July 18--Mike DeCicco has felt pain in his arm nearly as long as he's played baseball. Sometimes it's intense. Other times it just feels sore.
He also has days when his arm feels good. Those days remind DeCicco what it was like to throw 100 pitches in a baseball game -- he threw that many in a state tournament game when he was 13.
Professional pitchers take days to recover from that high a pitch count. But back then, DeCicco would pick up a baseball the next day.
"I remember trying to throw the ball and my arm was just throbbing," said DeCicco, now 19. "I thought I was going to pass out."
DeCicco, of Northfield, is not alone. Children today play year-round sports at younger ages, never giving their still-growing bodies a chance to recover. Consequently, doctors regularly see younger patients with overuse injuries such as DeCicco's that they rarely saw 10 years ago.
The federal Centers for Disease Control and Prevention says more than half of all sports injuries in children are preventable, and overuse injuries are responsible for nearly half of all sports injuries to middle and high school students.
Some of the most common overuse problems are stress fractures; Osgood-Schlatter disease, a painful inflammation just below the knee; and Sever's disease, an injury to the heel's growth plate.
Baseball and softball players tend to receive the most doctor care due to the overwhelming elbow and shoulder issues they can develop. Twenty percent of children ages 8 to 12 have arm pain during a baseball season, the American Academy of Orthopaedic Surgeons reported in 2009. The number jumps to 45 percent in children ages 13 to 14.
Local doctors see similar trends and do not expect the situation to improve any time soon.
Dr. Arlene Goodman, a pediatric sports medicine specialist for the Children's Hospital of Philadelphia, has treated children as young as 6 for overuse injuries. Typically, overuse injuries begin around age 8 or 9 and usually run through puberty.
"It's easy to help fix the problem, but it's hard to capture patients before it develops," said Goodman, who has a practice in Hamilton Township.
Dr. Stephen Zabinski, the service chief of orthopaedics at Shore Memorial Hospital in Somers Point, said children are playing more sports year-round and are on more teams. They are not playing on just high school teams anymore, but travel teams and all-star teams as well, often with overlapping seasons.
"In children, the growing part is the weak part of the bone. That is the part that is most subject to overuse injuries," Zabinski said. "They are trying to play at a younger age in hopes of bringing up their skills they could use as they develop."
DeCicco played on three travel baseball teams during the summer, often pitching two or three days a week.
He would throw the ball as hard as he could -- no one ever told him not to. As long as DeCicco was getting people out, there was nothing wrong. But beyond throwing a lot, DeCicco also used poor mechanics. He also never told his parents he felt pain until it became unbearable when he was in high school.
Two MRIs and countless doctor visits later, DeCicco's diagnoses have always come back as either tendonitis or a strain in his flexor pronator, a tendon in the forearm. This injury has landed a few Philadelphia Phillies pitchers on the disabled list over the years.
"I'm trying to rehab my arm back," said DeCicco, who currently plays baseball for Atlantic Cape Community College and for Northfield in the Atlantic County Baseball League. "My arm couldn't really handle all the major stress."
In recent years, many youth leagues have instituted pitch limits and rest recommendations for pitchers ages 9 to 18. The pitch limits are one way of cutting down the risks of overuse injuries.
But pitch limits alone will not stop the problem. Immature bones, insufficient rest after an injury and poor training or conditioning contribute to overuse injuries among children, says Safe Kids USA, a nonprofit organization dedicated to eliminating preventable childhood injuries.
When these injuries happen, the patients usually require rest, or stopping all together until a young person's body can recover.
"We can't ask him to stop," said DeCicco's mother, Jane, 56, who works at Eastern Shore Physical Therapy in Linwood. "It's something he loves. You have to be smart enough to know when it's too painful. You have to decide if you are going to give it up or not. I never wanted to tell him to stop."
Even though DeCicco is rehabbing his arm and strengthening his core, Jane's biggest concern is not what's going to happen now. She thinks about his future and where her son will end up.
"I say to him, 'Mike what are you going to be like in your 30s?'" she said. "You see these professional athletes hobbling around like old men. That's my main concern."
Unfortunately, the pressures facing young children are bigger than that. Sports are seen as a gateway to college, a means of earning full or partial scholarships.
As children feel the burden of their parents' responsibilities, they sometimes do not want to stop playing, even in the face of injury.
"Getting that money may be the only way to get into an institution of higher learning they want to go to," Zabinski said. "I understand the motivation behind it, but I plead to parents: Look at professional athletes. They are protective of their bodies. They have seasons for playing and a season of rest and conditioning."
To avoid overuse injuries, Goodman recommends several practices: ensuring all muscles are worked and not just the ones needed for a specific sport, taking off at least one day a week and increasing flexibility.
She also said children should not do one sport year-round.
"Overuse can come from muscle fatigue," Goodman said. "These kids do two or three tournaments on a weekend, and as they get tired, they are more likely to sustain an injury. To counteract muscle fatigue, spend more time with strength and conditioning and less time doing sport-specific training."
For DeCicco, the days of starting pitching and constant throwing are gone, replaced by the lingering pain. He plays the infield now, with an occasional relief pitching appearance mixed in when he can.
"If I can go back, I wish I was taught the right way to throw," DeCicco said. "No one ever told me, 'You had to fix this.' I am not going to stop throwing either, until I literally can't throw anymore."
Contact Susan Lulgjuraj:
609-272-7187
SLulgjuraj@pressofac.com
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