"In pitcher's plight, a warningA parent urges caution after elbow problems end the short career of Brendan Sharpe."

"It's an American icon: A dad playing catch with his son in the back yard.But in the case of Charles Sharpe and his son Brendan, backyard baseball may have been a contributing factor to an American tragedy. Brendan underwent an operation last summer for a case of O.C.D. (osteochondritis dissecans), an extreme form of what is popularly known as Little League Elbow, and it's likely that he'll have some permanent impairment.Despite the fact that the first signs appeared while Brendan was pitching for a Little League team and continued through his participation in Babe Ruth, Sharpe has no animosity toward either program and assigns no blame for his son's situation. Parents need to be informed about the potential for crippling injury, Charles Sharpe says. That to me is the big issue.Parents and coaches must take elbow pain seriously, he said. It can't be ignored, and you certainly can't pitch through it. 'Take pain like a man' is totally incorrect when it comes to an elbow.I'm not mad at anybody. This island has good programs and good people. They just don't have the money for proper medical education. A doctor should speak to every Little League coach, and I'd like to see a mechanism to inform parents every year of the danger of this injury.Dr. Joseph Engman, who performed the operation on Brendan's elbow, suggests one very simple mechanism:Listen to your kids. Classically, if a kid complains of elbow pain, he should stop throwing and be X-rayed.Often he's told to shake it off, to keep going. Or parents might to go pediatricians or their family doctors, who usually don't do X-rays. A sports medicine physician or orthopedist knows what to look for.Little League Elbow arises because of the existence of growth plates in children -- layers of soft cartilage with limited blood supply at the ends of the radius, ulna and humerus bones which meet to form the elbow. These relatively delicate plates may be subjected to injury from constant, repetitive stresses. Like throwing a baseball.The more common injury is on the inner side of the elbow, where ligaments can become strained.In Brendan's case, the problem area was on the outside. Repetitive compression forces caused part of the bone to die and pieces to eventually break off. Sharpe described his son's progressively worsening condition as a cautionary tale.Hard throwingBrendan began in T-ball, pitched in the minors in 1993, and was promoted to the majors the following year, though he played little.In Sharpe's view, 1995 was the watershed year.He was one of only two pitchers used the entire season, Sharpe said. That was likely the true beginning of the problem. In addition to the actual game pitches, there were general warmups, pre-game pitching warmups, pre-inning warmups. There's a belief that throwing curve balls is what causes Little League Elbow. But that's a myth. It's the repetition of throwing hard over and over again.Noticing a change in Brendan's pitching mechanics during the season, Sharpe took his son to see a doctor, who suggested several weeks' rest.Playing Babe Ruth the following year, Brendan began complaining of elbow pain.There was nothing out of the ordinary, Sharpe said. He was pitching the normal amount.The problem was diagnosed as tendonitis, with rest and tubing exercises prescribed. But the pain didn't go away.The following year, beginning to lose his effectiveness, Brendan was relegated to relief roles. Now he wasn't throwing enough to complain of pain, Sharpe said. And he didn't make a big deal of it. Kids are often vague about pain, when and where it hurts.So father and son continued playing catch.In 1998, now a BHS freshman, Brendan pitched and played third base for the C team. My elbow was still bothering me, but the pain would go away after I warmed up, Brendan said. We still thought it was tendonitis, so I'd ice it every night. But that was the last year he'd play baseball.In the summer of 2000, with Brendan out of baseball for well over a year, the Sharpes built a backyard climbing wall. Shoveling pea gravel, nailing nails, little everyday motions proved painful.He wouldn't climb for a month and a half because his elbow was sore, Charles Sharpe said. It was then that I knew something was terribly wrong with it.The diagnosisThis time the elbow was subjected to an MRI exam. It revealed a dark spot, a bomb crater in the elbow.The doctor said it was the worst case he'd ever seen, Brendan Sharpe said. It's kind of a miracle that I can use my arm at all. But it's almost back to normal. The only thing that's different is that my arm doesn't straighten out completely. Sometimes it catches a little and there's some pain.Climbing has been just fine. I've made some adjustments in technique so I can cope with it. But throwing is definitely not in my future.Long-term, Engman sees the likelihood for a relatively normal elbow for Brendan, with some loss of motion and a probable permanent bone deformity.There's an abnormal space in the joint, he said. He has some scar tissue, rather than a normal bone surface. He could have a normally functioning elbow for daily use, but probably not for a high level of activity.The point is, there is the potential for permanent effects and deformities if Little League Elbow is undiagnosed and untreated.Ken Guy, president of Bainbridge Island Little League, said his organization is taking steps to prevent similar situations from arising.League officials have brought up the topic at coaching clinics, distributed articles to coaches and other District 2 Little Leagues, and we have posted information and links at the league's website www.myteam/go/bill.Geoff Roach, president of Babe Ruth, said that his organization focuses on making its coaches very conscious of potential elbow injuries. We have clinics for our coaches, we keep careful pitch counts, he said, and we've had Dan Spillner, a 16-year major leaguer, working with our pitchers to improve their mechanics.Sharpe hopes that better publicity and the measures taken by Little League and Babe Ruth will prevent other parents from repeating his experience.After my son came out of surgery, I saw those bone chips from his elbow in a jar, he said, and I thought 'What a waste.' "

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