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SPORTS MEDICINE

JOHN DOHERTY: Time to open up the mailbag for reader questions, comments

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This week, readers weigh in on a variety of topics.

Dear John: Your article of June 20, “Time to slow down young pitchers,” was spot on! As a former high school player, I couldn't agree more with your comments relating to the current status of pitching in professional baseball where speed has become paramount. Batters seem to focus on meeting the speed with hits into the outfield seats. Seeking base hits and a higher batting average is not the approach of today. Hopefully, a return to the time of a "crafty" pitcher will happen soon and arm injuries will lessen. — Howard, St. John

Dear Howard: I thought I might hear some contrary opinions but your observations sum up what I heard in the wake of that column. Aside from the injuries, the increased velocity has resulted in strikeouts, walks, foul balls, home runs — and balls rarely in play. Fans like you are turned off. Read on.

Dear John: After reading your column about slowing down young pitchers, I can’t wait to hear the groans from the Little League dads. — Mary, Munster

Dear Mary: I thought I would hear a groan or two from high school dads, too. But not a one — yet.

Dear John: I enjoyed your article about arm injuries related to pitching. The simple solution is bigger seams on the baseball. Enhanced natural movement of the baseball would decrease the desire for cheating with sticky substances, decrease the torque needed on a pitchers arm and likely de-emphasize hard throwers. — Chris, Boulder, Colorado

Dear Chris: I agree. Studies by the NCAA and MLB and publicized in Bat Digest in 2020 (Flat Seam vs Raised Seam Baseball | Data | BatDigest.com) and — of all places — the Wall Street Journal in 2019, respectively, support your argument. Batted balls with flatter seams create less air drag, so fly farther. The NCAA flattened the seams in 2015 in response to a 2012 rule change that had deadened the recoil provided by metal bats. Pitchers were no longer in a shooting gallery but home run numbers in the college game had plummeted. MLB has never varied from its wooden bat mandate but was similarly motivated to increase offensive power numbers. Their significant drop in the post-steroid era was being compounded by the explosion in the number of power pitchers. At both levels, the flattened seams have increased the number of home runs but have had little effect on total run production or batting average.

Dear John: Nice column on April 5 about aphasia. I am a big Bruce Willis fan. Any updates on football helmet technology improvements? What behaviors are indicative of concussion concerns for parents that may have been missed by coaches/athletic trainers? — Jim, Munster

Dear Jim: You may have seen my column last month about football helmet add-ons, such as the Guardian Cap. The NFL’s claims notwithstanding — to justify their new mandate for some positions to use the devices in pre-season practices — the study the League cited offered only a lukewarm endorsement at best. Other studies show add-ons are of no use and may actually do more harm than good. As for the actual helmets, the NFL released its most recent ratings in March. In all, 21 helmets received a rating of “better laboratory performance.” Six were rated “not recommended” but still allowed. Another 16 were prohibited.

The thing to keep in mind about these ratings, though, is that they are entirely laboratory-based. Multiple studies that have matched game/practice concussion rates to helmet models have never found a correlation that would favor one over another, regardless of the brand or vintage.

Still, if lab studies are to be believed, there was one published in the Journal of Neurosurgery in 2011 that found that leather football helmets provided protection to the brain as well as or better than modern helmets.

When it comes to concussion-related signs and symptoms, parents may be best at judging a change in demeanor. Loss of consciousness, dizziness, headache, nausea and vomiting, noise and light sensitivity, and unsteady gait are all relatively easy to spot for sideline personnel. However, a change from one’s typical mood is often apparent only to those with whom you live. After game or practice, if your child is quieter, crankier or even more euphoric than usual, it is worth inquiring about a hit to the head.

Dear John: I always enjoy your columns. How about something regarding ankle and knee injury prevention for athletes? Braces, wraps, taping, stretching, weight training, etc.? What works (if anything), what doesn't? — Art, Michigan City

Dear Art: Numerous studies have demonstrated that athletic tape and commercially available lace-up braces significantly reduce the risk of ankle sprains, with the braces being more economical and effective than the tape. Knee braces offer more uneven results. Those originally designed to prevent tears to the anterior cruciate ligament (ACL) actually are very effective preventing injuries to the medial collateral ligament (MCL) but not at all to the ACL. That is why you see them on virtually every NFL and major college offensive lineman.

There are, however, effective exercise programs that prevent ACL tears and — as a side benefit — other injuries to the lower extremity including the ankle. They involve strengthening the hamstrings and gluteal muscles and practicing how best to jump and land. To be effective, coaches must be willing to devote 15-20 minutes of a practice, at least twice a week. The “FIFA 11+” is one such program that is relatively easy to implement, regardless of sport. (FIFA is the Federation International de Football Association, which governs soccer worldwide.) 

John Doherty is a licensed physical therapist and athletic trainer. This column reflects solely his opinion. Reach him at jdoherty@comhs.org. Follow him on Twitter @JDohertyATCPT.

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