Baseball and softball are some of the safest sports for children to play, but parents and coaches should make sure young players are properly trained and keep from pushing them too hard, according to new guidelines from U.S. pediatricians.
The American Academy of Pediatrics, or AAP, said in the journal Pediatrics that one of the biggest risks is that kids are stressing their arms too often and learning new skills before their bodies are ready for them.
"Moderation is key here. Don't push that kid too hard, too young," said Timothy Hewett, head of the Sports Medicine Biodynamics Center at Cincinnati Children's Hospital, and a consultant to the AAP's guidelines committee.
"There are so many young Roger Clemenses out there that don't make it into high school or college ball, because their arms are shot by the time they get there."
While injuries are infrequent in youth baseball and softball compared to other sports, those that do occur are more likely to be severe, such as broken bones and concussions. Still, catastrophic, life-threatening injuries are very uncommon.
The new guidelines stress preventing injuries through equipment and teaching, as well as moderation when it comes to growing athletes.
The youngest Little Leaguers especially should use lower-impact balls and wear face guards on their batting helmets or use other protective eyewear. Batting gloves and rubber spikes, instead of metal ones, are recommended, as are cups for boys.
All children should be taught how to avoid fastballs coming at them in the batter's box, or line drives hit straight back to the pitcher's mound. And as in other sports, any children showing signs of a concussion after getting hit in the head need to be checked by a doctor.
An automated external defibrillator (AED) should be kept nearby in case heart rhythm is thrown off after a ball hits the chest, the guidelines added.
Researchers agreed that the most preventable injuries, and some of the most worrisome, are overuse injuries.
Pitchers especially shouldn't pitch if their arms are still tired from the last game, shouldn't learn new pitches like sliders and curveballs too soon, and should do exercises to strengthen their core muscles.
Children 14 and under shouldn't be throwing more than 65 pitches a day, and should be pitching no more than three days a week, said Hewitt, at Cincinnati Children's Hospital.
Orthopedic surgeons are treating more injuries in children that used to be typical only in older, more experienced athletes, and some players are pitching in multiple leagues as well as in showcase events on weekends, some experts said.
"Sometimes, for their own good, you have to hold them back, and that's what gets lost on people," said Stephen Rice at the Jersey Shore Sports Medicine Center, a lead author of the guidelines.
"Every child grows and moves forward at different rates.You don't want to hurry and push your kid to do things they aren't ready for."