Keeping Kids Safe On & Off the Baseball Field

With baseball season now upon us, there is a lot of excitement for young ballplayers. Just like winning takes a full team effort, baseball safety needs players, coaches, officials, and families all working together to keep kids safe. 

Baseball is still part of my family’s activities, having played adult coed softball on an Irvine team for years.  Those of us who were doctors and nurses doubled as the team “medics,” tending to the various injuries of both teams.

For other baseball families, the first step is preparing for the season. Then as coaches, parents and even observers we should all be prepared to recognize and respond to injuries. 

Recently, I checked in with Dr. Chris Koutures — a pediatrician and sports medicine specialist — to find out what Irvine parents should know to keep their kids safe on and off the baseball field.

Below are Dr. Koutures’ recommendations.

BASEBALL SAFETY: BEFORE TAKING THE FIELD

Before children step on the field, some important preparation can help coaches better understand and serve their athletes.

• Kids with medical issues (asthma, diabetes, sting allergies) can best participate when they have action plans developed by medical providers that list key medications and how to respond to emergencies. Make sure that both the action plan and medications are at all games/practices and can be easily found and put into use.
• Encourage parents and coaches to learn basic first aid and Cardiopulmonary Resuscitation (CPR)/Automatic External Defibrillator (AED). First aid is more likely to be used on-field with players, while CPR might be more needed for spectators (grandparents) or even in non-sports situations. Although rare, a direct impact to the chest from a batted ball can cause the heart to stop. If that happens, having an AED on site can be life-saving. Adding training in “Stop The Bleed” (compression and potential use of tourniquets in cases of severe bleeding) is also part of being prepared. 
• Stock (and restock) first aid kits with items such as gloves, gauze pads, and bandages. The kits should always be readily accessible to coaches and team parents.
• Before every practice or game, check the infield for any rocks or holes that could cause injury when a hard-hit ball takes a “bad hop.” Inspect fences for any sharp edges. Make sure to tell players about any lack of warning tracks when going for deep flies or foul balls.

BASEBALL SAFETY: RESPONDING TO AN INJURY

While you hope that injuries won’t happen, it is best to have a plan in place that covers:

• Who will evaluate the injured player and who will stay with the rest of the players?
• Who brings the first aid kit and who will be calling the family if they are not at the ballpark?
• If a 911 call is needed, who will make the call and who goes into the parking lot to guide the medics to the field?
• Which league officials need to be notified and what paperwork needs to be filled out?
• Who will stop a nosebleed from a bad hop or find a chipped tooth from a collision at first base?

BASEBALL SAFETY: BALL AND BAT CONTROL

There is not a more terrifying sight than multiple kids swinging bats in the dugout or several balls coming to the coach who just yelled “balls in.” All players and coaches must be aware of swinging bats and flying balls and know how many balls are live on the field.

Coaches should teach kids:

• To make sure the targeted player is ready before throwing the ball.
• Only one player should be swinging a bat at any time. This means no swinging of bats in the dugout or on-deck circle in lower-level baseball.

Parents and coaches should exercise close supervision with bat use in and around batting cages.

To further protect players:

• Batting helmets should be required for any kid swinging a bat, running bases, or base coaching.
• To protect themselves, base coaches should not hesitate to move toward the dugout or down the foul line. This is especially important if a strong kid who swings early/late is up to bat.
• Dugout fences should be high enough to protect players from foul balls or errant throws.
• Ensure all gates are shut during play.
• Realize that no fence or helmet can provide full protection. Teach all players to be alert and always keep their eyes on the field.

BASEBALL SAFETY: TEACHING THE RUNNING GAME

Using breakaway bases for sliding practice can help keep kids safe on the base paths. Coaches should not encourage or allow head-first sliding in younger players. It is better for shins and feet to use running shoes in place of cleats for outfield conditioning and running drills.

BASEBALL SAFETY: CONCUSSIONS

A concussion is a form of traumatic brain injury that can come from a hit to the head or body, or even from a whiplash motion of the neck. Kids do not need to be “knocked out” to have a concussion. Common causes include fly balls lost in the sun, foul tips, bad hops, line drives, and collisions. Signs of a concussion may include: headaches; dizziness; problems with sunlight; vomiting; or acting out of character. Remove from play any player who has changes in behavior or any sign or symptom of concern (when in doubt, sit them out). Good practice (and many state laws) require medical evaluation and not allowing a player to return to the game until all signs and symptoms are gone. There is also a multi-step return to play process that can take several days to complete.

BASEBALL SAFETY: WARMING UP, STRETCHING AND COOLING DOWN

Unlike what most of us were probably taught, stretching is thought to be best done after 3-5-minute warm-up running/agility drills or even at the end of practice.

Warming up to throw starts with short-toss, then long-toss with an arc, then finally longer throws on a line. This should be done before and even during games for players coming in as defensive replacements. Pitchers can do this before starting to do warm-up throws from the mound. It is best not to bring in relief pitchers cold. Sending relief pitchers to the bullpen earlier in the defensive inning or while the team is batting gives them a better warm-up.

It is also important not to leave the field without an appropriate cool down. Use the same stretches and include light running for 3-5 minutes.

BASEBALL SAFETY: PROTECTING SHOULDERS AND ELBOWS

At times it seems that all baseball players have shoulder and elbow pain, especially in the early season when players are getting into shape or later in the season when fatigue sets in.

Using buckets can help protect young arms. Have kids field balls and drop them in a bucket instead of making excessive repetitive longer throws (outfield to home).

Shoulder or elbow pain can be a problem for baseball players. Ideally, there should be no pain before, during or after throwing a ball. However, I particularly worry about any pain that can be located with just a fingertip. Pain all around the elbow is one level of worry, but being able to use a fingertip to point out the exact site on the inside of the elbow is a cause for concern.

For more details on elbow injury prevention, see Common Athletic Injuries – Elbows and for shoulder injury prevention, check out Common Athletic Injuries – Shoulders.

BASEBALL SAFETY: PROTECTING PITCHERS

For pitchers, there are recommended maximum daily pitch counts and rests days from pitching between outings. Below are age-appropriate guidelines. Now, pitch counts work best if everyone is following them, but don’t be a slave to just pitch counts to determine when to pull a pitcher. Kids shaking their arm, walking around the mound between pitches, dropping elbows or getting lit up are all signs of arm fatigue. Tired arms often lead to injuries — so take tired pitchers out before more serious arm problems and tired outfielders really show up.

BASEBALL SAFETY: PROTECTING CATCHERS

Catchers are in a tough position that very few want to play. Balls in the dirt, foul tips, and lots of throws. When the pitcher is pulled, the catcher tends to stay put. There are many ways to protect catchers. Make sure equipment fits; have kids play multiple positions; and teach kids to come out of a squatting position to make throws. Not playing pitcher and catcher in the same game is a good idea as well.

Use a bucket to help protect the knees of young catchers. Instead of squatting during practice or bullpen sessions, have the catcher sit on an upside-down bucket. (This works for adult coaches as well.)

THE BOTTOM LINE

Promote baseball safety within your team and league. Never hesitate to have a player get an evaluation from a pediatric sports medicine specialist. Our goal is the same as yours: keeping kids safe and on the field.

You can find resources for CPR/AED and Stop the Bleed training by contacting the Irvine Community Services Department at (949) 724-6600. Click here to watch UCI Trauma Surgeon Dr. Jeffry T. Nahmias demonstrate how to address a trauma wound.

Dr. Chris Koutures is a dual board-certified pediatric and sports medicine specialist who practices at ActiveKidMD in Anaheim Hills. He is a team physician for USA Volleyball (including participating in the 2008 Beijing Olympics); the U.S. Figure Skating Sports Medicine Network; Cal State Fullerton Intercollegiate Athletics; and the Chapman University Dance Department. He offers a comprehensive blend of general pediatric and sports medicine care with an individualized approach to each patient and family. To learn more about Dr. Koutures, visit activekidmd.com or follow him on Twitter @dockoutures.

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Phyllis Agran, MD, MPH, FAAP

Phyllis Agran, MD, MPH,FAAP, serves on the executive committee of the American Academy of Pediatrics (AAP) Council on Injury, Violence and Poison Prevention. A recipient of the Council’s Fellow Achievement Award in recognition of her commitment to youth violence prevention and pedestrian safety, including her work with the National Safe Routes to School Task Force, Dr. Agran has testified at local, state and national hearings to promote child health and safety policies. She is past president of AAP California Chapter 4 and a Professor in the Department of Pediatrics at UCI's School of Medicine.

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