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High Price to Play: How to Make School Sports Safer

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Too Much, Too Soon

Nick Mulcahy is only 17 years old, but he's already had as many surgeries as a professional athlete. A baseball pitcher for two league teams as well as for the Lancers at Malden Catholic High School outside Boston, he's been throwing hundreds of pitches a day for years -- and it's taken a toll. He was 12 when he heard "a funny clicking sound" in his right arm while lifting weights in gym class. "My elbow got stiff, then locked up so badly I couldn't straighten it," he says. X-rays revealed that a sliver of bone had chipped off and lodged in the joint, and there were similar fragments in his left arm as well. Nick had two operations to remove them, but so much scar tissue developed he had to go back under the knife twice to have it removed.

Pitcher's arm, runner's knee, swimmer's shoulder, gymnast's wrist, and more -- all are overuse injuries caused by repetitively stressing tendons, muscles, or bones, without giving them sufficient time to heal. According to the American Academy of Pediatrics, such cases now account for as many as half of all injuries among student athletes. Dr. Micheli says 70 percent of the patients he treats suffer from exercise overload, up from 10 percent in the 1980s. Injuries that were once prevalent among 15- to 18-year-olds are now common in kids as young as 6. Depending on the type of damage, the long-term effects include chronic pain, premature arthritis, and stunted bone growth.

To prevent injury, experts recommend limiting playing and practicing to 12 hours a week in any one sport, or 20 hours per week for multiple sports; anything more and your kids should be supervised by a sports doctor. Workouts should proceed slowly, with increases in time, distance, or intensity not exceeding 10 percent over the course of a week.

For Nick, a safe regimen includes counting the number of pitches he throws (experts advise no more than 100 a day for a 16-year-old). "With all the surgeries he's had, we've made sure he did all the physical therapy and was cleared to play by his doctor," says his dad, Steve. "And his coach would break him in slowly, by putting him in for only a couple of innings at a time until he was back to full strength." Even so, the last season hasn't been pain free. "Sometimes I feel a twinge -- or worse," says Nick. "But the whole game's on you, and you have to keep going. You play through the pain."

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