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1. Health first

• Complete required sports physicals and clinician-recommended screening.
• Share allergies, conditions, medications and emergency contacts.
• Tell the coach about current pain or restrictions.

2. Plan the workload

• List every team, lesson, camp and tournament.
• Choose who records practice and game workload and rest days.
• Agree that one athlete has one total workload.

3. Build gradually

• Increase running, throwing and practice volume over time.
• Teach a consistent dynamic warm-up.
• Prioritize movement quality and fun.

4. Prepare for emergencies

• Confirm the venue and emergency action plan.
• Locate water, shade, first aid and an AED.
• Review heat and symptom-reporting procedures.

Before opening day: parents, coaches and athletes should know how workload, symptoms and emergencies will be handled.

Stop activity now

• Sudden or sharp pain
• A pop with pain, swelling or lost function
• Numbness, tingling or visible deformity
• Inability to fully bend or straighten a joint

Schedule an evaluation

• Pain that returns with activity
• Soreness that does not improve as expected
• Loss of motion or strength
• Declining control, speed or endurance
• Repeated changes in mechanics
• Pain affecting sleep or daily activity

Call 911 for an emergency

Collapse, confusion, seizure, loss of consciousness, trouble breathing, chest pain, suspected heat stroke, severe injury or another life-threatening symptom.

Concussion

Remove the athlete from play for a suspected concussion. Do not allow same-day return. Follow medical evaluation and return-to-play requirements.

Asthma

Follow the athlete's clinician-developed action plan. Confirm rescue medication access through the approved process and call 911 for severe breathing trouble.

Seizure

Protect from injury, clear the area, time the seizure and do not restrain the person or put anything in the mouth. Follow the athlete's action plan.

Heat emergency

Stop activity, move to a cool area and begin rapid cooling. Call 911 for confusion, collapse, seizure, loss of consciousness or suspected heat stroke.

Athlete-specific plans

Parents should provide current clinician-approved asthma, seizure, allergy or other emergency plans when applicable. Store and share them only through the league-approved confidential process.

Coach boundary

Recognize, remove from activity, provide first aid within your training, activate emergency services and refer for medical evaluation. Do not improvise treatment or return an athlete to play against medical restrictions.

Ages 3-5

Play, balance, running, jumping, catching, simple directions and fun.

Ages 6-8

Movement skills, coordination, body control, short activities and broad sport exposure.

Ages 9-12

Supervised technique, body-weight strength, landing skills, mobility and gradual skill development.

Ages 13-18

Progressive supervised strength and power training, individualized workload and recovery habits.

Good practice at every age

• Use qualified supervision.
• Teach technique before load or speed.
• Progress gradually.
• Stop painful movements.
• Do not use exercise as punishment.
• Keep training positive.

Parent rule: young athletes should not copy adult lifting, weighted-ball or velocity programs.

Before

• Check weather and heat risk.
• Begin hydrated.
• Bring water and provide shade.
• Adjust time, length and intensity.

During

• Schedule water and cooling breaks.
• Do not wait for thirst.
• Use a buddy system.
• Watch closely early in the season.

After

• Continue fluids and cooling.
• Eat a balanced snack or meal.
• Monitor symptoms.
• Do not return with ongoing symptoms.

Know the warning signs

Cramps, heavy sweating, headache, dizziness, nausea, weakness, confusion, fainting or hot skin.

• Take action: stop activity, move to a cool area, begin cooling and monitor symptoms.
• Call 911 for confusion, collapse, seizure, loss of consciousness or suspected heat stroke.

Before activity

• Eat familiar foods.
• Include carbohydrates for energy.
• Add a moderate protein source.
• Start hydrated.

During

• Water is the default for routine activity.
• Use scheduled fluid breaks.
• Pack easy snacks for long tournament days.
• Avoid unfamiliar supplements.

After

• Replace fluids.
• Eat a balanced meal or snack.
• Include carbohydrates and protein.
• Return to the regular family meal pattern.

Simple options

• Banana and yogurt
• Fruit and a cheese stick
• Whole-grain sandwich
• Crackers with nut or seed butter, when allergy-safe
• Water and a balanced meal after play

Ask before using

Energy drinks, performance supplements, weight-loss products or restrictive diet plans are not routine youth-sports tools. Discuss individual nutrition needs, allergies or medical concerns with a qualified clinician or dietitian.

Parent rule: consistent meals, snacks, fluids and sleep matter more than a single “perfect” game-day food.

Complete this worksheet with league leadership and review it with every coach and assistant. Update it when locations, equipment or contacts change.

Venue and access

• Venue / field:
• Street address:
• EMS entrance / gate:
• Meeting point:

Emergency equipment

• AED location:
• First-aid location:
• Cooling supplies:
• Access notes:

Response roles

• Call 911:
• Retrieve AED:
• Meet EMS:
• Contact family:

Important contacts

• League contact:
• Phone:
• Facility contact:
• Phone:

Pre-event check

• AED located and accessible
• Exact address confirmed
• EMS route clear
• First aid and cooling available
• Emergency contacts accessible
• Roles reviewed with staff

Before every event

• Know the exact venue address and EMS entrance.
• Locate the AED and verify it is accessible and shows a ready status.
• Locate first aid, water, shade and cooling supplies.
• Assign who calls 911, retrieves the AED and meets EMS.

If a serious emergency occurs

• Stop play and assess scene safety.
• Call 911 and give the exact location.
• Begin appropriate first aid or CPR within the responder's training.
• Retrieve and use the AED by following its prompts.
• Send someone to direct EMS to the athlete.

AED issue: if the cabinet is locked, the unit is missing, the status indicator shows a problem or supplies appear expired, notify the league immediately and document the issue. Do not wait until game day.

Program purpose

Give coaches, assistants, parents and volunteers practical exposure to CPR, AED use and common youth sports emergencies.

• Community education format
• Recommended, not a coach-certification requirement
• Open to the broader sports community as resources allow
• Scheduling and registration information to be announced

Planned topics

• Recognizing cardiac arrest
• Calling 911 and activating the emergency plan
• Hands-on CPR practice
• Using an AED and following prompts
• Choking and common sports-emergency awareness

Use now

Coaches may review the American Heart Association's youth sports and community training resources while the local program is being developed.

Preseason

• Confirm required sports physicals.
• Collect emergency contacts through the approved process.
• Confirm allergies, conditions, restrictions and action plans.
• Tell families how to report pain and symptoms.
• Identify who will record workload and rest.
• Complete the emergency action-plan worksheet for each venue.

In-season

• Coordinate with every other team the athlete plays for.
• Follow workload limits and required rest.
• Manage heat and stop activity when warning signs appear.
• Make symptom reporting safe and expected.
• Never use a workload ceiling as a target.

Offseason

• Protect real time away from the primary sport skill.
• Restore movement and mobility.
• Develop total-body strength and athleticism.
• Encourage other sports and enjoyable activity.

The family's year-round role

• Report every team, lesson and event.
• Protect rest, sleep, nutrition and time away from the primary skill.
• Report pain, fatigue and performance changes early.
• Follow medical restrictions and return-to-play instructions.

Referral pathway

Use SLMA Sports Medicine for questions about sports injuries, throwing pain, return-to-play concerns and sports medicine appointments. Call 985-262-1639. Call 911 for life-threatening symptoms rather than the routine appointment line.

Program rule: one athlete has one total workload, even when recreation, travel, school, lessons and showcases overlap.

Track game pitches by the athlete's actual age.

How parents and coaches should use the chart

• Use the athlete's actual age. League rules may be stricter.
• Record totals across recreation, travel, school and tournament play.
• Required rest means no pitching, even for another team.
• Fatigue, pain or medical restrictions can require an earlier stop or longer rest.

Example: an 11-year-old who throws 52 game pitches needs three days of rest before pitching again.

Track the total workload

• Game pitches for every team
• Bullpens and warm-up pitches
• Lessons, camps and showcases
• Long toss and high-intensity throwing
• Catching and demanding position throws
• Pain, soreness, fatigue or performance changes

Pitch count = game pitches. Other throwing still matters when judging fatigue and recovery.

Every game day

• Confirm eligibility before pitching.
• Record pitches immediately.
• Watch mechanics, command and fatigue.
• Do not pitch and catch the same day.

Stop and speak up

• Joint or sharp pain
• Loss of motion, control or velocity
• Altered mechanics or unusual fatigue
• Numbness, tingling or swelling

Parent rule: a second team does not reset the pitch count, required rest or fatigue.

Before throwing

• Raise temperature: three to five minutes of easy movement.
• Move dynamically: leg swings, trunk turns, lunges and arm circles.
• Prepare movement: squats, lateral shuffles and short accelerations.
• Activate: controlled shoulder work when properly coached.
• Throw gradually: begin close and easy, then increase.

After activity

• Cool down with easy movement.
• Rehydrate and eat a balanced snack or meal.
• Record pitches, other throwing and symptoms.
• Follow required rest and restrictions.
• Avoid extra hard throwing on recovery days.
• Prioritize consistent sleep.

Remember: warm up to throw. Do not use hard throwing as the warm-up, force motion or stretch into pain.

Protect time away from pitching

Pitch Smart recommends age-specific time away from throwing or competitive pitching each year. Use the athlete's age guidance and choose the more protective plan when teams or seasons overlap.

Build the whole athlete

• Restore comfortable movement and mobility.
• Build total-body strength with supervision.
• Develop balance, speed, agility and coordination.
• Play other sports and keep activity enjoyable.

Return gradually

• Start close, easy and low volume.
• Increase distance before intensity.
• Add mound work and competition later.
• Do not rush after pain, illness or inactivity.

Watch for year-round specialization: overlapping teams, lessons and showcases can eliminate true recovery.

Before leaving

• Record the game-pitch total.
• Record other throwing and any symptoms.
• Confirm the next eligible pitching date.
• Cool down with easy movement.
• Begin fluids and a balanced snack or meal.

At home

• Protect the required pitching rest.
• Avoid extra hard throwing on recovery days.
• Prioritize sleep and normal meals.
• Check for pain, swelling, lost motion or performance changes.
• Follow medical restrictions exactly.

About cold therapy

A wrapped cold pack may provide short-term comfort for minor post-activity soreness. Do not apply ice directly to the skin. Limit use to about 20 minutes at a time and stop if the skin becomes numb or painful.

Pain needs attention

Cold therapy is not a reason to continue throwing and is not a substitute for evaluation. Stop throwing and seek medical attention for joint pain, persistent or worsening soreness, swelling, weakness, lost motion, numbness, altered mechanics or reduced performance.

Parent rule: recovery begins with workload control and symptom reporting, not with a single treatment.

The ulnar collateral ligament (UCL) is the structure that stabilizes the inside of the elbow under the extreme stress of throwing. Most players do not do enough to protect it until there is a problem.

The harsh reality

• UCL injuries are at an all-time high, with Tommy John surgeries increasing across all levels of baseball.
• Not just pitchers are at risk. Catchers, shortstops and outfielders are at risk too.
• Pitchers are throwing harder than ever, but training, recovery and workload management have not caught up.

Common symptoms

• Pain on the inside of the elbow
• Loss of velocity or throwing control
• Pain with acceleration or release
• A pop followed by immediate pain
• Tingling into the ring or small finger

Important: “Tommy John” refers to both the injury and the reconstruction surgery. Not every UCL injury requires surgery.

Equipment needed

• 2 lb dumbbell
• Chair
• Table to support your body
• 1 light resistance band
• 1 towel

Exercise frequency

• In season: 1 set x 10 reps, 1-2 days per week.
• Out of season: 2 sets x 10 reps, 2-3 days per week.

1A. Diagonal pattern D2 extension

The involved hand grips the tubing handle overhead and out to the side. Pull the tubing down and across your body to the opposite leg, leading with your thumb.

1B. Diagonal pattern D2 flexion

Gripping the tubing handle in the involved hand, begin with the arm 45 degrees out from the side and the palm facing backward. Turn the palm forward, flex the elbow and bring the arm up and over the uninvolved shoulder. Turn the palm down and reverse to the starting position in a controlled manner.

2A. External rotation at 0 degrees abduction

Stand with the involved elbow fixed at your side, elbow at 90 degrees and the arm across the front of the body. Grip the tubing handle with the other end fixed to a stationary object. Pull out with the arm, keeping the elbow at your side. Return slowly and controlled.

2B. Internal rotation at 0 degrees abduction

Stand with the elbow at your side fixed at 90 degrees and the shoulder rotated out. Grip the tubing handle with the other end fixed to a stationary object. Pull the arm across the body, keeping the elbow at your side. Return slowly and controlled.

3A. External rotation at 90 degrees abduction

Stand with the shoulder abducted 90 degrees and the elbow flexed 90 degrees. Grip the tubing handle with the other end fixed straight ahead, slightly lower than the shoulder. Keeping the shoulder abducted, rotate the shoulder back with the elbow at 90 degrees. Return to the start position.

3B. Internal rotation at 90 degrees abduction

Stand with the shoulder abducted 90 degrees, externally rotated 90 degrees and the elbow bent 90 degrees. Keeping the shoulder abducted, rotate the shoulder forward with the elbow bent. Return to the start position.

4. Shoulder abduction to 90 degrees

Stand with the arm at your side, elbow straight and palm against your side. Raise the arm to the side, palm down, until it reaches shoulder level. Hold 2 seconds and lower slowly.

5. Scaption, internal rotation

Stand with the elbow straight and thumb up. Raise the arm to shoulder level at a 30 degree angle in front of the body. Do not go above shoulder height. Hold 2 seconds and lower slowly.

6. Prone horizontal abduction (neutral)

Lie face down on a table with the involved arm hanging straight to the floor, palm down. Raise the arm out to the side parallel to the floor. Hold 2 seconds and lower slowly.

7A. Prone horizontal abduction (full external rotation, 100 degrees abduction)

Lie face down on a table with the involved arm hanging straight to the floor and the thumb rotated up (hitchhiker position). Raise the arm out to the side slightly in front of the shoulder, parallel to the floor. Hold 2 seconds and lower slowly.

7B. Press-ups

Seated on a chair or table, place both hands firmly on the sides, palms down and fingers pointed outward, equal with the shoulders. Slowly push down through the hands to elevate your body. Hold 2 seconds and lower slowly.

7C. Prone rowing

Lying on your stomach with the involved arm hanging over the side of the table, dumbbell in hand and elbow straight, slowly raise the arm, bending the elbow and bringing the dumbbell as high as possible. Hold 2 seconds, then lower slowly.

7D. Push-ups

Start in the down position with hands no more than shoulder width apart. Push up as high as possible, rolling the shoulders forward once the elbows are straight. Start with a push-up into a wall, then progress to tabletop and eventually the floor as tolerated.

8. Elbow flexion

Standing with the arm against your side and palm facing inward, bend the elbow upward, turning the palm up as you progress. Hold 2 seconds and lower slowly.

9. Elbow extension (abduction)

Raise the involved arm overhead and provide support at the elbow with the uninvolved hand. Straighten the arm overhead. Hold 2 seconds, then lower slowly.

10A. Wrist extension

Supporting the forearm with the palm facing down, raise the weight in your hand as far as possible. Hold 2 seconds, then lower slowly.

10B. Wrist flexion

Supporting the forearm with the palm facing up, lower the weight in your hand as far as possible, then curl it up as high as possible. Hold 2 seconds and lower slowly.

10C. Wrist supination

With the forearm supported on a table and the wrist neutral, use a weight or hammer to roll the wrist to the palm-up position. Hold 2 seconds and return to the start.

10D. Wrist pronation

With the forearm supported on a table and the wrist neutral, use a weight or hammer to roll the wrist to the palm-down position. Hold 2 seconds and return to the start.

Stop any movement that causes pain and ask your clinician before starting a new program after an injury.

1. Shoulder

• Injury: rotator cuff impingement syndrome. Symptoms: pain, weakness, limited range of motion.
• Rotator cuff tendinopathy is an overuse injury typically caused by programming errors, excessive weight progression and improper form. For some lifters the cuff may begin to fray, leading to degenerative or partial tears.
• Prevention: use proper form and technique, increase weight and intensity gradually, and strengthen the rotator cuff muscles.

2. Knee

• Injury: patellofemoral pain syndrome. Symptoms: vague discomfort around the kneecap.
• It is often related to poor tracking of the patella, and can be worsened by muscle imbalances, most frequently a relatively weak quadriceps or an imbalance between quadriceps and hamstrings.
• Prevention: balance quadriceps and hamstring strength, improve flexibility, and use proper form during squats and lunges.

3. Lower back

• Injury: lumbar strain. Symptoms: pain that may radiate into the buttocks, difficulty maintaining normal posture, and pain that worsens when bending, stretching, coughing or sneezing.
• A herniated disc in the lower back typically causes pain in the lower back, buttocks, thigh and calf, sometimes with numbness or tingling.
• Prevention: maintain proper posture during exercises, strengthen core muscles, and use proper lifting techniques.

4. Elbow

• Injury: lateral epicondylitis, or tennis elbow. Symptoms: pain on the outside of the elbow.
• For a lifter, elbow pain can come from lifting too heavy, repeating the same exercises every workout and improper technique. A common error is exaggerated wrist flexion at the end of a lift such as a biceps curl, seated row or lat pulldown.
• Prevention: keep the wrist in a neutral position during lifts, avoid repetitive movements, and use an appropriate weight.

5. Biceps

• Injury: biceps tendonitis. Symptoms: pain or achiness in the upper arm and an occasional snapping sound or sensation in the shoulder.
• Workouts and sports that require repetitive overhead motion, such as swimming, tennis and baseball, can put people at risk.
• Prevention: avoid overuse in overhead motions, use proper form in biceps curls and pull-ups, and build in rest days.

Prevent injuries, maximize performance

• Warm up properly
• Use correct form
• Progress gradually
• Listen to your body
• Rest and recover

Experiencing persistent pain? Our sports medicine specialists at SLMA are here to help. Call 985-262-1639 for more information.

Why heart screenings matter for young athletes

• Sudden cardiac arrest is the number one medical cause of death in young athletes.
• 1 in 300 youth have a detectable, potentially life-threatening heart condition.
• In 80% of sudden cardiac arrest cases in athletes, death is the first symptom.
• Only 1 in 10 survives an out-of-hospital cardiac arrest.

What your team can do

• Ask about heart screening when you schedule sports physicals for your team or family.
• Keep an emergency action plan and an AED plan for every field or venue.
• Make sure coaches hold current CPR and AED certification.

To ask about athlete heart screenings and sports physicals, call SLMA Sports Medicine at 985-262-1639.

What is a Tommy John injury?

• The ulnar collateral ligament, or UCL, stabilizes the inside of the elbow during throwing. Repetitive stress can stretch or tear the ligament.
• Common symptoms: pain on the inside of the elbow, loss of velocity or throwing control, pain with acceleration or release, a pop followed by immediate pain, and tingling into the ring or small finger.

Tommy John refers to both the injury and the reconstruction surgery. Not every UCL injury requires surgery.

Common youth baseball injuries beyond the UCL

• Little League elbow: overuse irritation or injury near the inner elbow growth plate.
• Little League shoulder: stress injury to the upper arm growth plate from repetitive throwing.
• Rotator cuff irritation: shoulder pain, weakness or fatigue during repetitive throwing.
• Flexor strain: pain in the muscles and tendons that support the inner elbow.
• Wrist and hand injuries: jammed fingers, sprains, fractures and impact injuries.
• Lower-body injuries: ankle sprains, knee pain and hamstring strains affect the entire kinetic chain.

Why overuse matters

• Young athletes are still growing. Repetitive throwing without sufficient rest can overload the elbow and shoulder before the body fully recovers.
• Track workload across every team. League play, travel ball, showcases, private instruction and bullpen sessions all count.

Protective habits

• Follow age-based pitch-count and required-rest guidelines.
• Stop pitching when mechanics change or fatigue appears.
• Take at least four months away from throwing each year for most youth age groups.
• Avoid playing for multiple teams at the same time.
• Do not pitch through elbow or shoulder pain.
• Warm up gradually and build preseason throwing volume.
• Strengthen the legs, core, back and shoulder complex.
• Encourage participation in other sports.

Daily pitch-count limits vary by age. Use MLB Pitch Smart or your league's approved guidelines and track pitches across all teams and events.

Know the warning signs: when arm pain is not just soreness

• Persistent inner elbow pain, especially during or after throwing.
• Loss of velocity or control, a sudden or progressive drop in performance.
• Difficulty straightening the arm, with stiffness, swelling or reduced range of motion.
• Popping, tingling or numbness, especially into the ring or small finger.

Stop throwing and schedule an evaluation. Early assessment may prevent a minor problem from becoming a season-ending injury.

SLMA sports medicine services

• Injury evaluation and diagnosis
• Non-surgical treatment and rehabilitation
• Return-to-play planning
• Sports physicals and injury prevention

Joseph M. Garcia, MD, is board certified in Family Medicine and in Primary Care Sports Medicine.

Is it normal to have pain in the foot or ankle?

• No. Pain or discomfort is not normal. It signals a problem that needs to be evaluated, diagnosed and treated by a specialist who fully understands this part of the body.
• The foot has 26 bones, 33 joints, 107 ligaments, and 19 muscles and tendons. Feet hold us up and absorb the shock of each step, and the way your foot is structured affects other areas such as your back.

Does seeing a foot and ankle surgeon mean surgery?

• No. Foot and ankle surgeons are trained to make all reasonable efforts to treat foot and ankle problems non-surgically if at all possible.
• Surgery is recommended only if other options are not feasible or do not adequately relieve the problem.
• A foot and ankle surgeon is a podiatric physician who holds a Doctor of Podiatric Medicine (DPM) degree, completes four years of podiatric medical school and typically three years of residency in foot and ankle surgery.

Reasons to see a foot and ankle specialist

• An injury such as a sprain or broken bone
• Swelling in your foot or ankle
• A medical condition such as diabetes or poor circulation that can affect the feet
• Impaired ability to function in certain activities
• Heel pain in the morning
• Any painful condition of the foot, ankle or lower leg
• Discomfort after standing for a while
• Changes in the appearance of your foot or ankle
• An abnormal growth

Conditions treated

• Bunions and hammertoes
• Heel pain, including plantar fasciitis
• Flatfoot and foot or ankle arthritis
• Sports injuries and tendon disorders
• Fractures and ankle sprains
• Diabetes-related foot complications
• Ingrown toenails, neuromas, skin conditions and tingling feet

SLMA Podiatry clinic: 1224 David Drive, Suite 103, Morgan City, LA 70380. Call 985-385-2616.

How this connects to sports medicine

• Running, court and field sports load the foot and ankle every stride, so heel pain, Achilles pain, shin pain and repeat ankle sprains are common reasons athletes are referred.
• Primary Care Sports Medicine handles evaluation, non-surgical treatment and return-to-play planning, and works with SLMA Podiatry when a foot or ankle problem needs specialist care.
• Shoe wear matters: replace running shoes around every 300 to 500 miles and wear court shoes for pickleball and racquet sports.