Preventing Baseball/Softball Injuries
Jeremiah Clinton, MD
With spring nearly over the boys and girls of summer are heading to the
mound for competitive and recreational baseball and softball. It may surprise
you to know that in 2015, 265,000 Americans were treated for baseball
related injuries and 10,000 of the injuries resulted in hospitalization.
Even though we consider baseball a non-contact sport most serious injuries
occur from direct contact with a bat, a ball, another player or the ground.
Also of concern are overuse injuries to the shoulder and elbow from the
repetitive nature of the game. Although we cannot prevent all injuries
we can try and reduce them by making sure players have properly prepared
before the season starts, that appropriate equipment is used, ensure the
field is safe, and by focusing on the proper techniques of the game.
Preparation for the game is important for both coaches and players. For
players warming up before you start the game is very important. You do
not see the professionals running out cold and playing. They spend up
to several hours before the game warming up, stretching, and practicing
before the first at bat. It probably is not reasonable to think the average
player can spend an hour or more warming up before the game but take 15-30
minutes and warm up with easy calisthenics like jumping jacks, pushups,
and sit-ups. Run the bases at a light jog, not only to warm up but also
to become familiar with the field and any danger it may pose. Stretching
before the game can keep you playing without injury. It is especially
important to stretch your shoulders, hamstrings, and back. In the big
leagues, 22 pitchers that did a specific stretching routine for their
shoulders did not miss an inning over the course of a 3 year period. In
contrast, a different study followed 39 pitchers that had tight shoulders
that were identified in spring training. These players did not do a specific
stretching routine, and of the 39 players followed during the study, 23
of them or 60% had to stop playing because of shoulder injuries. Your
coach or athletic trainer may be able to give you a simple stretching
program that you can do before the game to avoid injury. From a coaches
perspective ensuring players are warming up appropriately, using proper
form and technique, that pitch counts and innings played are closely watched,
and that the players have the right equipment can avoid games missed.
Like any sport the right equipment makes the game safer and more fun.
Baseball shoes that fit properly and have the appropriate cleats for the
surface can decrease the likelihood of foot and ankle injuries. The catcher
requires position specific equipment to include: mitt, helmet, facemask,
throat guard, chest protector, shin guards and a protective cup. Both
the player at bat and the player on deck should have batting helmets on
and they should be worn until the player has returned to the dugout. For
additional safety a protective face mask can be added to the helmet to
avoid facial injuries. In recent years batters have the option of using
protective jackets to avoid injuries to the chest and back from wild pitches.
Softer balls should be used in the youth leagues to avoid injury from
pitches or balls that have been hit into play. Players should also be
coached on how to avoid being hit by the ball verses taking the hit from
Many of the more serious injuries that occur during a game or practice
are centered on base running. Specific instructions and coaching the appropriate
technique can decrease the risk significantly. It is recommended that
players under the age of 10 not be taught to slide and when initially
learning to slide should do so without a base in place or use a specific
"sliding bag." Fielders should be taught and should adhere to
the "obstruction rule," and avoid blocking the runner or base
when you are not in possession of the ball, as collisions on the field
can lead to serious injury to both the runner and fielder. In contrast
to the majors in little league and high school ball the runner is required
to attempt to avoid contact with the defensive player, if they fail to
do so this is considered "malicious contact" and the player
can be thrown from the game. Players should attempt to slide into home
and avoid smashing into the catcher as this can lead to very serious injuries
and typically the runner gets the worst of it and unless the play is very
close is usually still put out.
Pitching is another common source of injury to players, because of the
enormous amount of force the throwing arm must generate and the stress
this puts on the shoulder and elbow specifically. The American Baseball
Medical and Safety Advisory committee has developed guidelines to limit
both pitch counts per game and pitches per week. Additionally they have
made recommendations when to teach young pitchers specific pitches. Pitchers
should avoid playing for more than one team at a time, as it has been
shown to increase the risk of shoulder and elbow injuries. In general
young athletes should not participate in the same sport year round. Breaks
are needed allow for young bodies to recover can decrease the risk of
overuse injuries. Playing other sports also allows for the development
of other skills that may cross over to their play on the diamond.
Finally, good communication between coaches and parents is important when
an injury is suspected, since some players will try and hide an injury
to avoid being removed from play. When injury does occur return to play
should only happen when the player's symptoms have completely resolved.
If a joint has been injured it should not be swollen or painful, have
full range of motion and full strength. If a player has sustained a concussion
they should not return to play until being cleared by a medical provider
and are 100% asymptomatic both at rest and at play. For players with overuse
injuries to the shoulder and elbow a gradual return to throwing should
occur through a structured plan which progressively increases the number
and distance of throws depending on the position of the player and the
length of time away from the game.
With proper preparation, equipment, and coaching many injuries that occur
in baseball and softball can be avoided allowing players to enjoy the
great American past time.
Questions and or comments regarding this week's health column please
contact Jeremiah Clinton, MD at Bitterroot Orthopedics and Sports Medicine,
a service of Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton,
MT 59840. Working together to build a healthier community!