Q: Both my 7- and 9-year-olds love baseball and will be playing a lot of little league this summer. Are there any special precautions we should take?
A: In general, playing little league baseball is quite safe. Although about 2 percent to 8 percent of players do get injured during a season, most of these injuries are minor ones to the soft tissues of the body. "Little League elbow," which was fairly common in the 1960s and 1970s, has become much less so with changes in pitching rules. These include using a coach as pitcher for children under 10 and limiting pitchers 10 and above to a maximum of six innings of pitching per week with mandatory rest periods between games. Teaching pitchers the correct way to throw is also important. Sliding into a base is a common cause of injury to the leg, but this can be minimized by using breakaway bases or by not anchoring the bases at all.
Most concerns center on direct injuries to the head (including the eye) or chest of young players. Children between the ages of 5 to 14 have the highest incidence of such injuries. Recently, the American Academy of Pediatrics (AAP) issued a policy statement on injuries from participation in baseball or softball. Besides the recommendations cited above, the AAP suggests the following for players 5 to 14:
* Use of batting helmets, especially those with polycarbonate face guards that meet standard F910 of the American Society for Testing and Materials. These face guards cover from the tip of the nose to below the chin. Such face guards are mandatory for functionally one-eyed athletes (those whose best corrected vision in the worst eye is less than 20/50 or with previous eye trauma or surgery). These children should also wear polycarbonate sports goggles when fielding.
* Use of the catcher's helmet, mask, chest and neck protectors.
* Use of rubber shoe spikes if spikes must be used.
* Consideration of using low-impact baseballs and softballs (especially for children under age 10) that meet standards of the National Operating Committee on Standards for Athletic Equipment (NOCSAE). Studies evaluating these low-impact balls are under way, so it is too soon to say whether this approach will be of benefit.
* Not having an on-deck circle and making sure dugouts and benches are properly screened.
* Not sliding into base head-first (for children under 10).
Baseball games should be lots of fun for all who participate. Following these simple rules will help to assure that you and your children spend your time at the field and not in the emergency room.
Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.