1. Presented By: Joshua Field, DPT Jfield@peaksportsandspinept.com Created By: Dan Swinscoe, MPT, CSCS dswinpt@msn.com 425-391-9211 Beyond the First Aid Kit

2. The plan for today… Statistical risk factors which increase the likelihood of injury What to do if one of your athletes is hurt Suggestions for a good pre-game/practice warm up.

3. What research tells us, a numbers barrage 50% of pitchers 9-14 years old experience elbow or shoulder pain at some time during their season 15% of all appearances resulted in elbow or shoulder pain Pitch type counts as much as pitch counts 52% higher frequency of shoulder pain with curve 86% higher frequency of elbow pain with slider Little leaguers who throw > 75 pitches per game have a 35% increased risk of elbow pain and 52% increased risk of shoulder pain

4. Highly correlated but not quantified….. barrage without the numbers Pitching twice in the same game. Eg: Pitcher, LF, Pitcher Pitching later in the day after pitching in game. Eg: back yard coaching Participation in “show cases” Pitching for more than one team at a time Year round play. 9 months is the line in the sand. Everyone needs an off season. Push to return to the multi-sport athlete (Dave Donnatucci) MECHANICS: Studies show that similar body position and movement patterns are used by successful pitchers regardless of age or performance level.

5. MECHANICS: The Big three Stay on top of the ball. Watch the spin Keep elbow up. Reference to shoulder Stride toward the plate * All the things that help prevent injury also improve performance

6. Pitch counts per ASMI and USA Baseball Pitch count asterisk: 9-10 year old: 50/game, 75/week, 1000/season, 2000/calendar year 11-12 year old: 75/game, 100/week, 1000/season, 3000/calendar year 13-14 year old: 75/game, 125/week, 1000/season, 3000/calendar year Once the pitcher reaches his fatigue point the risk of injury goes up with each additional pitch. Professional pitchers younger than 25 this number is 100 pitches. For little league this number is not known. Think of all the factors that will change the number from game to game. HOW DO YOU KNOW ????? Typically you’ll see the elbow drops, pitches consistently miss up in the zone. Learn your pitchers and pay close attention.

7. Coach my arm hurts… Simple rule: Muscles good, joints bad Ask a lot of questions……act based on the answers. Ice is always good. Recipe is 3x/day 10’ each. If all else fails…..check back to slide number 1 and call or send an email. Remember this is LITTLE LEAGUE when in doubt be conservative it’s not worth risking a child’s health

8. Dehydration Fluid loss leads to increased body temp –1. Decreased ability to concentrate and focus –2. Dehydration causes fatigue and/or cramps –3. Thirst –4. Heat stroke –5. Death. Decreased athletic performance Increased risk of muscle injury (muscle 75% water) Only takes 2% loss of body wt with sweat to affect performance. 4% is medical emergency

9. What to do Trade snack parent for water parent –Technically water or Gatorade are essentially the same in the intestine. Allsport and Powerade have much more sugar and are not nearly as good. Soda and juice actually de-hydrate you because of the sugar content. *Bonus to have water parent also have ice and bags in case of injury.

10. Warm-ups Remember why you’re doing it Physical and non physical benefits Begins sport focused thoughts Provides mental comfort zone doing it the same every game Opportunity to become familiar with the field of play Shunts blood to muscles that will be used thus it should mimic the intended activity “Wakes up” nervous system Don’t be backwards ! Warm up to throw, don’t throw to warm up

11. Rookie and lower Run bases jumping jacks >>>baseball dance grab the candy stork stand>>>goal posts Free samples !

12. High knee skip et.al. Hip openers- lift knee high as possible and circle out Hip closers- lift knee high as possible and cross over midline Long & low forward(or lateral) like lunges but don’t bob Long and low lateral with angle punch-Martial Arts style Butt kickers toes pulled up- short quick strides heel to butt Tin soldiers (touch toe of extended leg with opposite hand) Shuffle shuffle sprint Foot slaps (turning in or out) Pioneer and up…..

13. Russian twist- lunges with rotation of “something” out in front of body held with both hands over the forward leg or “helicopter” arms Carioca- left to right and right to left Forward-backward sprints XC skiers Hip swivels If dry: Inch worms or bear crawls Continued……… Pick out the ones you like

14. A growing body of research over the past few years strongly suggests that static stretching has a place but it is NOT immediately prior to performance because stretching DECREASES electrical activity in the muscles being stretched. This creates measurable decreases in performance. So remember stretching isn’t bad it’s just a bad idea to do it right before performance. If you like stretching make it the early part of your movement preparation.

15. Time for a walk off !

16. Have a great season ! Joshua Field, DPT Dan Swinscoe, MPT, CSCS