Kids' Baseball Injuries Down But Some Still Play "Until It Hurts"

At a recent baseball game, the 12-year-old second baseman on my son's team had a ground ball take a nasty hop, hitting him just next to his right eye. He was down on the field for several minutes and was later diagnosed at the hospital with a concussion.

Thankfully, acute baseball injuries like this are on the decline, according to a new report. However, several leading physicians say overuse injuries of young players caused by too much baseball show no signs of slowing down.

Our unlucky infielder's hospital injury report may become part of a national database called the National Electronic Injury Surveillance System (NEISS), part of the U.S. Consumer Product Safety Commission. It monitors 98 hospitals across the country for reports on all types of injuries.

Bradley Lawson, Dawn Comstock and Gary Smith of Ohio State University filtered this data to find just baseball-related injuries to kids under 18 from 1994-2006.

During that period, they found that more than 1.5 million young players were treated in hospital emergency rooms, with the most common injury being, you guessed it, being hit by the ball, and typically in the face.

The good news is that the annual number of baseball injuries has decreased by 24.9 percent over those 13 years. The researchers credit the decline to the increased use of protective equipment.

"Safety equipment such as age-appropriate breakaway bases, helmets with properly-fitted face shields, mouth guards and reduced-impact safety baseballs have all been shown to reduce injuries," Smith said. "As more youth leagues, coaches and parents ensure the use of these types of safety equipment in both practices and games, the number of baseball-related injuries should continue to decrease. Mouth guards, in particular, should be more widely used in youth baseball."

Their research is detailed in the latest edition of the journal Pediatrics.

The bad news is ...
 

While accident-related injuries are down, preventable injuries from overuse still seem to be a problem, according to author Mark Hyman. In his recent book, "Until It Hurts," Hyman admits his own mistakes in pressuring his 14-year-old son to continue pitching with a sore arm, causing further injury.

Surprised by his own unwillingness to listen to reason, Hyman, a long-time journalist, researched the growing trend of high-pressure parents pushing their young athletes too far, too fast.

"Many of the physicians I spoke with told me of a spike in overuse injuries they had witnessed," Hyman told Livescience. "As youth sports become increasingly competitive — climbing a ladder to elite teams, college scholarships, parental prestige and so on — children are engaging in a range of risky behaviors."

One expert he consulted was Dr. Lyle Micheli, founder of one of the country's first pediatric sports medicine clinics at Children's Hospital in Boston. Micheli estimates that 75 percent of the young patients he sees are suffering from some sort of overuse injury, versus 20 percent back in the 1990s.

"As a medical society, we've been pretty ineffective dealing with this," Micheli said. "Nothing seems to be working."

Young surgeries

In severe overuse cases for baseball pitchers, the end result may be ulnar collateral ligament surgery, better known as "Tommy John" surgery. Dr. James Andrews, known for performing this surgery on many professional players, has noticed an alarming trend in his practice. Andrews told The Oregonian last month that more than one-quarter of his 853 patients in the past six years were at the high school level or younger, including one 7-year-old.

Last spring, Andrews and his colleagues conducted a study comparing 95 high-school pitchers who required surgical repair of either their elbow or shoulder with 45 pitchers that did not suffer injury.

They found that those who pitched for more than eight months per year were 500 percent more likely to be injured, while those who pitched more than 80 pitches per game increased their injury risk by 400 percent.  Pitchers who continued pitching despite having arm fatigue were an incredible 3,600 percent more likely to do serious damage to their arm.

Hyman encourages parents to keep youth sports in perspective. "I think that, generally, parents view sports as a healthy and wholesome activity. That's a positive. But, we live in hyper-competitive culture, and parents like to see their kids competing," he said. "It's not only sports. It's ballet and violin and SAT scores and a host of other things.  It's in our DNA."

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NASCAR Fans Drive Faster

If you plan on watching your favorite NASCAR driver this weekend, you may want to have your designated driver take you home. Not only should he be sober, but he also should have no interest in motor sports.

According to Australian researchers, being a race fan makes you more likely to not only speed in your own car but also to see little wrong with it.

Several factors have been found to influence a driver's attitude towards speeding and aggressive driving, including age, gender and what psychologists call "sensation seeking propensity." This thrill-seeking behavior may also be a result of a driver's environment.

Paul Tranter and James Warn of the University of New South Wales wanted to see if following professional motor sports as a fan added to the need to be fast and furious.

Specifically, they considered whether social cognitive theory, made famous by American psychologist Albert Bandura, explained a fan's need to imitate their favorite drivers by pushing the limits on public roads.

In 2004, with illegal street racing becoming a problem on the streets of Sydney and Melbourne, Tranter and Warn focused on young drivers. In a survey of 180 males between the ages of 15 and 24, they measured interest in organized motor sports against attitudes towards safe driving and obeying traffic laws. Each driver's own violation history was also considered.

Results showed an interest in organized racing had a direct effect on not only involvement in illegal racing but also higher violations and riskier attitudes towards traffic laws. Maybe young fans figured that if Danica Patrick can maneuver a 650 horsepower beast around an oval track for a few hours, they should be able push their modified Civic to 100 mph.

Even though the researchers were careful to control for the sensation-seeking personality variable in their survey population, they still wanted to expand their study to older race fans to see if the same relationship held.

In their latest study, published in the journal Accident Analysis and Prevention, Tranter and Warn looked only at drivers 25 and older with at least 2 years driving experience. Insurance companies consider this age group a much safer population. A similar survey was distributed to residents of a small NSW town and asked for three things: their level of interest in motor sports; their attitudes toward speeding and traffic laws; and their own self-reported negative driving habits.

The strongest correlation in this group was between an interest in racing and a pro-speeding attitude. So, even among the safer, older group of fans, an intentional lead foot existed.

So, should we put restrictor plates on all cars? No, say Tranter and Warn, but maybe a more visible safety PR campaign to the masses may help.

"There remains a need to get the message out to the driving community that speed is linked to accidents, and that attitudes that condone speeding are a road safety problem," Tranter writes. He adds that another idea would be to shift a young driver's need for risk taking to other sports, (like downhill skiing or mountain biking) that have a more positive "thrill to bad outcome" ratio.

Then again, Tranter comments that the attraction expressed to him by street racers may just be, "'chicks and fast cars,' rather than a desire to engage in illegal activity."

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For Kids' Health, Just Let Them Play

As usual, your Mom was right. When she told you to get outside and play, she instinctively knew that would be good for you.

Health science researchers at the University of Exeter have found that kids' natural short bursts of play energy contribute just as much to a healthy lifestyle as longer bouts of organized exercise, such as gym class.
As of 2008, 32 percent of U.S. children were overweight or obese, as measured by their body mass index. While many organized programs have studied this epidemic, the prescription remains the same: less food, more exercise.

In fact, a previous health science study of 133 children found that the physical activity of the obese children over a three-week period was 35 prcent less during school days and 65 percent less on weekends compared to the children who were within accepted healthy weight norms.

In the new study, Michelle Stone and Roger Eston of Exeter's School of Sport and Health Sciences measured the activity level of 47 boys aged between 8 and 10 over seven days using an accelerometer strapped to each boy's hip (similar to the one inside your iPhone or Wii controller that senses motion).
The key was to find a model that would record the shortest bursts of energy, sometimes less than 2 seconds. As any boy's parents know, those spurts can happen all afternoon, whether it be chasing the dog, throwing rocks in the lake or climbing a tree.

The researchers also measured waist circumference, aerobic fitness and blood pressure of each boy. They found that even though their activity levels came in many short chunks, their health indicators were all in the normal range.

Stone explains their conclusion, "Our study suggests that physical activity is associated with health, irrespective of whether it is accumulated in short bursts or long bouts. Previous research has shown that children are more naturally inclined to engage in short bursts of running, jumping and playing with a ball, and do not tend to sustain bouts of exercise lasting five or more minutes. This is especially true for activities that are more vigorous in nature.

Their findings are in the April edition of the International Journal of Pediatric Obesity.

The researchers admit that more research is needed to measure long-term effects on health.  Establishing activity guidelines for parents and schools will help the kids plan time to move each day.

The National Football League has even started a program called NFL Play 60 that encourages kids to move for at least 60 minutes each day.  "Our players know the importance of staying healthy and it’s important that young fans also understand the value of exercise," said NFL Commissioner Roger Goodell. "Play 60 is an important tool in ensuring children get their necessary daily physical activity as recommended by health and fitness experts."

So, more recess and less physical education in our schools? Maybe, according to Stone, "If future research backs up our findings, we would do better to encourage young children to do what they do naturally, rather than trying to enforce long exercise sessions on them. This could be a useful way of improving enjoyment and sustainability of healthy physical activity levels in childhood."

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Your Heart Can Warn You Of Future Attacks

Many people exercise to improve the health of their hearts. Now, researchers have found a link between your heart rate just before and during exercise and your chances of a future heart attack.
Just the thought of exercise raises your heart rate. The new study shows that how much it goes up is related to the odds of you eventually dying of a heart attack.

More than 300,000 people die each year from sudden cardiac arrest in the U.S., often with no known risk factors. Being able to find early warning signs has been the goal of researchers like Professor Xavier Jouven, of the Hopital Européen Georges Pompidou in Paris.

Jouven's team has been examining data from a study of 7,746 French men employed by the Paris Civil Service and given health examinations between 1967-1972, including exercise tests, electrocardiograms and heart rate measurements. Over an average 23-year follow-up, 83 eventually died of heart attacks, also known as sudden cardiac death (SCD).

In 2005, Jouven's team first showed that how a heart behaves before, during and after exercise could predict future problems. The risk of a future heart attack was about four times higher than normal in men whose resting hearts beat faster than 75 beats per minute (bpm) or did not speed up by more than 89 beats during exercise. Likewise, heart attacks were twice as likely in men whose heart rates didn't slow down more than 25 beats in the first minute after exercise stopped.

Just a thought
In the latest study, published last week in the European Heart Journal, the French researchers found another interesting clue in the same data set. Not only was the resting heart rate of each person taken, but also another reading right before they were to start a strenuous exercise bike test. This rate is affected by what they called "mild mental stress." It measures the body's physiological anticipation of exercise.

Think of this type of stress as the brain's warning to the body that some difficult, sweaty work is about to begin. It is normal for this rate to be slightly higher than the resting rate, but for some it is significantly higher.

The men who had the highest increase in heart rate during this period (increasing by more than 12 beats a minute) had twice the risk of eventual future sudden cardiac death compared to men who had the lowest increase in heart rate (an increase of less than four beats a minute).

So, the high-risk heart overreacts to the anticipation of exercise, and then does not respond to the full extent needed during exercise. Afterwards, it does not regulate itself down fast enough.

What's going on
Jouven hypothesized that the autonomic nervous system (ANS), the body's internal control governor, must be out of whack.

The ANS has two parts, the sympathetic and the parasympathetic. Joeven suggests we think of the sympathetic system as the accelerator that turns up our response to exercise by increasing our heart rate. Putting the brakes on this acceleration are the vagus nerves, part of the parasympathetic system, preventing our heart from running out of control.

"There is a balance between the accelerator (sympathetic activation) and the brake (vagus nerve activation)," Jouven explains. "During an ischemic episode, when blood flow to the heart is reduced, sympathetic activation occurs to counteract it. However, if there is no protection by the vagal tone (the brake), the activation can become uncontrolled and then it becomes dangerous."

Finding this connection between heart rate and future heart problems is encouraging for future research, according to Jouven.

"These findings may carry significant clinical implications," he said. "Few measurements in medicine are as inexpensive and as easy to obtain in large general populations as to measure the heart rate difference between resting and being ready to perform an exercise test. The results will contribute towards a better understanding of the mechanisms of cardiac death."

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Thoroughbred Horse Injuries Rise But Race Times Stay Flat

Imagine trying to walk on all fours using just your big toes and your middle fingers. That is similar to what modern thoroughbred racehorses endure when racing around a track at up to 30 mph.

This weekend's Belmont Stakes will be missing one of this year's stars, Rachel Alexandra, on the precaution that she needs to rest.  Just before last month's Kentucky Derby, three top contenders, Quality Road, I Want Revenge and Square Eddie were forced out of the race due to hoof and shin injuries.

Critics claim selective breeding may be producing an unstable horse anatomy that is prone to injury. Yet, a recent study claims that it all may be for naught, as thoroughbreds may have already reached their theoretical upper limits of speed.

Running on their toes
One of out ten thoroughbreds will suffer from some orthopedic problem, including fractures, which often lead to decisions to destroy them. In the United States, for every 1,000 horses starting a race, there will be 1.5 career-ending injuries, which is almost two per day.

By breeding for speed and power, the bulk of the horse increases while the ankles and lower legs do not,according to some veterinarians.

"Anatomically speaking, they run on their toes," said Lawrence R. Soma, professor at the University of Pennsylvania School of Veterinary Medicine. "That makes them very fragile."

The pounds per square inch load that is put on their hoofs would be similar to humans walking on their middle fingers, experts say. One misstep on a soft patch of the turf can cause a break.

So they're faster, right?
Given the large sums of money spent on breeding champion racehorses and the potential health side effects, is it worth it? Are the race times getting faster thanks to these selective genetic performance filters?  The answer is no, according to Mark Denny, Professor of Biology at Stanford University.

In a recent study published in the Journal of Experimental Biology, Denny analyzed the race time records for the three U.S. Triple Crown races; the Kentucky Derby, the Preakness Stakes, and the Belmont Stakes. The plateau for similar times for the Kentucky Derby began in 1949, while the Preakness and the Belmont set their plateaus in 1971 and 1973, respectively, Denny found.

"Evidence from the Triple Crown races suggests that the process of selective breeding of thoroughbreds (as practiced in the US) is incapable of producing a substantially faster horse," Denny writes. "Despite the efforts of the breeders, speeds are not increasing, and current attempts to breed faster horses may instead be producing horses that are more fragile."

The solution
Denny also tried to predict the fastest possible time for these horses. Using statistical modeling, he found that the maximum speed of a thoroughbred would be only 0.5 to 1 percent faster than seen today.

"These results suggest that definite speed limits do indeed exist for horses and that their current speeds are very close to these predicted limits," Denny said.

One reason for the limit may be the gene pool. Today's thoroughbreds descend from a lineage of only 12-29 ancestors, with 95 percent of today's thoroughbreds tracing their paternal roots to a single stallion, The Darley Arabian.

Denny suggests that breeding from outside this line might produce the potential for improvement.

Please visit my other sports science articles at Livescience.com.