The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.
Pitch counts of 250-350? over how many games? Numbers seem a bit high there, Billy.
yeah, per LittleLeague.org pitching rules, the pitch limits PER day are based on League age:95 (age 13-16),85 (age 11-12),75 (age 9-10),50 (age 7-8).
They also have mandated rest days if a player reaches a certain pitch count:2 days rest for 36-50 pitches pitched;1 day rest for 21-35 pitches pitched;0 days rest for 1-20 pitches pitched.
Stephen and Richard: Thanks for these more realistic pitch count numbers! We are going to address this in an upcoming Mailbag - see below...
My name is Jake Stelter. I am EM trained out of Northwestern University in Chicago and am currently finishing up a Sports Medicine fellowship at the University of Cincinnati. I just finished March 2020 EM:RAP and wanted to discuss the piece on apophysitis. I really appreciate Billy and Stuart discussing this important and often overlooked topic and I think it was really valuable. I wanted to mention a few things. First, it was said that "apophysitis is inflammation around the growth plate, the physis." It is important to clarify that apophysitis is inflammation and irritation of the "apophysis" and not the "physis." The "physis" is the true growth plate of bones between the epiphysis and the metaphysis and is what most non-orthopedic trained physicians think of when they hear "growth plate." In contrast, an apophysis is a secondary ossification center that occurs at a location where tendon from a muscle attaches to bone. This is a completely separate entity from the physis of the bone. Salter-Harris fractures apply to injuries involving the physis of the bone and not to the apophysis. Also, apophysitis is seen only in patients that have non-fused apophyses, which is going to be older children and adolescents. Once those apophyses fuse, apophysitis is no longer a diagnosis. It was mentioned that when working a long ED shift causes heel pain, this is essentially apophysitis. That is not correct. There may be irritation at the enthesis which is the muscle tendon attachment to bone, termed "enthesopathy." However, if it is in an adult with fused apophyses, it is not apophysitis. Also, I wanted to make a plug for the growing group of EM docs that are subspecialty trained in sports medicine. It seems often mentioned that orthopedics is a weak point for most EM residency programs. We have a lot to offer in educating all types of EM clinicians in EM-relevant orthopedic knowledge. Thanks for listening and thank you for all you do! Your podcast is incredible and your segments are relevant and educational. It keeps me up to date with everything coming out in our field as well as serves as a great refresher on topics not often encountered. Thanks!
Jake - thank you so much for your comments - they are very appreciated! In fact, I have forwarded them to Billy M. and have proposed that we do a segment to cover these points (and maybe a few others!) during an upcoming Mailbag segment. Let us know if you want to participate!
Hey Stuart. Absolutely and thank you. I would definitely be interested in participating.
Great segment as always, but I did have one question. Did anyone else listen to this and have a hard time imagining Billy Mallon playing soccer? I always pictured him as more a rugby, Aussie Rules Football, or demolition derby type guy 🤔🤔🤔
What you do matters.