DEAR DR. DONOHUE: Have you ever discussed Little League elbow? I have a boy, 11, who eats, breathes and lives baseball. He is a pitcher and plays just about every day. He doesn’t pitch every day, but he can play many positions well. I wonder if this is too much for an 11-year-old arm. – N.B.

ANSWER: Little League elbow is an annual topic, and it’s worth discussing every year.

Elbows that have not fully matured are vulnerable to injury from the repetitive stress of throwing a ball. Prevention lies in limiting the number of pitches thrown and in supervising the kinds of pitches thrown. Sufficient rest between pitching sessions is also important.

Most official organizations have rules limiting the number of innings a boy or girl should pitch, how many pitches should be thrown per game and how many games should be pitched each week. Your boy’s team should have a copy of those rules, and if it doesn’t, insist that it obtain one.

As a rough guide, 11- and 12-year-olds should not throw more than 68 pitches a game and should not pitch more than two games a week.

The number of pitches thrown in practice has to be watched carefully. I can’t specify an exact number, but common sense must intervene.

If a pitcher complains of elbow pain, he or she should be put on rest until the pain leaves. If it doesn’t leave shortly – in a day or two – bring the child to the doctor.

The kinds of pitches should also be limited. Curveballs should not be thrown until a pitcher is 15 or 16.

Young pitchers don’t like to have such limitations put on them. Tell them that if they injure their elbow from using it too much, they are going to have to take two to six weeks of enforced rest, or they might never be able to pitch again.

DEAR DR. DONOHUE: Do you consider cheerleading a sport? I do, but I am a cheerleader. Few others agree with me. If you can back me up with any statistics, I would be deeply appreciative. – E.F.

ANSWER: Cheerleading stands on its own merits and definitely qualifies as a demanding athletic activity.

It requires a high level of agility, balance and strength – often higher that the level attained by the athletes being cheered.

There is a dark side to cheerleading. Some cheerleading instructors have an ill-advised policy of insisting their female cheerleaders stay unwholesomely thin. It’s the same attitude that pervades ballet.

I can give you good ammunition to defend the position that cheerleading is a demanding athletic endeavor. Are you familiar with the expression “one repetition maximum” – 1RM? It’s the maximum amount of weight a person can lift one time and is often used as a criterion of strength.

In the bench press, the average 1RM for male cheerleaders is 224 pounds, equal to or better than the 1RM for baseball and basketball players of comparable age. For female cheerleaders, their bench-press 1RM is 81 pounds, the equivalent 1RM of female basketball players.

DEAR DR. DONOHUE: I spend all summer at my family’s cottage. I am a runner, and I wonder about running on sand. Is it as good for you as running on a firm surface? Does it have any advantages? – R.J.

ANSWER: Sand running has been put to the test, and it comes out better than running on a road or track.

It has been shown that six weeks of sand running increases a runner’s thigh circumference more than does six weeks of road running. It also increases the vertical jump of sand runners over that of road runners. Both are measures of leg strength.

It’s also been demonstrated that sand running helps people cover greater distances in 12 minutes than does training by running on roads.

The energy cost of running on sand is greater than the energy cost of running on a solid surface. Muscles have to work harder to stabilize the foot and leg.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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