Incidence of injuries in high school softball and baseball players
Shanley E, Rauh MJ, Michener LA, Ellenbecker TS. J Athl Train. 2011; 46(6): 648-654
http://www.ncbi.nlm.nih.gov/pubmed/22488191 (Full text available for free online)
Over the last ten years, participation rates have increased in baseball and softball (3.9% and 8.4% at the interscholastic level, respectively). Despite this rise in popularity, a dearth of knowledge exists concerning the incidence of injuries sustained by high school baseball and softball players. Therefore, the authors conducted a prospective cohort study of high school athletes (247 athletes; 103 female, 144 male) to determine initial and subsequent injury rates; compare injury rates between sports, practices, and games; and categorize injuries by body location, type, severity (time lost), season trends (by month), and position. Injuries and athlete exposures (AE) were documented using two systems: the Simtrak Mobility and the Athletic Health Care System Daily Injury Report (DIR) form. An AE was considered one athlete participating in one practice or game. Incidence rates were calculated per 1000 AE’s for initial and subsequent injuries, practice vs. game, and severity. Overall, the injury incidence rate was 4.5 per 1000 AE’s while separately, softball players demonstrated a higher rate (5.6/1000 AE’s) than baseball players (4.0/1000 AE’s). Initial-injury rates for baseball players were slightly higher than softball players but the opposite was true for subsequent-injury rates. Softball players also showed increased likelihood of being injured in a game compared to baseball. One-third of all pitchers reported an injury during the season, though baseball position players had slightly higher injury rates than baseball pitchers. Of the twelve softball pitchers in the study, six sustained an injury. For entire cohort, the shoulder had the highest proportion of injuries reported (34.7%) with elbow (28.6%) a close second. However, baseball players sustained 12 of 14 elbow injuries reported. The highest injury rates occurred in the first (7.96/1000 AE’s) and third month (4.72/1000 AE’s) of the season with shoulder rates highest in the first month and elbow rates highest in the third month. Different patterns for shoulder and elbow injury emerged, as shoulder injury rates declined for both sports decisively after the first month but elbow injury rates peaked in the third month for baseball players.
Baseball and softball athletes are often lumped together, despite differences in bat and ball characteristics, field dimensions, and pitching style. While injury rates were low in both sports, trends emerged that may promote unique clinical decisions for each sport. The upper extremity had the highest injury rates, which emphasizes the demand placed on the shoulder and elbow and the need for preventive training programs. While injuries rates peaked in the first month of the season the timing of elbow injuries, whether the result of fatigue over a long season or poor mechanics predisposing the athlete, were a notable because they peaked later in the season. This trend, coupled with baseball players suffering the majority of reported elbow injuries (85%), suggests that clinicians should closely monitor baseball players for signs/symptoms of elbow pathology as the competitive season progresses. Though further research with larger samples is needed, is this trend evident with the baseball and softball athletes that you see in the clinic or athletic training room? Would this type of data lead you to tailor preventative or rehabilitative training programs based on position or point in the season for these athletes?
Written By: Laura McDonald
Reviewed by: Jeffrey Driban
Related postsShanley E, Rauh MJ, Michener LA, & Ellenbecker TS (2011). Incidence of injuries in high school softball and baseball players. Journal of Athletic Training, 46 (6), 648-54 PMID: 22488191