Youth softball and baseball could undergo some major changes if an influential group of national medical experts wins over coaches, players and parents.


Many pitchers and infielders — particularly the youngest and least-skilled players — will wear head and face protection to guard against injuries.


All young pitchers will get instruction on proper throwing mechanics and then stick with strict pitch-count limits and recommended days of rest between outings.


Pitchers also will take at least three months off each year, pitch for only one team at a time and avoid playing catcher for their team.


And softball and baseball players won’t take practice swings in on-deck circles, which won’t exist anymore.


These are among the recommendations included in an updated policy statement on youth baseball and softball released today by the American Academy of Pediatric’s Council on Sports Medicine and Fitness.


Dr. Joseph Congeni, director of the Sports Medicine Center at Akron Children’s Hospital, is a co-author of the statement, which is being shared with pediatricians nationwide.


The last update to the safety guidelines dates back more than a decade.


Since then, new recommendations have been carefully researched and added to promote safe participation in youth baseball and softball, Congeni said.


An estimated 8.6 million children ages 6 through 17 participate in organized or recreational baseball, according to the pediatric group. More than 2 million girls ages 12 to 18 compete in fast pitch softball each year.


The group isn’t discouraging kids from playing America’s Pastime, Congeni said.


“Teaching kids baseball at a young age is encouraged,” he said. “But it does have some real issues that go with it.


“… The best we can tell people is for coaches or parents who really care for the safety of their kids to be aware of the recommendations.”


Break head


According to the researchers, about one in every 10 sports injuries treated in emergency departments among children younger than 15 are baseball- or softball-related.


In the updated guidelines, the pediatric group stresses that all coaches should know the quickest way to reach the closest emergency medical crew at all times, particularly for cardiac problems. Quick access to an automated external defibrillator can save lives if cardiac arrests occur.


“The first thing to do nowadays, even before starting CPR, is calling 911,” Congeni said.


Many of the new recommendations center on young pitchers and prevention of overuse injuries.


The American Academy of Pediatrics’ recommendations follow Little League Baseball’s guidelines that limit pitchers 10 and younger to 75 or fewer pitches per day.


As many as 35 percent of youth baseball pitchers who suffer from growth plate injuries because of overuse are never able to pitch again, Congeni said. So-called “Little League elbow” or “Little League shoulder” injuries have become more prevalent as year-round play has increased in popularity and the level of competition has risen.


“Their bodies just are not fully developed,” he said.


Along with discouraging curveballs until age 14 and sliders until age 16, the guidelines also state: “Parents, coaches and players should be educated about the early warning signs of elbow and shoulder overuse injuries. … Athletes should cease pitching immediately when signs of arm fatigue or pain occur; they should be encouraged to seek timely and appropriate treatment of significant or persistent pain.”


“The sooner you pick them up,” Congeni said, “the better.”


When Clayton Romanoski of Green complained about soreness in his elbow after pitching several years ago, his family and coach took his pain seriously.


A visit to Congeni’s office revealed the then-13-year-old pitcher had a growth-plate injury from overuse, said his mother, Debbie Romanoski. At the time, he was starting to throw curveballs and off-speed pitches.


“I just think he did too much,” his mother said. “I don’t think he was ready for it.”


After rest and physical therapy, Clayton, now 16, is continuing to play ball, though he doesn’t throw any “junk” and limits his innings, his mother said.


She said she believes all parents and coaches need to listen when a young player says, “This doesn’t feel right.”


“It could have ruined his arm forever,” she said.


To view the American Academy of Pediatrics’ full list of updated recommendations for youth baseball and softball, visit http://pediatrics.?aappublications.org/cgi/doi/10.1542/peds.2011-3593


Cheryl Powell can be reached at 330-996-3902 or chpowell@thebeaconjournal.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.