Organizers of youth baseball leagues learned a simple truth over time – that if they let a pitcher throw without any limits, he was more likely to suffer a devastating tear to a ligament in his elbow.
The player would have to undergo a reconstructive operation known as Tommy John surgery, and in many cases, could no longer play competitive baseball. That toll led Little League Baseball Inc. to adopt a pitch limit based on a player’s age. A 10-year old is allowed to throw 75 pitches in a game; an 18-year old, as many as 105.
Now Chris Nowinski, co-director of the Boston University Center for the Study of Traumatic Encephalopathy, advocates a “hit count” for kids playing organized football that would significantly limit the number of blows to the head they can take in practice and games. He believes it should be modeled after the approach taken in Little League Baseball, where guidelines also establish the number of days of rest pitchers must get between games.
“In football,” Nowinski said, “starting at 6 years old you’re allowed to start hitting kids in the head as much as you want.”
Nowinski, a former college football player and professional wrestler who sustained multiple concussions as an athlete, was one of the panelists who spoke at Health Journalism 2013 in a session looking at whether research will drive more changes in youth sports. He was joined on the panel by Dr. Kathryn Ackerman, co-director of the Boston Children’s Hospital Female Athletes Program and a former competitive rower, and Mark Hyman, an independent sports journalist and author from Baltimore.
At one point, Nowinski asked how many attendees had sustained a hard blow to the head in the past year. Two raised their hands, one of whom said he had endured multiple blows.
“Combined,” Nowinski said, “this group has probably taken under 10 blows to the head in the last year – collectively.”
But data shows that some kids take 2,500 blows to the head in a single season.
“How do we not do this to the next generation?” he asked.
Efforts to reduce the toll of injuries include laws in 42 states that prohibit youths from returning to games if they’ve sustained a concussion, to studies of chronic traumatic encephalopathy, a disease linked to mood changes, depression, dementia and premature death that is tied to repeated blows to the head.
Between 30 million and 45 million school-aged kids in the United States participate in organized sports, and suffer more than 4 million sports injuries a year, Ackerman said. Those injuries include torn knee ligaments, stress fractures and a host of other ills that can be blamed, at least in part, on the time kids spend on the field and the fact their bodies are still growing.
Ackerman described something she called the “female athlete triad” – the relationship between energy, menstrual function and bone health. Young female athletes often have interrupted menstrual cycles as a result of training, and that and the way the body processes energy can shut down the production of hormones that help build bones. Such girls are at much higher risk for stress fractures, early onset osteoporosis and other injuries, Ackerman said.
Making youth athletics safer will require not just medical research, but changes to the culture of youth sports, Hyman argued.
He noted that before Little League Baseball was started in 1939, almost all youth sports were school-based and overseen by teachers and others whose backgrounds helped them understand the physical and emotional development of kids. Youth sports is now parent-driven. And parents’ desire to see their children succeed has led to a youth soccer program for 18-month-olds, and constant travel for some youngsters who play on multiple teams in multiple leagues year round.
And it’s become big business – one town in Texas hosts about 20,000 youth baseball players each weekend for tournaments that pump millions of dollars into its economy.
“Sports for kids often is really about what we need and want from sports, and that sometimes puts kids at risk, physically and emotionally,” he said.
Hyman knows from experience. His son, Ben, was a very good pitcher. And Hyman encouraged him to play more often. But Ben’s baseball career ended at 16 when he tore the ulna collateral ligament in his throwing elbow.
“I thought I was helping him to reach his potential, but ultimately it was the opposite,” Hyman said.