When a Little League Injury Is a Major League Problem

The entire sports-watching world shared an eye-covering, gasp-inducing, nausea-prompting moment last week when Indiana Pacers All-Star Paul George suffered a brutal open fracture during a USA Basketball scrimmage. The endless looping replay of the incident on SportsCenter and YouTube (over 9 million views at the time of writing) has made it difficult to miss. If you have managed to do so, consider yourself fortunate.

This most recent catastrophic injury has probably been viewed more times in a mere 10 days than Joe Theismann's legendary hobbling at the hands of Lawrence Taylor. We pay attention to these injuries because they happen to big, supremely athletic men. These are men that earn millions of dollars; men that play on the most prominent stages of American sports; yet they are men that have fallen victim to freak accidents. It's hard not to watch a train wreck.

So while it's been a big week for armchair orthopedists, the prospect of a Paul-George-style injury shouldn't concern many weekend warriors, or even serious athletes. Sports related open fractures are exceedingly rare. The types of injuries that I'm concerned about are likely to be suffered by another breed of attention-grabbing international athlete that will be making headlines this August; those now playing in the Little League World Series. As heartwarming as their performances may be, the potential for life-impacting injury exists for every player on the diamond, and that's the problem that should really concern us.

I say this as a baseball fan, a sports medicine specialist, and a father of three budding athletes. I'm concerned, because aside from a growing, and appropriate focus on brain health, youth sports don't often attract headlines for the injuries that they risk. The truth is that they should. Take this fact: approximately 30 million American children and adolescents will play sports this year, and nearly two million of them will suffer an injury. Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students. For baseball players, 45 percent of kids age 13 and 14 will experience arm pain during the season. Even more disturbingly, since 2000 serious shoulder and elbow injuries, including Little League Elbow, have increased in frequency by 500 percent for baseball and softball players.

If parents are wondering why this is the case, look no further than our collective obsession with sporting excellence that seems to demand athletic specialization at ever younger ages. Kids as young as six and seven now routinely play one sport all year round, not just to the detriment of their experience (maybe they'd love fencing!), but increasingly at their physical peril. Yes, it's true that becoming good at a sport requires, diligence, practice, and continued dedication. But if you're so inclined to have your son or daughter dedicate season after season to a sport, remember this: professional athletes don't train year round at one sport. Neither should your budding Derek Jeter, Mia Hamm, Serena Williams, or Michael Phelps. Remember Manny Pacquiao hits the hardwood; Steve Nash takes to the soccer pitch, and Jameis Winston, last year's Heisman trophy winner, finds a home on the proverbial sandlot.

This focus by elite competitors on a multi sport athletic life isn't an accident, it's actually crucial to their athletic success. It keeps them healthy by removing strain from the muscle groups that their primary sports' demand, while strengthening muscle groups that don't get worked as much. The result is a better, and healthier, overall athlete.

Yes, repetitive stress is a concern for mature athletes as well, but it's a particular problem for younger ones. Sticking with our focus on baseball, and the aforementioned Little League Elbow, it's worth examining why this particular injury happens. At its heart, this is about age, and physiology. The injury occurs because the adolescent growth plate is weaker than the ligament, and throwing the baseball too hard, too often can cause serious injury that impedes future athletic performance. Frequently, it's the best athletes on the field that face the threat, and the reality is that the strain caused can hurt an athlete's prospect of continuing to compete. While there have been real strides in orthopedic surgery, as evidenced by Tommy John Surgery, a procedure that has allowed dozens of Major League pitchers to return to the mound from what would have previously been career ending injuries, the fact is that too many athletes have to stop playing sports that they love far too young.

So, when you're watching this summer's most compelling sporting event, where the passion is as real as it gets, (take that World Cup!), it's important to remember that these young athletes are playing a high stakes game at a very high level. Getting there is demanding, and it can also be damaging. Let's make sure that their path, and that of all of that follow them to Williamsport, is as safe as possible. That's likely to make it even more fun for all involved.