for fractures and concussions.
The good news, he says, is that improved equipment now offers increased protection, and many injuries can be prevented by taking common-sense precautions.
Khabie said players, parents and coaches should focus on three specific areas to minimize the risk of injury: preparation, the right equipment and knowing a child's limits.
Preparation: Before the season begins, every player should have a complete sports physical that includes a check of overall health and a complete injury history as well as testing for strength, endurance and flexibility.
Preseason conditioning: Many injuries occur at the beginning of the season, when athletes are more likely to be out of shape. Strength and general conditioning should begin several months before the season starts, should be designed for baseball and should incorporate specific exercises for the position played. For all players but especially pitchers the shoulder is the area most prone to injury. Shoulders should be stretched and strengthened before the season.
Pre-game warm-up: Cold muscles are most prone to injury. While warming up is always important, it is particularly critical during a child's growth spurt, when muscles and tendons are tight.
Carlos Farias of Game Gear Sports in Bedford Hills recommends warming up as the No. 1 tip for young players. Stretching, from Day One, he said. It goes a long way.
Farias has coached and trained all levels of baseball and played professionally in Puerto Rico and the Dominican Republic. He said a lot of children will come in with arm injuries, especially if they play year-round.
Equipment: Improvements in equipment are helping to reduce the rate of injuries. Softer safety baseballs offer increased protection from being hit by a ball; breakaway bases have lowered the number of strains, sprains and broken bones. Catchers should always use a catcher's mitt and wear a helmet, face mask, throat guard, long-model chest protector, protective supporter and shin guards. And all players should wear properly fitted, molded and cleated baseball shoes. Players who wear glasses must have shatterproof lenses and sports frames.
Limits: Overuse injuries can be prevented by not allowing a child to play on more than one team in a season and by not playing and training for a single sport all year round. Strictly enforcing pitch count and innings limits is critical for protecting young pitchers.
Its a throwing issue, Farias said. Whether its a shoulder or an elbow, thats pretty consistent every year. The kids that are playing a lot spring, summer and fall those kids that go a little harder tend to get shoulder injuries. This can be a result of not getting the proper throw coaching, Farias said, or not warming up enough, especially if an injury goes undetected.
Coaches and parents can also help prevent injuries by creating an atmosphere of healthy competition, which means not pushing children to win at all costs and all the time. Putting too much focus on winning can make a child risk serious harm by ignoring the signs of injury and playing in pain.
If that means more Cracker Jacks and fewer injuries, then everyone wins.
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