PITTSBURGH — Getting the news that he would have to stop playing baseball for the rest of the summer was difficult for 9-year-old Garrett Rusnak, but getting to throw the first pitch before the Pirates took on Cincinnati at PNC Park gave him something to look forward to.

“I was kind of nervous because there were thousands of people,” Rusnak said, recalling how he felt before the pitch.

There to support Rusnak were family friends, school friends and family members, including Albert and Mary Ann Thompson, his grandparents; John and Amy Rusnak, his parents; and Hunter Rusnak, his older brother. Hunter Rusnak had practiced throwing with Garrett Rusnak a couple of times a day to ensure he could make the pitch.

In spite of the pressure, Rusnak pulled it off. Not only did the Pirates win their first game of a doubleheader 4-2 that day, but Rusnak believes he had his own “good toss.”

Amy Rusnak, who admits she became emotional as Rusnak pitched, said, “It was an amazing experience altogether. It was something that we would’ve never expected him to get a chance to do — a once-in-a-lifetime opportunity.”

Garrett Rusnak, who lives in Dillonvale, is going into fourth grade at Hills Elementary School in Mingo Junction. He was diagnosed at the age of 5 with Perthes disease, a rare condition in children that causes limping and pain in the hip due to disrupted blood flow to the head of the thigh bone.

Although the condition is not life-threatening, Amy Rusnak said “it is life-changing.” When Garrett Rusnak was first diagnosed, his mother said, he had to wear double leg casts for several weeks and had to use a wheelchair during his year in kindergarten.

He began seeing Dr. Rachel Hildebrand, a pediatric physical therapist in Weirton, with whom he received three years of weekly physical therapy. Amy Rusnak said Hildebrand was their “lifeline” during moments of disappointment and uncertainty. Currently, Garrett Rusnak is a patient of Dr. Mark Sangimino, an orthopedic surgeon with the Allegheny Health Network in Wexford, Pa.

Garrett Rusnak was “given the all-clear” in 2022, his mother said. However, he had to have another appointment with Sangimino four weeks ago after the pain returned. At the appointment, Sangimino recommended that Garret Rusnak stop playing baseball with the Indian Creek Youth Baseball Team, for which he’s a shortstop, to give his hip some time to rest.

“When (Sangimino) gave him that news,” Amy Rusnak said, “it was following that that he had asked him about throwing the first pitch.”

Recalling the interaction, Sangimino said he has a number of different charity programs. When an opportunity to have an individual throw the first pitch at a Pirates’ game in connection with a message from the Neighborhood Ford Store, Sangimino said, he was asked to look for someone in his practice who had “overcome a lot of challenges” and loves baseball to participate in the event.

Sangimino said, “Neighborhood Ford Store (the event’s sponsor) … approached me and asked me whether I had a really amazing patient who might want to throw out the first pitch but would also represent … the importance, in their eyes, of maintaining proper safety of seatbelts … and also safety for pets.

“(At the appointment,) Garrett was telling me how much he loves baseball,” Sangimino said, “and that’s why I thought … that he would really enjoy that experience.”

Garrett Rusnak said he was not speechless when he got the offer, although his mother said, “Yes, you were speechless. You were like, ‘I don’t know if I can do that.'”

Overcoming his trepidation, Garrett Rusnak accepted, and Sangimino got him in contact with representatives from the Neighborhood Ford Store.

Joining Rusnak for the pitch was a golden retriever named Yummee, who acted as the catcher with the help of the Pirate Parrot. Rusnak and Yummee, who is owned by Greater Pittsburgh Golden Retriever Club members Bill and Marcy Kronz, helped Neighborhood Ford Store, to “spread the message … that vehicle-safety when traveling with children and pets is important to everyone on the road,” said Nancy Lewis, PR manager for the marketing group that includes Ford dealers in the Tri-State Area and a portion of Maryland.

Lewis said that, according to the National Highway Safety Administration, “46% of car seats and booster seats are used incorrectly, while the National Digital Car Seat Check Form database reveals that more than half of all car seats brought in for inspection to child passenger safety technicians are improperly installed and used.”

Additionally, Lewis said, “The American Humane Society reminds drivers that lose pets inside of vehicles can become deadly distractions for drivers. Moreover, unrestrained pets can become hazards themselves during an accident.”

The opportunity to pitch tempered the disheartening news of Garrett Rusnak’s recommended break from baseball. In addition, his mother said, Garrett Rusnak has had a good support system present in friends and family.

Garrett has remained active, finding other activities that are not as physically strenuous, including going to the zoo, doing crafts, watching movies, fishing, going on walks and hiking.

Dealing with the condition during the last four years has been difficult, Garrett admits. His mother said they will go to see Sangimino again in four months for a follow-up appointment to “plan for the next steps,” which may include surgery.

“We’re hoping that, with rest, especially over the winter, that hopefully he’ll be able to play baseball again in the spring,” Amy Rusnak said.

Sangimino said, “Garrett has had a real challenge that would really knock most kids down, but he’s been strong. … He’s done everything I’ve asked him to do, in conjunction with an incredibly loving family, and those things I’ve asked him to do have been very, very difficult things for a growing boy who doesn’t want to restrict his activities.”

The kids he treats, Sangimino said, amaze him with how they teach him about life through their strength and how doing the right thing can allow them to heal. The kids have also taught him about the importance of family in the midst of that adversity, he said.

Garret Rusnak has been an exemplar of courage amid having to return for treatment again and again, Sangimino said.

Although he says he’s no motivational speaker, Garrett Rusnak has let his actions speak louder than words about perseverance in the face of challenges. He has acted as a model for other kids who might be dealing with similar issues, and, hopefully, he will be returning as a shortstop very soon.