Many parents support their kids in playing a sport year-round with little to no down time. No down time means an increased risk of injury. Parents are worried about their child “falling behind” and losing participation opportunities – but they may want to think about whether or not this punishing schedule is destroying their child’s long-term ability to participate at all.

So what exactly does rest time mean for the youth baseball player?

Is taking a week off between fall ball ending and winter ball starting rest time? Is ending fall season and immediately starting pitching lessons and velocity programs considered resting?

Common phrases we hear from parents of baseball players during this time of year include, “My son will fall behind all the other kids,” “My son has to do the programs with the school or else he won’t make the team,” “The coaches want the team to be playing catch indoors to keep up their arm strength,” and of course my favorite, “My son is the best kid on the team and he needs to play.”

Why are these young athletes being pushed so much into this concept of year round playing and early specialization of sports? Why are camps, showcases and pitching lessons being pushed during the only rest time the kids get all year round? Are we as a community really concerned for the athletes wellbeing or are we interested in making money?

Fall season ends in late October for most organizations and preparation for spring ball starts 2 weeks later for most schools and travel teams. These young athletes need at least 2 months of consistent rest from baseball activities, which means no throwing of any kind and no hitting of any kind. Velocity programs are being emphasized more and targeting younger age groups. The fear of falling behind other athletes or pressure from coaches, travel teams and baseball experts to do lessons and showcases is dramatically increasing injury rates.

How does this affect the youth athlete? Too many pitches, too many games and no rest to recover causes injuries. Medical epicondyle avulsion fractures, UCL strain, UCL tears, labral tears, RTC tears equal significant reduction in the ability to make it to a collegiate or professional level. If a 10 year old has an avulsion fracture he has at most a 10% chance of making it to college baseball…that might be a generous statement.

Parents, athletes and coaches need to be educated to advocate for a reduction in year round sports. I advise all my athletes to rest for 2 months – no throwing and no hitting. I encourage them to play another sport and use this time to do a graduated weight program to rebuild strength and stamina. This allows the skeletally immature body to rebuild, grow and achieve strength back to baseline. Overhead athletes will loose range of motion and strength as the season progresses. This is a scientific fact.

Here are some other tips to give patients and parents to follow during this rest time:

1. Do not throw for 2 consecutive months for the 14-18 year olds, 3-4 months for the 10-13 year olds. Consider not playing fall baseball for the youth athletes.
2. Do not overhead press weights or bench press weight excessively – pectoralis muscles are nice to look at but it does nothing but cause problems for the overhead athlete. Focus on scapular stabilization and posterior shoulder muscles.
3. Work on lower extremity mobility and core and hip strength as part of your off season workouts.
4. Play another sport; it will keep the athlete well balanced.
5. Begin prep for spring season in January with a good arm maintenance program and a graduated throwing program.
6. Use a pyramid type throwing program starting at 30 feet and building over a month to 150/180 feet then begin a mound progression starting with 25 pitches at 50% effort to 60-70 pitches at 80% for another month. Game situations can begin with 1-2 innings and build towards 4-5 innings.
7. Find a good physical therapist that can do a throwers’ screen to outline areas of weakness that can be targeted during this rest time.

As a community, we need to educate each other on the risks of overuse in the overhead athlete. I am a big supporter of allowing these kids to rest and rebuild. I have many athletes that I will discharge from PT and give them a program to work on during their rest time and then resume PT to prep for spring season. We need to care about the extended health and safety of the athlete.

If you’re a PT, PTA or trainer who’d like like more guidance on working with overhead athletes, join me for our special course coming up in the following cities:

Boston, MA – March 10-11 – Advanced Concepts for the Overhead Athlete

Dallas, TX – April 8-9 – Advanced Concepts for the Overhead Athlete

Angela T. Gordon PT, DSc, MPT, COMT, OCS, ATC, FMS

Co-Owner Advanced Kinetics Physical Therapy and Sports Performance

Physical Therapist for the Washington Nationals Baseball Team

Board Certified Orthopedic Specialist

Certified Orthopedic Manual Therapist

Certified Athlete Trainer

References:

Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 200319(4):404–20.

Burkhart SS, Morgan CD, Kibler WB. The Disabled Throwing Shoulder: Spectrum of Pathology Part III: The SICK Scapula, Scapular Dyskinesis, the Kinetic Chain, and Rehabilitation. Arthroscopy. 2003;19(6):641–61.

Reinold MM, Wilk KE, Macrina LC, Sheheane C, Dun S, Fleisig GS., et al. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med. 2008;36(3):523–7.

Reinold MM, Wilk KE, Reed J, Crenshaw K, Andrews JR. Interval sport programs: guidelines for baseball, tennis, and golf. The Journal of orthopaedic and sports physical therapy. 2002;32(6):293–8.

Axe MJ, Snyder‐Mackler L, Konin JG, Strube MJ. Development of a distance‐based interval throwing program for Little League‐aged athletes. Am J Sports Med. 1996;24(5):594–602.

http://www.stopsportsinjuries.org/resources/coaches-curriculum-toolkit/overuse-injuries.aspx

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445080/