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Newsletter - Volume 1, Issue 1, 2008
MRSA
MRSA, Methicillin Resistant Staphylococcus Aureus, are type of staph infections that are resistant to antibiotics that are commonly used to treat staph infections, such as penicillin or amoxicillin.
According to the Centers for Disease Control and Prevention (CDC), approximately 25% to 30% of the population are staph carriers and 1% of the population are carriers of MRSA.
SIGNS AND SYMPTOMS
Staph and MRSA infections produce skin infections- pimples or boils that are red, swollen, painful or have pus or other drainage.
PREVENTION
Practice good hygiene and avoid contact with drainage from skin lesions.
Proper prevention includes:
Keep hands clean by washing thoroughly with soap and warm water or using an alcohol based hand sanitizer.
Encourage showering immediately following activity.
Keep cuts and scrapes clean and covered with a bandage until healed.
Avoid contact with other people’s wounds or bandages.
Avoid sharing personal items such as towels or razors or daily athletic gear.
Properly wash athletic gear and towels after each use.
Maintain clean facilities and equipment.
MANAGEMENT
Seek appropriate medical care for all active skin lesions or lesions that do not respond to initial treatment.
If you are given an antibiotic, take all of the doses, even if the infection is getting better, unless instructed by a physician.
Do not share antibiotics or save them for use for another time.
Baseball pitching injuries are most commonly attributed to the repetitive pitching motion which causes micro-tearing at the shoulder and elbow joints. It is especially important to pay attention to youth baseball players and their risk of injury because their growth plates in the shoulder and elbow joints are still open; leaving them more susceptible to stress- related injuries. Growth plates are cartilaginous disks at the end of long bones where growth of these bones take place.
For young pitchers, between the ages of 9-14 years old, it is recommended that they should not throw breaking pitches because of the dangerous loads placed on the elbow and shoulder joints and the higher incidence of pain. These types of pitches should be avoided until puberty and the focus should be on proper fast-ball pitch mechanics. For this age group, the fastball and changeup should be used exclusively.
Parents and coaches must pay attention to taller and heavier pitchers for signs of injury because they are able to throw the ball harder, hence increasing the forces that their joints are subjected to. In addition, they must react appropriately to arm pain and seek medical attention. It has been found that pitching despite arm fatigue or pain increased the risk of injury by over 30%. Open and direct communication between parent, coaches and the young athlete must be embraced and encouraged to ensure that any injury or soreness is reported.
Risk factors for elbow pain include:
Increased weight
Decreased height
Lifting weights
Participation in more than one league
Decreased satisfaction with one’s pitching
Pitching with arm fatigue
Risk factors for shoulder pain include:
Decreased satisfaction with one’s pitching
Pitching with arm fatigue
The number of pitches thrown in a game
The number of pitches thrown in a season
When pitches increase to 75-99 per game, there is a 35% increased risk of elbow injury, along with over 50% increased risk for shoulder injury. It also has been demonstrated that the number of game pitches thrown during a season is significant risk factor for injury. Risk for elbow pain steadily increases as the pitch level reaches to 601-800 pitches per season; while risk for shoulder pain increases beyond 800 pitches per season.
It is recommended to limit pitchers, between the ages of 9-14 years old, to 75 pitches per game, and 600 pitches in a season. Also, the number of batters faced during a game and season should be limited to 15 and 120 respectively.
It is important to note that these pitch recommendations do not include warm-up pitches, practice pitches, throwing drills, throwing from other positions, etc. They only refer to full effort, game pitches.
To summarize, parents and coaches must closely monitor pitch counts and react appropriately to reports of arm pain or soreness. Emphasis should be placed on proper warm-up and stretching techniques, general physical conditioning and proper pitch mechanics. All of these will help ensure the long term physical health of the young baseball pitcher.
Safety Recommendations for Adolescent Baseball Pitchers per Olsen et. al
Avoid pitching with arm fatigue.
Avoid pitching with arm pain.
Avoid pitching too much.
Avoid pitching more than 80 pitches per game.
Avoid pitching competitively more than 8 months per year.
Avoid pitching more than 2500 pitches in competition per year.
Monitor pitchers with the following characteristics closely for injury:
Pitchers who regularly use anti-inflammatory drugs or ice to “prevent” an injury.
Regularly starting pitchers.
Pitchers who throw with velocity >85 miles per hour.
Taller and heavier pitchers.
Pitchers who warm up excessively.
Pitchers who participate in showcases.
References:
Olsen SJ., Fleisig GS., Dun S., et al. Risk Factors for Shoulder and Elbow Injuries in Adolescent Baseball Pitchers. Am J Sports Med. 2006;34: 905-912.
Lyman S., Fleisig GS., Andrews J., Osinski ED. Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball Pitchers. Am J Sports Med. 2002;30: 463-468
