It's baseball season. A time when all you need is a baseball, a mitt and some decent weather.
And if you're lucky, it will always be so simple. For too many baseball players, though, it isn't.
More and more young baseball players, especially pitchers, are coming down with "Little League elbow," and to a lesser degree "Little League shoulder." Don't let the names fool you; these are real medical diagnoses with real consequences, from short-lived swelling to fractures to ligament damage.
Among pitchers under 12-years-old, as many as 45 percent complain of chronic elbow pain, according to several published studies. At the high school level, nearly six in every 10 pitchers suffer chronic elbow pain.
Yet another study--in the Journal of the American Academy of Orthopaedic Surgeons (AAOS)--showed that it may be even worse than that, with 50 percent to 75 percent of all adolescent baseball players--not just pitchers--reporting elbow pain.
"I'll tell ya, there's a lot of this going on," said local pitching guru Dick Schoonover. "It's bad. Many parents -- and coaches -- don't understand how many pitches a kid should throw. They think, they're young, they're healthy, they can't get hurt.
But they can and they do.
Youth Baseball: Should it be Year-Round?
And for most young baseball players with throbbing elbows that's the real problem -- the never-ending baseball season.
Boys this age are now playing more baseball than ever before. Even in cold-weather climates like Northeast Ohio, baseball has become a year-round sport --and that more than anything is leading to the increasing number of elbow injuries.
"I tell coaches there are three main causes" said Dr. Joe Congeni, director of Akron Children's Hospital's sports medicine center. "Too much pitching, too much pitching and too much pitching."
It used to be that baseball was relegated to late spring and summer. No more.
"Kids start younger," Congeni said. "They throw more pitches. They play year-round --40, 50, 60 games a year. They play spring ball, summer ball, fall ball. They play tournaments -- three or four or five games in a weekend. And now they play winter ball, either playing games or practicing.
"We strongly recommend kids take off at least one of those four seasons completely."
Baseball Youth Injuries Increasing
Combine overuse with inherent physical weaknesses and you've created a situation perfect for injury.
Congeni is seeing an increasing number of young baseball players in his office. Most will heal with a combination of rehabilitation and rest -- sometimes two to three months without throwing a baseball. Others will need surgery.
They're typically between 8 and 15 years old. And they're almost exclusively boys, because the round-house motion used by female softball pitchers doesn't create stress on the elbow the way pitching a baseball overhand does.
Little League elbow "is very unique to throwing a baseball," Congeni said. "Quarterbacks don't get it. Softball players don't get it. Just the mechanics of how you throw a baseball puts more stress on the inside of the elbow."
The problem stems from two basic factors -- the physical immaturity of adolescents and overuse.
Between the ages of 8 and 14, boys are still maturing physically. In the elbow, that means the growth plates of the bone are weaker than the tendons.