One way to tell that spring is almost here is the cry of “Play ball!” on baseball diamonds across the nation, where youngsters between the ages of seven to 18 engage in what has been called America’s favorite pastime.

Little League baseball season is in full swing, and local chapters in Venice, Santa Monica, Del Rey and Westchester are fielding several teams in their respective leagues. While teaching the fundamentals of sliding, bunting, and throwing remain foremost in the minds of Little League coaches, safety is also a top priority.

Following a rash of injuries to the arms and elbows of some of its players in recent years, Little League International, the parent organization for youth baseball, instituted a new policy last year regarding the number of pitches that a player can throw during a game.

The pitch count regulations govern how many pitches a player can throw in an inning. A 13- to 16-year-old player, for example, has a 95-pitch count ceiling, and according to the anecdotal evidence by several doctors and youth baseball officials, the new policy has tremendous potential to reduce the number of ailments among young players, especially pitchers and catchers.

“It’s great news,” said Dr. Orr Limpisvasti of the Kerlan-Jobe Orthopaedic Clinic in Westchester. “It’s taken a combined effort between youth organizations and coaches (to reduce the level of injuries).

“The biggest change that has occurred is the awareness of overuse.”

Nine- and ten-year-olds are limited to 75 pitches per day, players between the ages of seven and eight are allowed 50 and 11-to 12-year-old players can throw up to 85 pitches a game.

The Westchester Little League has had a similar policy in place for five years, and was the first league on the Westside to do so, says Keith Kutler, the safety coordinator of the Westchester chapter.

“The old system was based on innings per week, and after my kids started moving up in levels, we saw that the old method was not an accurate way to track pitches,” Kutler explained.

Pitchers could throw a wide range of pitches per inning, anywhere from six to 30, and with that wide variance, officials at the Westchester league felt it was prudent to employ a different standard for charting the number of pitches thrown.

“When you have such a wide range, how could you get an accurate reading (using the former method)?” Kutler asked.

Reports of an increasing number of injuries to the elbows and arms of young players caused trepidation among doctors, managers and Little League officials, as well as the families of some of the players.

Emergency room physicians and primary care givers, along with surgeons who specialize in reconstructive procedures, saw an astounding rise in arm maladies among Little Leaguers over a four- to five-year period.

“It certainly is alarming,” Clarke Holmes, director of Sports Medicine at Georgetown University, said in an interview with ABC News last year. “We just shouldn’t be seeing 12-, 13-, 14-year-olds in our office with these types of injuries, and we didn’t see them five to ten years ago nearly as frequently.”

What has caused doctors such as Limpisvasti alarm is the number of “Tommy John” surgeries that have been performed in recent years on preteens and teenagers. The surgical maneuver, named after a former Los Angeles Dodger pitcher, is a procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body.

Dr. James R. Andrews, an Alabama surgeon who specializes in Tommy John surgeries, has seen a marked increase in high school age pitchers among his newer patients. Between 2003 and 2006, 24 percent of Andrews’ patients were in their teen years, compared to eight percent between 1995 and 1998.

“(The pitch count rule) is certainly one of the most important injury prevention steps ever initiated in youth baseball by the leaders of youth baseball,” Andrews, the director of America Sports Medicine Institute, said in a statement.

Primary physicians are often the first lines of defense when young players need medical assistance, and convincing them to take time off to heal is not an easy proposition. Dr. Danelle Fisher, a Westchester pediatrician, has a number of patients who have been hurt on the baseball diamond.

“When a kid gets hurt, they usually come to us first,” Fisher, chair of the department of pediatrics at Saint John’s Health Center in Santa Monica, told The Argonaut. “We see so many kids that get injured, and when we tell them to rest, that’s very hard for them to swallow.”

Kutler says that the new rules have made managers and coaches more conscious about using more that one or two pitchers during a season.

“Much to the chagrin of some coaches, they’ve had to use other pitchers, but ultimately, it’s about the kids having fun,” he said.

The North Venice Little League has not seen a rash of arm or elbow injuries, says Richard Brisacher, the league’s communications director.

“I’m not aware of any overuse injuries to any of our players,” he said.

Brisacher agreed with Kutler that the pitch count regulation has forced coaches to develop deeper pitching staffs and not rely too heavily on one or two star hurlers.

Limpisvasti says that even strengthening programs designed for Little Leaguers should be regimented because the young athletes often are still in the early stages of growth. Using arm weights, for example, might be risky for some youngsters, he says.

“Pre-adolescents cannot always respond to strength training routines,” said the doctor.

Fisher recommends seeking treatment immediately when there is pain or discomfort in the elbow, shoulder, wrist or arm.

“These are kids with immature bone structures,” she noted. “You can set yourself up for further damage in later years if an injury is not treated promptly and properly.”

Limpisvasti says that taking time off from baseball and engaging in other sports can also help guard against damage to an athlete’s elbow or arm.

“The data suggests that four months (without playing baseball) over the course of the year is helpful,” he said.

Kutler, who has one son in Little League and a 13-year-old in the Babe Ruth League, believes that the pitch count and other injury prevention procedures are beneficial for the sport and the players.

“Ultimately, it’s about safety, and it’s about the kids having fun,” he said.

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