Louis Rizio, MD

National Baseball Day ! Great time of year but also a good time to think about how we can keep our players on the field and injury free. COMMENT “Baseball” for a link to my Substack site for content on preventing youth injuries and a free injury prevention program with paid subscription

Check out my new SubStack post on throwing injuries in youth sports. Causes, prevention and patterns discussed. Go to the link to subscribe. https://open.substack.com/pub/sportsmeddoc/p/play-ball?r=82hcv8&utm_medium=ios.

🚨 The Hidden Drivers of Youth Sports Injuries - Patterns I see as a Sports Orthopedic Surgeon

Many youth injuries aren’t random — they follow predictable patterns.

Here are 7 common mistakes driving the youth sports overuse epidemic:

⚠️ Early specialization → repetitive stress injuries
⚠️ Playing on multiple teams → workload stacking
⚠️ No true off-season → chronic overuse
⚠️ Sudden load spikes → stress fractures
⚠️ Playing through pain → injuries that require surgery later
⚠️ Poor sleep → slower recovery and higher injury risk
⚠️ No strength training → poor mechanics and higher injury rates

Youth athletes today often train more intensely than professional athletes did decades ago — but without the same recovery structure.

The solution isn’t less sports.

It’s better structure, smarter training, and real recovery.

✔ Multi-sport development
✔ Scheduled rest periods
✔ Strength and neuromuscular training
✔ Listening to pain signals early

If you’re a parent, coach, or athlete, these changes can prevent many injuries I see in clinic.

👇 Comment: What sport do your kids play?

🔁 Share this with a coach or parent who needs to see it.

The Best!

Great job from all the folks that got this to presentation today! AAOS 2026

Thank you NJ Family for opportunity to weigh in on some skiing safety questions.

Honored!

MPFL Reconstruction: First-Time vs Recurrent Dislocations 🏃‍♂️

🔁 Redislocation Risk
• 7% → First-time dislocation + surgery
• 3.9–10% → Multiple dislocations + surgery
• 30% → First-time dislocation + rehab only

⏱️ Return to Sport
• 5.1 months → First-time cases
• 7.6 months → Recurrent cases
• 85–93% return to sport overall
• 68–74% return to same or higher level

📊 Function & Satisfaction
• Excellent Kujala scores: 87–94
• First-time cases → higher final scores
• Recurrent cases → greater improvement
• ~76–77% patient satisfaction

🏆 Activity Level
• 95% first-time patients return to prior activity
• 72% with recurrent instability

💡 Takeaway
➡️ Earlier stabilization = faster return + better activity outcomes for athletic patients

Ideal for athletes, parents, and coaches | Education only

⚾🏐 Shoulder Rotation Deficits & Injury Risk in Overhead Athletes

Dr. Louis Rizio MD | Sports Surgery Specialist

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What Is GIRD?
• Glenohumeral Internal Rotation Deficit (GIRD) = loss of internal rotation in the dominant shoulder.
• Common in overhead athletes: baseball, tennis, volleyball, cricket.

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Why It Matters
• A >15–20° deficit in internal rotation increases risk of shoulder & elbow injuries.
• Reduced total rotational motion (TROM) = higher stress on the joint.
• Alters throwing mechanics → increased torque and impingement risk.

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Key Stats
• ⚠️ ≥25° loss of IR = up to 4× greater injury risk in high school baseball players.
• 🏐 Volleyball players with ≥17° GIRD & ≥5° TROM asymmetry → more shoulder pain.
• GIRD worsens over years of overhead play & is influenced by prior injuries.

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Common Injuries Linked to GIRD
• Rotator cuff tendinopathy or partial tears
• SLAP/labral injuries
• Posterior shoulder tightness & impingement
• UCL strain at the elbow

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Prevention & Management
• 🧘‍♂️ Sleeper & cross-body stretches
• 💪 Posterior cuff mobility + scapular control work
• 🩺 Regular screening of shoulder rotation during season
• ⚖️ Maintain total shoulder motion within 5° of non-throwing side

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Pro Insight:
Not all GIRD is “bad.” Some loss of IR is a normal throwing adaptation — the key is balance and monitoring total motion, not just one direction.

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Take-Home Message
➡️ GIRD matters — small rotation losses can lead to big injury risks.
➡️ Early detection, consistent mobility work, and season-long monitoring protect performance and longevity.