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Young athletes dealing with more repetitive-use injuries

By Andy Dworkin, The Oregonian

September 30, 2009, 2:16AM

With school starting back up, it's no surprise doctors are starting to see some high school kids with football injuries.

But the other football -- aka soccer -- is increasingly injuring athletes too young to play fall ball. More and more elementary schoolers play in soccer leagues for most of the year. And young, growing bodies repeating the same motions all year long is a recipe for repetitive-use injuries that can damage bones and joints, sometimes permanently.

"There are leagues with 4-year-olds playing soccer, and it goes on fall and winter and summer," said Dr. Susan Haralabatos, an orthopedic surgeon with the Legacy Bone & Joint Clinic in Portland. "Those are things we wouldn't dream of asking any professional athlete to do. But we have no trouble asking it of our children."

Soccer isn't the only sport injuring young athletes. Anytime people devote themselves to one physical activity, they risk injuries that come from using the same muscles, bones and tendons over and over. Many kids, from gymnasts to cheerleaders, increasingly pursue one activity year-round, said Dr. Ron Turker, a Lake Oswego orthopedic surgeon.

"The Irish dancers, those kids who just dance with their feet, they have an incredible number of fractures," Turker said. "It is a miserable practice if all your kids are dancers."

Repetitive-use injuries are among the most common injuries in the United States and aren't limited to kids. Adults frequently suffer these pains from repeated activities at work, such as lifting things all day, or at play. Tennis elbow, a tendon inflammation, is a classic example.

Overuse injuries generally come on gradually and don't go away with rest or exercise, Haralabatos said. They may feel like joint, muscle or bone pain and limit how you can move. If you have an overuse injury, she added, trying to "play through the pain" is the worst thing you can do. Instead, you need to stop and rest.

If pain lingers even with rest and usual care, like ice and a bandage, it's probably time to see a doctor, Turker said.

"Six weeks is kind of the magic number," he said. "After that, you've gotta stop" playing and seek help.

Kids are at high risk for repetitive-use injuries for a couple of reasons. Physically, children still have active growth plates -- softer areas near the ends of bones where bone growth happens.

"The growth plate is the weak link, typically," Turker said, and prone to injury. And kids who injure their growth plates severely can have lifelong problems, Haralabatos said. If the growth plate in a leg bone is injured, for instance, a child may become bow-legged.

Growth causes other weak spots and problems. Certain kinds of injuries can cut off blood flow, killing bone and permanently damaging a joint, Turker said.

Adolescent boys, in particular, go through a phase where their muscles are stronger than their bones, Haralabatos said. With repeated use, their muscles can actually pull off bits of bone where tendons attach, causing intense pain.

Social pressure to specialize in an organized sport from an early age also fuel repetitive use injuries. A generation ago, elementary school kids rarely played in organized sports leagues, Haralabatos said. For older kids, it was cool to play multiple sports and get three or four varsity letters. Now, she said, society pushes even young kids to focus on one sport, which can cause painful injuries.

"We are pushing children at a younger and younger age," she said.

A cottage industry of private coaches and summer leagues adds to the pressure, telling kids and parents they have to work full time to succeed.

"There is this definite, boiling pressure within more and more sports that, if you want to make it, you've got to do this," Turker said. "The implied message is if your child doesn't do this year-round, they're not committed and they won't be the starters."

Some sports leagues have recognized the dangers of overuse injuries and acted to protect young athletes. Some Little Leagues, for instance, passed rules limiting how many pitches kids can throw. And while football causes its share of injuries, there is relatively little organized practice out of season.

Parents and young athletes should watch their playing time in leagues that don't take such precautions, Haralabatos said. Cycling through several sports in season is a great way to stay active and limit overuse injuries, since different sports generally stress different muscles and bones. Parents should also be wary of leagues that stratify elementary-age children by their level of ability, she said.
Andy Dworkin: 503-221-8271;




How to Get the Most from Your Baseball Swing

Yes, it’s time to dust off the ‘ol bat and start preparing for another season of baseball. In today’s “sport specific” training methods it is not only the professional who is training for baseball in the winter months but also Canadian youth baseball players. Many of these ball players are lengthening their seasons by taking advantage of indoor baseball camps and finding themselves playing in a season as long as their American counterparts. This article is presented to those who are eager to get back into this highly skillful game and shake off the rust from their swing while the snow is still falling. This will be one of two articles focusing firstly on the mechanics of hitting and later, some mental approaches to succeed at home plate during the season. While watching a Major League Baseball game, it is evident that there are almost as many hitting stances as there are hitters. This tells us that youth hitters should not be taught the many “cookie cutter” swings found in most coaches’ instruction book but rather the BASIC fundamentals of hitting mechanics. Many young hitters have been taught that power comes from a high leg kick and large stride. Albert Pujols of the St. Louis Cardinals proves otherwise. Albert has a WIDE stance and SMALL stride. Due to the success of present day “short stride” hitters, along with more accumulated baseball research, most hitting philosophies have shifted from linear (long stride) energy transfer to a combination of linear and rotational energy transfer. This new approach of optimal energy transfer employs the biomechanical components of dynamic balance and body torque.

 Dynamic Balance

Dynamic balance is the technical term for STAYING UNDER CONTROL while hitting. Staying under balance allows for more efficient energy transfer and has the added benefit of giving the swing a ‘smoother’ look. Controlling stride length is a simple start to maintaining dynamic balance. The hitter’s stride length, previously thought of as what creates the power of the swing, is simply a timing mechanism. A short stride allows the hitter to maintain dynamic balance by controlling the amount of movement that occurs with the body’s centre of gravity. Hitter’s with a ‘lower’ stance will have more control over their centre of gravity as it is closer to the ground. (Case in point: Albert Pujols). By maintaining balance through movement, the body can now efficiently transfer energy when it reaches its axis of rotation (point where body torque occurs).

Body Torque

When the hitter decides to swing at a pitch, he must now transfer the energy accumulated from the backside of the body to the ball. This is done by allowing the back leg to rotate as the body comes back to the axis of rotation. A right handed batter rotates his right leg, a lefty his left leg. Rotation of the back leg creates a torque effect which generates the greatest amount of energy transfer from the lower body to the upper body. By rotating the leg BEFORE taking the bat to the ball, the energy of the lower body can be transferred to the torso, arms, wrists, and finally the bat. If the leg is not rotated and there is no torque effect, the hitter’s power is only a result of upper body strength. In other words, if the hitter does not use his legs to transfer his power from the “feet up”, he must equate the energy needed entirely from his upper body. Bat speed is a result of this proper transfer of energy from the feet up. The biomechanical term for efficient energy transfer throughout the swing is “kinematic sequence”. An efficient kinematic sequence transfers all energy from the feet up to the bat which results in the farthest and hardest ball hit from the hitter. An inefficient sequence will ‘leak’ energy, resulting in a swing that LACKS both POWER and CONSISTENCY. (These are two words coaches and scouts dread hearing.) For an example of energy transfer and what it means to hit a baseball, note this equation below. (Figures are examples only) 4000 N (force) = the amount of Force necessary to hit a home run 4000 N (force) = 2000 N (force of lower legs/hips) + 1500 N (force of torso) + 500 N (force of arms/wrists/bat) Note that this hitter’s force capability is sufficient to that necessary to hit a home run. It is important to note though, that this will only occur if the energy is transferred in a good kinematic sequence that lacks any energy ‘leaks’ or losses. With proper coaching and hard work, hitter’s can develop their hitting mechanics and expect great results when it comes time to make the transition from the indoor batting tunnels of winter to the grassy fields of summer.

Greg Morrison, BKin

Greg Morrison has recently retired from a 12 year professional baseball career including seasons with the Los Angeles Dodgers and Toronto Blue Jays organizations as well as numerous selections to Canada’s Senior National Team. His experience as a ‘Professional Hitter’ (Over 1000 minor league hits and 100 homeruns) combined with his formal education in Kinesiology (special interest in biomechanics and sport science) has provided a new approach to coaching by challenging the conventional wisdoms of baseball. Currently, he owns ‘big momentum sport inc’-injury & muscle therapy which operates in Alberta, CANADA.

How to be a Mentally Sound Baseball Hitter

“Baseball is 90% mental. The other half is physical.” -Yogi Berra Those of us familiar with the Yankees of yester-year are quite familiar with the author of the above quote. Yogi Berra, known for his one of a kind affirmations, verbalized what all baseball players can relate to in regard to the sport psychology of baseball. From “hot streaks” to “slumps” there are many anomalies of the great game of baseball. Wade Boggs, a career .300 hitter at the Major League Level, believed that by eating chicken before each game, he would give himself the greatest chance of success on the field. Nomar Garciaparra went through a ritual of toe taps and batting glove adjustments prior to each pitch in the batter’s box to get ready to hit. So why are baseball players so superstitious? From day to day a player’s physical skills do not change. How then, can a hitter go 4-4 one day at the plate with 2 homeruns, to 0-5 with 3 strike-outs the next? Is it simply the different caliber of pitching the hitter faces from day to day or does the MENTAL aspect of hitting influence success? Yogi had it right. On the playing field, physical skill and talent can affect a player’s ability to perform well but more importantly, the athlete’s mental attributes reveal his potential for long term success. These attributes specific to success as a hitter include CONCENTRATION, CONFIDENCE and DISCIPLINE.


“Concentrate!” is often heard from coaches to players on the ball field. But what do they mean? Concentration can be described as the level of mental focus or attention on a particular object. What some players fail to realize is that a lack of TOTAL concentration can lead to failure of becoming a successful hitter. An example of too little concentration includes a hitter worrying about his school exam during the game or who may be watching (parents?girlfriend?) in the stands while he’s in the on deck circle. While on deck, the hitter should be focusing on the pitcher’s release point (the area above the pitcher’s throwing shoulder where the ball first becomes visible to the hitter). This prepares him for his at bat by directing his attention to see the ball as soon as possible when it has been thrown by the pitcher. Each hitter must develop his ability to concentrate if he is to become a consistently successful hitter. The best way to practice concentration is to notice what he focused on and how he “felt” when he had a good day at the plate and attempt to duplicate this “feeling” before each game. Experience (many at bats) is the best way to develop concentration but visualization of successful at bats is another good way to advance this skill.


It is difficult to determine if confidence is a prerequisite to successful hitting or a result of successful hitting but it stands true that all great hitters have confidence. A hitter with confidence creates an atmosphere at home plate that can often be seen by others. Confidence helps the hitter by relaxing the body’s neuromuscular system (nerve-muscle connection). This reduced tension in the body allows the hitter to be smooth, quick and powerful rather than “choppy” and mechanical. Confidence helps provide the calm body and state-of-mind necessary to make the split-second decision of whether to swing at a pitch or not. Confidence can be developed through past success but also through visualization techniques. One visualization technique includes the hitter visualizing both a successful at-bat and the consequent feeling of confidence this success would bring.


Discipline is the most important mental attribute to success as a baseball player. It relates to hitting in two ways. First, a hitter must have discipline to wait for a good pitch to hit. It is the pitcher’s job to get the hitter to swing at bad pitches (balls out of the strike zone) or beat the hitter with thrown strikes. By swinging at balls outside the strike zone, a hitter’s chances of success greatly diminish. By remaining disciplined enough to only swing at balls in the strike zone, a hitter has already given himself a great opportunity to succeed. The second aspect of discipline pertains to hitting approach. Hitting approach refers to what the hitter is trying to accomplish with his swing. Is he trying to hit a homerun or simply a line-drive base-hit? Too often, hitters attempt to lead their team to victory with a homerun of epic proportions rather than be a “piece of the puzzle” in the team’s success. “Swinging for the fences” not only results in a high strike-out-to-at-bat ratio, but also reduces confidence in the coach that the job will get done. Successful hitters curb their natural inclination for “home run swings” by focusing on hitting line drive base-hits to centre-field or the opposite field gap. The trial and error of swinging at good and bad pitches and the resultant consequence can provide the experience necessary to establish discipline as a hitter but visualization can also develop this important mental attribute. Have you noticed that a way to develop each of the three important mental aspects of hitting in through VISUALIZATION? Look to start your visualization training in the off-season as this will set the framework for your mental approach at the plate. By working on the mental aspects of hitting, you can get the best out of your physical abilities and provide the consistency in your game that coaches and scouts look for. So why are baseball players like Wade Boggs and Nomar Garciaparra so superstitious? Superstition breeds confidence. So if eating chicken before every game or tapping your toes in the batters box makes you confident, use it as tool to get yourself to the ‘SHOW’.

Greg Morrison, BKin

Greg Morrison has recently retired from a 12 year professional baseball career including seasons with the Los Angeles Dodgers and Toronto Blue Jays organizations as well as numerous selections to Canada’s Senior National Team. His experience as a ‘Professional Hitter’ (Over 1000 minor league hits and 100 homeruns) combined with his formal education in Kinesiology (special interest in biomechanics and sport science) has provided a new approach to coaching by challenging the conventional wisdoms of baseball. Currently, he owns ‘big momentum sport inc’-injury & muscle therapy which operates in Alberta, CANADA.


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