White Sox's Head Physician, Dr. Bush-Joseph, Answers Your Questions

Welcome to this new forum for baseball and sports medicine. Hinsdale Little League is lucky to have the Head Physician of the Chicago White Sox, Dr. Bush-Joseph, answering your questions about sports medicine. Check back frequently for updates and email us at hinsdalelittleleague@gmail.com (subject "Ask the Doctor") if you have any questions.

Injury Prevention and Treatment

Injuries are and always will be part of the game.  That is the nature of sports and competition.  Fortunately at this level serious injuries are rare and most can be prevented with good coaching and parenting.  Injuries can occur traumatically (falls, collisions, contusions) or as a result of overuse. Most contusions are painful but rarely need more than an ice pack and a good hug.  For parents and coaches, the biggest decision we have to make is when to go to the emergency room.  Here a few guidelines:

1. Any full thickness cut or laceration greater than 1 cm should be cleaned and sutured.
2. Any visible deformity of the arm or leg usually represents a fractured and should be x-rays immediately.  If there is no deformity but only local tenderness, it is safe to wait 12-24 hours to see how the injury responds.
3. Any lower extremity injury in which the child is unable to bear weight (taking 2 or 3 steps) should be x-rayed.
4. Any significant head injury where there is any question that the child suffered a concussion or loss of consciousness.  Caution is the rule as the consequences can be very serious.

In baseball, overuse injuries relate to throwing too much too soon or too often.  Just like the major leaguers, arm strength take time to develop requires a graduated throwing program.  Everyday kids should work on throwing but not pitching.  A throwing program should include 15-20 short tosses, 15-20 long tosses, and 10-15 hard throws.  This allows the child to work on form and endurance of the throwing muscles.  As far as pitching goes, Little League International has established firm guidelines of pitch counts and frequency that all coaches must adhere to. Any child who complains of persistent shoulder or elbow pain needs rest.  Any loss of motion (typically the child is unable to fully straighten the elbow) demands rests until motion is restored.

An excellent injury resource available to all can be found at the website of the American Orthopaedic Society for Sports Medicine (AOSSM).  I suggest all download and print for a handy home reference.

Sportsmed Link

Past Articles:

Get to Know Dr. Bush-Joseph

With the arrival of Spring and the benefits of Daylight Savings time here, it is time to jump full speed into the 2006 Hinsdale League season.  As a seventeen year resident of Hinsdale who has one child in and two others who played in the Hinsdale Little League (HLL) system, I am proud of the development and advances that have occurred.  The HLL has a committed board and outstanding parental involvement that is the envy of most Chicagoland communities.  HLL’s tradition of continuous improvement led President Steve McKenna to provide parents and coaches current medical advice and information to further protect the health and welfare of our child playing the game of baseball.

I am an orthopaedic surgeon at Rush University Medical Center specializing in sportsmedicine. I have been taking care of adolescent, high school, collegiate, and professional athletes for the past 17 years.  While many concepts and ideas have changed in that time, several basic principles hold. 1. Children and adolescents develop physically and mentally at varying rates.  One 11 year old may have vastly different physical and competitive abilities than another of similar age. 2. Baseball is a game of skill more than physical ability and thus is learned.  Learning and development requires a fun and positive practice environment that children want to participate in. Otherwise children equate baseball with the perceived boredom and tedium of schoolwork and will quit at first chance. 3. Baseball is a team game that develops life skills that serve all.  While few if any of our children will ever play baseball for a living, most will remember it as a tool that teaches work, effort, responsibility, and teamwork.

In the coming weeks I will provide comment and information on various baseball topics including injury triage, conditioning, elbow pain, and competitiveness.  I would be happy to respond to questions via hinsdalelittleleague@gmail.com with the subject "Ask the Doctor" . 

Charles A. Bush-Joseph, MD of Midwest Orthopaedics at Rush (www.rushortho.com) is the Head Team Physician for the Chicago White Sox and a long time resident of Hinsdale.