I helped to moderate a STOP Sports Injuries tweetchat April 10, 2013. Since April is Youth Sports Safety Month, we discussed injuries in youth baseball and softball. The post below is a summary of that discussion.

For those of you unfamiliar with tweetchats, people answer questions posed by the moderator and comment on other tweets using the hashtag specified – in this case #SportsSafety. It often starts slowly, but it can become difficult to follow when many people get involved and respond to many different questions and comments. This month’s chat was especially lively with tweets from great minds all over the world!

If you enjoy fast-paced discussions about important sports medicine, healthcare, and social media topics, join us for future #SportsSafety tweetchats. We usually hold these chats on the first Wednesday of each month. The next #SportsSafety tweetchat will take place on Wednesday, April 24 at 8 PM ET.

STOP Sports InjuriesSTOP Sports Injuries ‏@SportsSafety
Getting ready to begin chatting about #baseball and #softball injury prevention. Join us with your tweets! #SportsSafety

STOP Sports Injuries ‏@SportsSafety
Remember for tonight’s chat to include the #SportsSafety tag with tweets. We will go through a Q&A format during the hour.

STOP Sports Injuries ‏@SportsSafety
Tonight @DrDavidGeier – from @MUSChealth will be joining us as well. Let’s get started on baseball and softball #SportsSafety!

STOP Sports Injuries ‏@SportsSafety
Q1: What can baseball/softball players do in practice and games to prevent injuries and have an overall healthy season? #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@SportsSafety Hey everyone! #SportsSafety

Chuck ‏@HammerSwinger
@SportsSafety What material bats should we use tee ball program. Very mindful of injuries, esp with bats. #SportsSafety

Carrie Boan ‏@carrie_boan
A1: Encourage warm-ups and stretching in practice and games. lots of coaches have gotten away from this #SportsSafety

STOP Sports Injuries ‏@SportsSafety
#SportsSafety MT @ChasePaulson ‏ limited pitch count, rotate positions, proper warm-ups with bands, proper technique from coaches.

Dr. David Geier ‏@DrDavidGeier
Q1: Huge % of youth baseball injuries are caused by or related to overuse. Efforts to limit too much pitching esp are a start #SportsSafety

STOP Sports Injuries ‏@SportsSafety
RT ‏@carrie_boan A1: Encourage warm-ups and stretching in practice and games. lots of coaches have gotten away from this #SportsSafety

Aaron Gray, M.D. ‏@MizzouSportsDoc
Follow the #SportsSafety hashtag for the tweetchat tonight about youth baseball/softball injury prevention (@SportsSafety)

Brad Morgan MEd AT ‏@PirateATC
#SportsSafety Follow pitch counts, and don’t place your pitchers in other “long throw” positions on off days. (Not C, 3rd, SS)

SportsMedCenter ‏@SportsMedCenter
Follow the #SportsSafety hashtag for the tweetchat tonight about youth baseball/softball injury prevention (@SportsSafety)

Dr. David Geier ‏@DrDavidGeier
@SportsSafety @carrie_boan How can we get players to stretch? Do we teach coaches exercises & have them get kids to do it? #SportsSafety

Carrie Boan ‏@carrie_boan
@DrDavidGeier @SportsSafety I teach my young athletes in the clinic, also encourage thier coaches to get ideas from coaching clinics

Brad Morgan MEd AT ‏@PirateATC
@DrDavidGeier @carrie_boan Baseball has an attitude, at least locally to me, that parents “know what they are doing and don’t need help.”

STOP Sports Injuries ‏@SportsSafety
RT @PirateATC #SportsSafety Follow pitch counts, and don’t place your pitchers in other “long throw” positions on off days. (Not C, 3rd, SS)

Aaron Gray, M.D. ‏@MizzouSportsDoc
A1: Pitchers should gradually build arm strength in preseason by long toss & focusing on good pitching mechanics. #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@PirateATC Guidelines don’t even count throws at other positions or advise against them. But agree that they still take toll #SportsSafety

JfitGirl ‏@JFitGirl
@MizzouSportsDoc @sportssafety #SportsSafety
Excellent learning resource for students too! We need to stay on top of focusing on prevention.

Aaron Gray, M.D. ‏@MizzouSportsDoc
A1: Avoid pitching in preseason “showcases” where kids often overthrow to try impress the radar gun #SportsSafety

Brad Morgan MEd AT ‏@PirateATC
#SportsSafety Far too many volunteer parents have no idea what good throwing technique is or how to teach it.

STOP Sports Injuries ‏@SportsSafety
@JFitGirl Thanks for joining tonight! #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@MizzouSportsDoc So true! Parents and coaches push these kids to these showcases, and they seem to have huge risk of injury #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@MizzouSportsDoc Many of these pitchers, esp good ones, don’t have a preseason to prepare. They pitch every season of the year #SportsSafety

Aaron Gray, M.D. ‏@MizzouSportsDoc
@DrDavidGeier had a youth softball player throwing 400 pitches per week in offseason and now w/ arm pain before season even starts!

SportsMedCenter ‏@SportsMedCenter
PRE for UE/LE strength in addition to biomechanics is a MUST, but research does NOT support the use of long toss (in pitchers) #SportsSafety

JfitGirl ‏@JFitGirl
@SportsSafety Thank you for another great chat! #SportsSafety

STOP Sports Injuries ‏@SportsSafety
Seems pitch counts are a popular topic tonight. Q2: Do leagues/orgs in your area use them for players – and to what effect? #SportsSafety

Agency4StudentHealth ‏@TheA4SHR
Should we not allow kids to play sports unless they pass a base level of physical performance? (FMS, baseline testing, echo) #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@carrie_boan That’s great! Gets to what Brad was saying about coaches. How do we teach warmups, technique properly? #SportsSafety

Carrie Boan ‏@carrie_boan
@DrDavidGeier education for coaches @ STOP Sports Injuries events is one idea; we provided good local resources for coaches to turn to

Carrie Boan ‏@carrie_boan
#SportsSafety parents/coaches underestimate “they can’t injure muscles or bones – they’re just kids!” Education is desperately needed

Dr. David Geier ‏@DrDavidGeier
@TheA4SHR Should we let people coach youth baseball w/o demonstrating knowledge of injury prevention, pitch mechanics, etc? #SportsSafety

Little League International has placed a ban on some composite bats in youth baseball.
STOP Sports Injuries ‏@SportsSafety
In addition to Q2 – @HammerSwinger asks about the materials used in bats for young ball players. How do you address? #SportsSafety

STOP Sports Injuries ‏@SportsSafety
Anyone else? #SportsSafety RT @PirateATC @SportsSafety Our community is little league affiliated and follows their rules for pitch counts.

Dr. David Geier ‏@DrDavidGeier
@carrie_boan Yes! And these kids don’t have the muscle strength to withstand the forces on their growing bones over and over. #SportsSafety

Agency4StudentHealth ‏@TheA4SHR
@DrDavidGeier Best of both worlds and require both? Seems like both coaches and players should pass entry requirements. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
@carrie_boan @DrDavidGeier That’s great – and glad the resources were helpful to the group. #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@SportsSafety @PirateATC Many use # of batters faced for ease of monitoring. Anyone feel strongly – pitch v batter v inning? #SportsSafety

Brad Morgan MEd AT ‏@PirateATC
@DrDavidGeier @sportssafety I don’t mind batters faced, but that needs to be more flexible. Days w/ more pitches/ batter= fewer batters.

Bobby Weisenberger ‏@BWW_ATC
@DrDavidGeier @SportsSafety @PirateATC I think overall pitch count is important. Could throw extra pitches to single batter

Agency4StudentHealth ‏@TheA4SHR
@PirateATC @drdavidgeier @carrie_boan Same culture in football on how tackling is taught. Education should never stop. #SportsSafety

Agency4StudentHealth ‏@TheA4SHR
@DrDavidGeier creating a system of education and certification is the biggest obstacle. #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@TheA4SHR I have wondered when the coaching certifications will be required – for many youth sports… #SportsSafety

Agency4StudentHealth ‏@TheA4SHR
@DrDavidGeier @sportssafety @pirateatc Some batters get 1 pitch while others get 12. Probably not the best method of inj prev #SportsSafety

Russ Barker ‏@russjbarker
@DrDavidGeier @TheA4SHR I’d like to see leagues/assoc require certification for coaches. Also like to see screenings offered upon signup.

Dr. David Geier ‏@DrDavidGeier
@TheA4SHR @PirateATC @carrie_boan You read my mind. Require tests for proper tackling technique, signs of concussions, etc? #SportsSafety

Carrie Boan ‏@carrie_boan
Q2: our little league follows pitch count, but travelball, middle, high schools have no rules. I’m pushing education in area #SportsSafety

Brad Morgan MEd AT ‏@PirateATC
@TheA4SHR @drdavidgeier @carrie_boan But then how will you get people to volunteer to coach? We are a small community and already struggle.

Concerned Mom ‏@ConcernedMom9
@PirateATC @TheA4SHR @DrDavidGeier @carrie_boan That fear was expressed when I discussed requiring CDC training for our soccer coaches …

Brad Morgan MEd AT ‏@PirateATC
@ConcernedMom9 @thea4shr @drdavidgeier @carrie_boan Ohio law permits only NFHSLearn or CDC course.

Concerned Mom ‏@ConcernedMom9
@PirateATC @TheA4SHR @DrDavidGeier @carrie_boan In my state, concussion training/info is only required at the high school level

Agency4StudentHealth ‏@TheA4SHR
@DrDavidGeier @pirateatc @carrie_boan Like a whole semester of education and prehab training. Working on that in CA now #SportsSafety

Youth PitcherSTOP Sports Injuries ‏@SportsSafety
MT @BWW_ATC @DrDavidGeier @PirateATC I think overall pitch count is important. Could throw extra pitches to single batter #sportssafety

Carrie Boan ‏@carrie_boan
@TheA4SHR @PirateATC @DrDavidGeier mandatory testing for sure, concussion and proper tackling def issue in youth football #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@SportsSafety @BWW_ATC @PirateATC And what about innings over course of year? Playing for different teams, so who monitors? #SportsSafety

Bobby Weisenberger ‏@BWW_ATC
@DrDavidGeier @SportsSafety @PirateATC In most cases the coaches know where their players are playing. Need cross communication #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@TheA4SHR Ideally I agree with you. Logistically who administers these certification programs? And who pays for them? #SportsSafety

Russ Barker ‏@russjbarker
Based on our 3D pitching data from several states, kids (esp 12-15 yo) aren’t prep’d to handle even the recomm pitch counts. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
A number of challenges posed discussing player safety but we will continue to Q3. Feel free to continue those convos! #SportsSafety

STOP Sports Injuries ‏@SportsSafety
Q3: How can baseball and softball players avoid burnout with different leagues, travel teams, etc? Can they safely balance? #SportsSafety

Carrie Boan ‏@carrie_boan
@DrDavidGeier @SportsSafety @BWW_ATC @PirateATC ultimately parents are responsible, education and examples are my only weapons #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@SportsSafety Parents always tell me kids really want to play on all these teams year round, but will an 8 yo really say no? #SportsSafety

Rachel Blakeman ‏@RachelATC
@DrDavidGeier @SportsSafety My ? to the parents would be why are they not being parents & setting the limits, rather than letting kids do so

Brad Morgan MEd AT ‏@PirateATC
@DrDavidGeier @sportssafety I have already told my kids they will do various sports throughout the year. NO SPECIALIZATION.

Jeremy Jackson ‏@PHSSportsMed
@PirateATC @DrDavidGeier @SportsSafety mine are 2 and under but I am totally with you. Let them be kids.

Jeremy Jackson ‏@PHSSportsMed
@DrDavidGeier @PirateATC Jv pitcher also plays catcher. Give the kid a break

Dr. David Geier ‏@DrDavidGeier
@carrie_boan @SportsSafety @BWW_ATC @PirateATC Sadly it’s true. We can educate as much as we can & hope they make good choices #SportsSafety

STOP Sports Injuries ‏@SportsSafety
MT @BWW_ATC All players need an offseason from their sport. Cross train or participate in other activities to keep fitness #sportssafety

Carrie Boan ‏@carrie_boan
@DrDavidGeier @SportsSafety kids will say what they think people want to hear; kids play too much too soon; abuse an issue too #SportsSafety

STOP Sports Injuries ‏@SportsSafety
MT @DrDavidGeier Parents tell me kids really want to play on all these teams year round, but will an 8 yo really say no? #SportsSafety

STOP Sports Injuries ‏@SportsSafety
#SportsSafety RT @PirateATC @DrDavidGeier I have already told my kids they will do various sports throughout the year. NO SPECIALIZATION.

Dr. Ray Solano ‏@DrRaySolano
@SportsSafety Q3: Difficult to do throughout the year w/o taking time off. Suggest varying positions in hopes it eases stress #SportsSafety

STOP Sports Injuries ‏@SportsSafety
#SportsSafety MT @ChasePaulson need to take time to cross train/de-stress from yr round play. Be a kid every now & then.

Dr. David Geier ‏@DrDavidGeier
@PirateATC But then you hear argument that they will fall behind other kids & lose chance at college scholarship, pro contract #SportsSafety

STOP Sports Injuries ‏@SportsSafety
MT @DrRaySolano Q3 Difficult to do throughout the year w/o taking time off. Suggest varying positions in hopes it eases stress #SportsSafety

SportsMedCenter ‏@SportsMedCenter
RT @BWW_ATC Coudn’t agree more! Personal experience and studies show multi-sport participation decreases risk of injury #sportssafety

Carrie Boan ‏@carrie_boan
Q3: difficult to avoid burnout since most coaches/parents expect unrealistic perfection lots of times. I see it too much #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@DrRaySolano @SportsSafety Agree! Ignoring physical toll, stress of year-round sport plus school will affect these kids #SportsSafety

Russ Barker ‏@russjbarker
@SportsSafety @ChasePaulson Parents feel psi to specialize to remain on the best teams. Youth sports becoming professionalized.#SportsSafety

STOP Sports Injuries ‏@SportsSafety
#SportsSafety MT @RachelATC My ? to the parents would be why are they not being parents & setting the limits, rather than letting kids do so

Youth pitcher and dadSteven Kleinman ‏@StevenRKleinman
#sportssafety parents should be biggest advocate for child safety no matter cost….pro contract or scholarship…keep kids healthy

STOP Sports Injuries ‏@SportsSafety
Some great responses tonight everyone. We will close with one final question and remind everyone to use the #SportsSafety tag!

Carrie Boan ‏@carrie_boan
@DrDavidGeier @PirateATC overuse injury, surgery best way to make scouts run in opposite direction #SportsSafety

Bobby Weisenberger ‏@BWW_ATC
@carrie_boan @DrDavidGeier @PirateATC I work with Pro team and while not baseball, can tell you we don’t take risk with players. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
Q4: How can you get young players (pitchers or otherwise) to tell you they are injured or hurting? Tips? #SportsSafety

Aaron Gray, M.D. ‏@MizzouSportsDoc
@SportsSafety A:4 Palpate firmly and watch their face #SportsSafety

Michael Duplantis ‏@mduplantispt
“@MizzouSportsDoc: A1: Avoid pitching in preseason “showcases” where kids often overthrow to try impress the radar gun #SportsSafety So true

Brad Morgan MEd AT ‏@PirateATC
#SportsSafety Q4: After nearly 20 years, I still have yet to figure this out. Every kid is different. You need to get their trust first.

Steven Kleinman ‏@StevenRKleinman
#sportssafety kids are afraid to tell cause they don’t want to lose position or rank, don’t hold that against child due to injury

Brad Morgan MEd AT ‏@PirateATC
#SportsSafety Q4: Gaining their trust can be next to impossible with parents that have other goals in mind.

Dr. David Geier ‏@DrDavidGeier
@StevenRKleinman College/pro argument nonsense. Don’t earn those at 8-10 yo. Marathon, not sprint. Stay healthy, earn it in HS #SportsSafety

Aaron Gray, M.D. ‏@MizzouSportsDoc
I would encourage parents/coaches to talk to kids about serious injury costing them season (Little Leaguer’s shoulder/elbow) #SportsSafety

Agency4StudentHealth ‏@TheA4SHR
Stress communication and review process of recovery before injuries occur, so they know what to expect. #sportssafety

Dr. Ray Solano ‏@DrRaySolano
@SportsSafety Q4: Get the parents on ‘your’ side. They are around the athletes more and can be a valuable extra set of eyes. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
RT @TheA4SHR Stress communication and review process of recovery before injuries occur, so they know what to expect. #sportssafety

Steven Iorio_ATC ‏@SIorio_ATC
@SportsSafety #SportsSafety Explain to them the importance of being honest, playing in the future may not be there without the truth now

Steven Kleinman ‏@StevenRKleinman
@DrDavidGeier #sportssafety most parents don’t think logically, not for marathon…it’s all about rank, standing, status.

jb humphrey ‏@PT_ATC_CSCS
@SportsSafety Q4: Build trust, teach good boundaries, and let him/her acknowledge their likely dwindling sport performance.
#sportsSafety

Carrie Boan ‏@carrie_boan
Q4: reassurance they’ll be taken seriously; early intervention = possible sooner return to play? this is most difficult issue #Sportssafety

Michael Keating ‏@KeatingSports
@SportsSafety How do you get a professional athlete to tell you? Now we have NFL lawsuits #sportssafety

Bobby Weisenberger ‏@BWW_ATC
@DrDavidGeier @KeatingSports @SportsSafety I drill mine with “better to miss one game than multiple games” Better for the team.

Dr. David Geier ‏@DrDavidGeier
@StevenRKleinman Steve, that is so true. Kids don’t want to let down parents, coaches, teammates #SportsSafety

Aaron Gray, M.D. ‏@MizzouSportsDoc
Coaches/Parents of pitchers should make sure they are pain free before and after each pitching game/practice/lesson #SportsSafety

Steven Iorio_ATC ‏@SIorio_ATC
“@PirateATC: #SportsSafety Q4: Gaining their trust can be next to impossible with parents that have other goals in mind.” #Truth

Dr. David Geier ‏@DrDavidGeier
@KeatingSports @SportsSafety Great point. Athlete honesty about symptoms is an issue at every level of sports. Ideas? #SportsSafety

Steven Kleinman ‏@StevenRKleinman
@DrDavidGeier #sportssafety we were all athletes, we all get it, probably why we all advocate so strongly for more control of youth sports

Russ Barker ‏@russjbarker
99% of kids we test w/ 3D have funcl weakness, don’t use lower body effectively & haven’t learned coord patterns reqd. #SportsSafety

Brad Morgan MEd AT ‏@PirateATC
#SportsSafety Parents, having grown up with “no pain, no gain” their whole lives fail to see what pain is. A warning sign of a problem.

Dr. David Geier ‏@DrDavidGeier
@StevenRKleinman Yes. And all of us here deal with the injuries that occur. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
Great night of discussion, everyone! As we hit the top the hour, feel free to keep those tweets coming. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
We also want to remind you that April is Youth Sports Safety Month. The tag #YSSM2013 is great to keep the conversation going. #SportsSafety

Baseball pitcherDr. David Geier ‏@DrDavidGeier
@MizzouSportsDoc Problem w that is that injury won’t manifest right away, maybe for years. But will eventually cause one #SportsSafety

Dr. Ray Solano ‏@DrRaySolano
@SportsSafety Thank you for hosting a very important and insightful discussion ! #SportsSafety

Aaron Gray, M.D. ‏@MizzouSportsDoc
@SportsSafety I’ve found some parents who didn’t realize the dangers of year round pitching and high pitch counts #SportsSafety

JfitGirl ‏@JFitGirl
@PirateATC “No pain, No gain” gets me fired up! I hear/see it even in younger people. They get a mini lecture on pain. #SportsSafety

Russ Barker ‏@russjbarker
@MizzouSportsDoc Hard for kids to desc type of pain..parents/coaches shld be educ how to ask. Lesson from own son’s injry. #SportsSafety

STOP Sports Injuries ‏@SportsSafety
We also have some resources to help promote #YSSM2013 in your community: http://www.stopsportsinjuries.org/sports-safety-month.aspx … #SportsSafety

STOP Sports Injuries ‏@SportsSafety
@DrRaySolano Thanks so much for participating! Hope to see you April 24th for our next chat. #SportsSafety

Michael Keating ‏@KeatingSports
@DrDavidGeier @sportssafety Very challenging issue. Peer pressure works great. Teammates taking care of Teammates. #SportsSafety

JfitGirl ‏@JFitGirl
@SportsSafety Thank you!! Another super informative chat! I learn so much from these. #SportsSafety #Prevention #Education

Steven Kleinman ‏@StevenRKleinman
@JFitGirl #sportssafety no pain, no gain 30-99yr olds in therapy all have that old school attitude, bad habit to break but must try

Aaron Gray, M.D. ‏@MizzouSportsDoc
It is always bad sign as a doctor, when you ask a young pitcher if their arm hurts and they look at their parent before asking #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@JFitGirl @SportsSafety Thanks for joining! Love all the great ideas! #SportsSafety

STOP Sports Injuries ‏@SportsSafety
@DrDavidGeier @JFitGirl Agreed! Our participants make these chats possible. #SportsSafety

Dr. David Geier ‏@DrDavidGeier
@SportsSafety I have to call it a night. Thanks everyone! Join us again in 2 weeks for another one for #YSSM2013 #SportsSafety

JfitGirl ‏@JFitGirl
@StevenRKleinman Absolutely!! Important to know the differences in pain/aches/soreness…onset/prior activity/duration…etc. #SportsSafety

Russ Barker ‏@russjbarker
@MizzouSportsDoc @SportsSafety Parents grasp for anyone telling them it will b ok & their kid is ok to play. #SportsSafety

JfitGirl ‏@JFitGirl
“@DrDavidGeier: @JFitGirl @SportsSafety Thanks for joining! Love all the great ideas! #SportsSafety

THANK YOU! Keep up the great efforts!

Bobby Weisenberger ‏@BWW_ATC
@TheA4SHR @SportsSafety Ultimately I would like them to take a whole season off to participate in other activities. few months #sportssafety

Bobby Weisenberger ‏@BWW_ATC
@russjbarker @MizzouSportsDoc @SportsSafety Agreed. Seen several cases of “Dr. Shopping”. They will find someone to clear them #sportssafety

Carrie Boan ‏@carrie_boan
@BWW_ATC @russjbarker @MizzouSportsDoc @SportsSafety yes, some medical professionals not totally honest with players/parents.#SportsSafety

Bobby Weisenberger ‏@BWW_ATC
@carrie_boan @russjbarker @MizzouSportsDoc @SportsSafety Story also changes Dr to Dr.They know what to say to get kids cleared #sportssafety

Gadino ‏@LincolnTrainer
“@PirateATC: #SportsSafety Far too many volunteer parents have no idea what good throwing technique is or how to teach it. And coaches

Sports Dad Hub ‏@SportsDadHub
@DrDavidGeier @sportssafety Will try to make the next #SportsSafety chat! Sorry I missed tonight’s.

Remember to join us for the #SportsSafety tweetchats! If you are interested, follow me on Twitter and follow STOP Sports Injuries as well!