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Ciccotti, Michael G., Keisha M. Pollack, Michael C. Ciccotti, John D’Angelo, Christopher S. Ahmad, David Altchek, James Andrews, and Frank C. Curriero. "Elbow Injuries in Professional Baseball: Epidemiological Findings From the Major League Baseball Injury Surveillance System." American Journal of Sports Medicine 45, no. 10 (June 2, 2017): 2319–28. http://dx.doi.org/10.1177/0363546517706964.
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Background: Elbow injuries cause significant disability for the throwing athlete. Scant data are available on the distribution and characteristics of these injuries in elite baseball players. No study exists that focuses solely on the epidemiological characteristics of elbow injuries in professional baseball players using a comprehensive injury surveillance system. Hypothesis: Professional baseball players have a high occurrence of elbow injuries influenced by factors including length of time playing, time period within the annual baseball season, and specific position played. Study Design: Descriptive epidemiological study. Methods: Data on elbow injuries occurring during the 2011-2014 seasons were collected from Major League Baseball’s Health Injury and Tracking System, a comprehensive injury surveillance system. Each specific type of elbow injury was evaluated with respect to overall injury rate, years as a professional player, mechanism of injury, treatment, average time lost, and return to play. Results: During the study period, 3185 elbow injuries (n = 430 Major League; n = 2755 Minor League) occurred. The mean number of days missed and percentage requiring surgery were similar between Major and Minor League players. Overall, 20.0% (650/3185) of the injuries required surgical treatment. Pitchers were the most likely to incur an elbow injury (40.0% of injured athletes were pitchers), were the most likely to require surgery (34.2% of injured pitchers required surgery), and had the greatest mean number of days missed when treated nonsurgically (33.2 days). Medial injuries composed 42.1% (1342/3185) of all elbow injuries. Of all elbow surgeries performed during the study period, the highest percentage involved ligaments (372/650; 57.2%). Conclusion: Elbow injuries are a considerable source of disability in professional baseball players. Pitchers are most likely to incur these injuries, are most likely to require surgery, and have the highest mean number of days missed when treated nonsurgically. The most common injuries involve the medial elbow, with ligament injuries most often requiring surgery. This study represents the only investigation to date using a comprehensive injury surveillance system to examine elbow injuries in professional baseball players. It provides a basis for injury prevention and treatment recommendations, establishes the most thorough framework for determining elbow injury risk, and focuses continued research on elbow injury prevention in the elite baseball player.
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Farooqi, Ali S., Alexander Lee, Eric Abreu, Divya Talwar, and Kathleen J. Maguire. "Epidemiology of Pediatric Baseball and Softball Player Injuries." Orthopaedic Journal of Sports Medicine 9, no. 12 (December 1, 2021): 232596712110525. http://dx.doi.org/10.1177/23259671211052585.
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Background: Baseball and softball are popular sports in the United States and are responsible for a large number of youth sports injuries each year. Purpose: To investigate recent differences in youth baseball and softball injuries evaluated in nationwide emergency departments. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) database was examined for softball and baseball injuries in pediatric patients (age, 7-21 years) from 2010 through 2019. Patients were classified as children (age, 7-13 years), adolescents (age, 14-18 years), or young adults (age, 19-21 years). Case narratives were used to categorize injuries as contact injuries (hit by bat or ball), field injuries (sliding into base, collision with another player, catching, or running), throwing injuries, or other. Results: An unweighted total of 24,717 baseball injuries and 13,162 softball injuries were recorded. A nationwide estimate of 861,456 baseball injuries and 511,117 softball injuries were sustained during the studied time period, with estimated respective injury rates of 86,146 and 51,112 per year. Injured softball players were most commonly adolescent (47%) and female (92%), while injured baseball players were most commonly children (54%) and male (90%). There was a greater proportion of baseball-related injuries involving the head/neck (41%) as compared with softball-related injuries (30%) ( P < .01). Conversely, a greater proportion of softball-related injuries involved the lower extremity (32%) as compared with baseball-related injuries (19%) ( P < .01). When comparing diagnosis, softball injuries were more often sprains/strains (28%) than baseball injuries (18%) ( P < .01). When comparing mechanisms of injury, baseball athletes were more likely to be evaluated with contact injuries than were softball athletes (49% vs 40%, P < .01). Conclusion: Youth baseball athletes were more likely to be injured through contact mechanisms and had a higher proportion of injuries related to the head/neck/face, whereas softball injuries more frequently involved the lower extremity and resulted in a sprain/strain. League guidelines should focus on reducing contact injuries within youth baseball, and injury-prevention programs should focus on reducing lower extremity injuries in youth softball.
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Trofa, David P., Kyle K. Obana, Hasani W. Swindell, Brian Shiu, Manish S. Noticewala, Charles A. Popkin, and Christopher S. Ahmad. "Increasing Burden of Youth Baseball Elbow Injuries in US Emergency Departments." Orthopaedic Journal of Sports Medicine 7, no. 5 (May 1, 2019): 232596711984563. http://dx.doi.org/10.1177/2325967119845636.
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Background: Youth athletes are starting sports earlier and training harder. Intense, year-round demands are encouraging early sports specialization under the perception that it will improve the odds of future elite performance. Unfortunately, there is growing evidence that early specialization is associated with increased risk of injury and burnout. This is especially true of pediatric and adolescent baseball players. Purpose/Hypothesis: The purpose of this investigation was to analyze national injury trends of youth baseball players. We hypothesized that while the total number of baseball injuries diagnosed over the past decade would decrease, there would be an increase in adolescent elbow injuries seen nationally. A further hypothesis was that this trend would be significantly greater than other injuries to the upper extremity and major joints. Study Design: Descriptive epidemiology study. Methods: Injury data from the National Electronic Injury Surveillance System, a United States Consumer Product Safety Commission database, were analyzed between January 1, 2006, and December 31, 2016, for baseball players aged ≤18 years. Data were collected on the location of injury, diagnosis, and mechanism of injury. Results: Between 2006 and 2016, an estimated 665,133 baseball injuries occurred nationally. The mean age of the injured players was 11.5 years. The most common injuries diagnosed included contusions (26.8%), fractures (23.6%), and strains and sprains (18.7%). Among major joints, the ankle (25.6%) was most commonly injured, followed by the knee (21.3%), wrist (19.2%), elbow (17.7%), and shoulder (16.2%). The incidence of the ankle, knee, wrist, and shoulder injuries decreased over time, while only the incidence of elbow injuries increased. A linear regression analysis demonstrated that the increasing incidence of elbow injuries was statistically significant against the decreasing trend for all baseball injury diagnoses, as well as ankle, knee, wrist, hand, and finger injuries ( P < .05). Additionally, the only elbow injury mechanism that increased substantially over time was throwing. Conclusion: The current investigation found that while the incidence of baseball injuries sustained by youth players is decreasing, elbow pathology is becoming more prevalent and is more commonly being caused by throwing. Given that the majority of elbow injuries among adolescent baseball players are overuse injuries, these findings underscore the importance of developing strategies to continue to ensure the safety of these youth athletes.
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Hamano, Noritaka, Hitoshi Shitara, Tsuyoshi Tajika, Takuro Kuboi, Tsuyoshi Ichinose, Tsuyoshi Sasaki, Takanori Kitagawa, et al. "Relationship Between Upper Limb Injuries and Hip Range of Motion in Elementary and Junior High School Baseball Players." Orthopaedic Journal of Sports Medicine 9, no. 2 (February 1, 2021): 232596712097091. http://dx.doi.org/10.1177/2325967120970916.
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Background: Shoulder and elbow injuries are major problems in baseball players. Tightness of the upper extremities has been reported as a risk factor for shoulder and elbow injuries in elementary and junior high school baseball players. However, few studies have been conducted on the relationship between decreased hip range of motion (ROM) and shoulder and elbow injuries. Purpose/Hypothesis: This study aimed to prospectively examine the relationship between hip ROM and throwing-related shoulder and elbow injuries in elementary and junior high school baseball players. The hypothesis was that players with unrestricted ROM in the hip would have a reduced risk of upper extremity injuries. Methods: The study included 263 baseball players (mean ± SD age, 10.5 ± 1.3 years; range, 7-14 years). The following physical parameters were assessed: (1) hip flexion ROM measured in the supine position and (2) hip internal and external rotation in the prone position. After the season, players completed questionnaires regarding shoulder and/or elbow injuries. For comparison, the players were classified as injured (not able to play for ≥8 days because of shoulder and/or elbow problems) or noninjured. Results: During the season, 52 players had shoulder and/or elbow injuries. When the injured and noninjured groups were compared, hip flexion on the dominant side (121.5° ± 12.0° vs 126.7° ± 9.8°, respectively; P < .01), hip flexion on the nondominant side (119.6° ± 11.7° vs 126.0° ± 9.9°, respectively; P < .01), and internal rotation on the dominant side (52.5° ± 11.3° vs 56.8° ± 10.8°, respectively; P = .01) were significantly reduced in the injured group. Conclusion: We identified preseason decreases in flexion bilaterally and internal rotation on the dominant side as risk factors for shoulder and elbow injuries in elementary and junior high school baseball players. Further studies are required to prevent disabilities in elementary and junior high school baseball players through development of prevention and intervention programs.
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Moats, William E. "Injuries in Baseball." Medicine & Science in Sports & Exercise 30, no. 10 (October 1998): 1558. http://dx.doi.org/10.1097/00005768-199810000-00016.
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Cassaza, Brian A., and Kirsten Rossner. "Baseball/Lacrosse Injuries." Physical Medicine and Rehabilitation Clinics of North America 10, no. 1 (February 1999): 141–57. http://dx.doi.org/10.1016/s1047-9651(18)30220-1.
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Ray, Tracy R. "Youth Baseball Injuries." Current Sports Medicine Reports 9, no. 5 (September 2010): 294–98. http://dx.doi.org/10.1249/jsr.0b013e3181f27403.
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Laurence, Michael. "Injuries in baseball." Journal of Bone and Joint Surgery. British volume 80-B, no. 6 (November 1998): 1085–86. http://dx.doi.org/10.1302/0301-620x.80b6.0801085c.
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Hultman, Kristi, Patrick F. Szukics, Adrienne Grzenda, Frank C. Curriero, and Steven B. Cohen. "Gastrocnemius Injuries in Professional Baseball Players: An Epidemiological Study." American Journal of Sports Medicine 48, no. 10 (July 21, 2020): 2489–98. http://dx.doi.org/10.1177/0363546520938759.
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Background: Gastrocnemius injuries are a common lower extremity injury in elite baseball players. There are no current epidemiological studies focused on gastrocnemius injuries in professional baseball players that provide information on the timing, distribution, and characteristics of such injuries. Hypothesis: Gastrocnemius injury in professional baseball players is a common injury that is influenced by factors such as age, player position, and time of season. Study Design: Descriptive epidemiological study. Methods: Based on Major League Baseball’s (MLB’s) Health and Injury Tracking System (HITS) database, gastrocnemius injuries that caused time out of play for MLB and Minor League Baseball (MiLB) players during the 2011-2016 seasons were identified. Player characteristics, including age, level of play, and position at time of injury, were collected. Injury-specific factors analyzed included date of injury, time of season, days missed, and activity leading to injury. Results: A total of 402 gastrocnemius injuries (n = 145, MLB; n = 257, MiLB) occurred during the 2011-2016 seasons. MLB players were significantly older at the time of injury (30.1 years, MLB; 23.9 years, MiLB; P < .001). Base running (36.1%) was the most common activity causing the injury, followed by fielding (23.6%), with 50.3% of base-running injuries sustained on the way to first base. In MLB players, gastrocnemius injuries were most common in infielders (48.3%), followed by pitchers (27.6%) and then outfielders (17.9%), while for MiLB players the injuries were more evenly distributed (33.5%, 28.8%, and 30.7%, respectively). The frequency of injuries in MLB players dropped off after the start of the regular season, whereas MiLB players had a consistent injury rate throughout the year. Conclusion: Gastrocnemius injuries are a common cause of lower extremity injury in professional baseball players, resulting in significant time out of play. Base running, particularly to first base, was the most common activity during injury. Outfielders had the fewest injuries; however, they required the longest time to recover. This study provides the first investigation to date with the HITS database to examine the characteristics and distribution of gastrocnemius injuries in professional baseball players, offering insight into risk factors, injury prevention, and recovery expectations.
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Chalmers, Peter, Rocco Bassora, Chris Inzerillo, Andrew Beharrie, Anthony Romeo, and Brandon Erickson. "Training with Lighter Baseballs Increases Velocity Without Increasing Injury Risk." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (July 1, 2020): 2325967120S0034. http://dx.doi.org/10.1177/2325967120s00341.
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Objectives: Pitch velocity has become an increasingly popular metric by which pitchers are graded and compared. Training programs that utilize weighted balls have been effective in increasing velocity but at the cost of increased injury risk. The purpose of this study was to determine if a baseball pitcher-training program utilizing lighter baseballs could increase fastball velocity without increasing injury risk. The author’s hypothesized that the training program with lighter baseballs would increase fastball velocity without causing injuries during the training program to the participants Methods: All baseball pitchers who participated in a 15-week pitching mechanic and velocity training program were included. Training program was broken down into three phases, and each participant went through the same program. Lighter balls (4oz and 3oz) and standard baseballs (5oz) were utilized as part of the training program. Weighted (heavier) balls were not used. Velocity was measured at four time points throughout the program. Injury rates for all players were recorded throughout the entire program. Results: 48 male pitchers aged 10-17 (average age: 14.7 +/- 1.8) years started the program and 44 had complete data and were included in the analysis. No pitcher sustained a baseball-related injury while participating in the training program (one player broke his ankle playing basketball, one player moved, one did not have baseline velocity data, and one experienced biceps soreness after participating in back to back showcases against recommendations). Fastball velocity increased by an average of 4.8mph (95% confidence intervals 4.1 - 5.5mph). Overall 43/44 players (98%) had an increase in fastball velocity over the course of the program. Conclusions: A 15-week baseball pitcher-training program with lighter baseballs significantly improved pitching velocity without significantly increasing injuries. Lighter baseballs should be considered instead of weighted baseballs when attempting to increase a pitcher’s velocity.
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Pasternack, Joel S., Kenneth R. Veenema, and Charles M. Callahan. "Baseball Injuries: A Little League Survey." Pediatrics 98, no. 3 (September 1, 1996): 445–48. http://dx.doi.org/10.1542/peds.98.3.445.
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Objectives. To determine the patterns of injury in youth baseball and apply the data to estimate the value of proposed safety equipment. Design. Prospective population-based injury survey. Participants. 2861 Little League baseball players (ages 7 to 18) for 140 932 player-hours. Measurements. An injury was included in the data only if it was serious enough to require medical/dental care, caused missing a game, or disallowed playing a certain position. The injuries were subdivided into acute or overuse. The acute injuries were classified as either catastrophic, severe, or minor. Injuries were categorized according to mechanism, area injured, and whether the player was on offense or defense. Results. There were 81 total injuries, of which 66 (81%) were acute and 15 (19%) were overuse. Of the acute injuries, 11 were severe and 55 were minor. The overall injury rate was .057 injuries per 100 player-hours. The severe injury rate was .008 injuries per 100 player-hours, of which 46% were ball-related injuries and 27% were collisions. The most frequent mechanism of injury was being hit by the ball, which represented 62% of the acute injuries. Of the 41 ball-related injuries, 28 (68%) occurred to players on defense. Of the 18 ball-related facial injuries, 16 occurred to players on defense. Conclusions. 1) Little League baseball is a safe activity with a low injury rate and a particularly low rate of severe injury; 2) impact by the ball causes more than half the acute injuries, thus safety interventions should be directed towards decreasing these injuries, especially on defense; 3) facemasks on batters can safely eliminate facial injuries to offensive players, but would only moderately reduce the incidence of ball-related facial injuries as most of these injuries are sustained by defensive players.
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Irawan, Fajar Awang, and Chuang Long-Ren. "Baseball and biomechanics: Injury prevention for baseball pitcher." Jurnal Keolahragaan 7, no. 1 (April 1, 2019): 57–64. http://dx.doi.org/10.21831/jk.v7i1.24636.
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Pitching was the fastest motion in baseball. Upper extremity has important roles especially in shoulder, elbow, wrist, and fingers. The purpose of this study was to integrate the information in a resume of biomechanical pitching and baseball pitcher’s injuries. The data base used refers to PubMed, SAGE, and Elsevier and several relevance journals related to baseball and injuries. Source refers to the data since December 2017 to the oldest 2000 to get data source in baseball pitcher injuries. Upper arm has the prominent role when pitching to get maximum motion and joints stabilize. Rotator cuff muscle generate rotation in the shoulder while pitching and control shoulder joints in the lower arm’s muscles and joints. Baseball pitcher has a special skill in the strength, speed, and endurance. They had to keep their performance to avoid from injury especially shoulder and elbow injuries. Biomechanical analysis can help to evaluated performance in monitoring dan give recommendation to elevate skills and prevent injury. Knowledge and understanding about basic of pitching have to mastering before elevate to the next level. Further study can focus on the time for the pitcher to improve the skills and maximizing the pitch type to avoid from injuries.
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Pytiak, Andrew V., Matthew J. Kraeutler, Dustin W. Currie, Eric C. McCarty, and R. Dawn Comstock. "An Epidemiological Comparison of Elbow Injuries Among United States High School Baseball and Softball Players, 2005-2006 Through 2014-2015." Sports Health: A Multidisciplinary Approach 10, no. 2 (October 25, 2017): 119–24. http://dx.doi.org/10.1177/1941738117736493.
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Background: Pitching is a common mechanism of injury in baseball, with known risk factors for elbow injuries among adolescent pitchers. Hypothesis: Elbow injury rates and mechanisms will differ between high school baseball and softball players. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Baseball- and softball-related injury data from the 2005-2006 through 2014-2015 academic years were collected from the High School Reporting Information Online (RIO) Internet-based data collection tool. Athlete-exposure (AE) and injury data were collected by certified athletic trainers. Rate ratios (RRs) were calculated comparing injury rates in the 2 populations. Injury proportion ratios (IPRs) comparing elbow injuries in pitchers and nonpitchers were calculated as the proportion of all elbow injuries in pitchers divided by the proportion of all elbow injuries in nonpitchers. Results: A total of 214 elbow injuries in male baseball players occurred over 2,327,774 AEs, for an overall elbow injury rate of 0.92 per 10,000 AEs. A total of 75 elbow injuries were reported in female softball players over 1,731,644 AEs, for an overall rate of 0.43 per 10,000 AEs. The rate of elbow injury was significantly higher for baseball than softball (RR, 2.12; 95% CI, 1.64-2.77). A significantly greater proportion of elbow injuries in baseball were pitching-related compared with those from softball, with 50.2% occurring while pitching in baseball versus 11.0% in softball (IPR, 4.58; 95% CI, 2.35-8.93). If all injuries occurring during pitching were removed from both sports, the difference in elbow injury rate for baseball and softball would no longer be significant (RR, 1.19; 95% CI, 0.88-1.62). Conclusion: The rate of elbow injuries is significantly higher in baseball than softball. This is attributable to differences in rates of pitching-related injuries between these 2 groups. Clinical Relevance: These results demonstrate that overhand pitching increases risk of elbow injury in high school athletes.
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Nicholls, Rochelle L., Bruce C. Elliott, and Karol Miller. "Impact Injuries in Baseball." Sports Medicine 34, no. 1 (2004): 17–25. http://dx.doi.org/10.2165/00007256-200434010-00003.
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Wang, Quincy. "Baseball and Softball Injuries." Current Sports Medicine Reports 5, no. 3 (June 2006): 115–19. http://dx.doi.org/10.1097/01.csmr.0000306299.95448.cd.
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Groleau, Georgina A., Elizabeth L. Tso, Jonathan S. Olshaker, Robert A. Barish, and Deanna J. Lyston. "BASEBALL BAT ASSAULT INJURIES." Journal of Trauma: Injury, Infection, and Critical Care 34, no. 3 (March 1993): 366–72. http://dx.doi.org/10.1097/00005373-199303000-00010.
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Ju, Derek G., Filippo F. Familiari, Gazi Huri, Paul D. Sponseller, and Edward G. McFarland. "Bilateral Leg Injuries - Baseball." Medicine & Science in Sports & Exercise 46 (May 2014): 314. http://dx.doi.org/10.1249/01.mss.0000494131.72535.dd.
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Coen, R. W. "High School Baseball Injuries." PEDIATRICS 122, no. 5 (October 31, 2008): 1159–60. http://dx.doi.org/10.1542/peds.2008-2480.
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Coen, R. W. "High School Baseball Injuries." PEDIATRICS 122, no. 6 (December 1, 2008): 1418. http://dx.doi.org/10.1542/peds.2008-2804.
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Shanley, Ellen, Mitchell J. Rauh, Lori A. Michener, and Todd S. Ellenbecker. "Incidence of Injuries in High School Softball and Baseball Players." Journal of Athletic Training 46, no. 6 (November 1, 2011): 648–54. http://dx.doi.org/10.4085/1062-6050-46.6.648.
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Context: Participation in high school sports has grown 16.1% over the last decade, but few studies have compared the overall injury risks in girls' softball and boys' baseball. Objective: To examine the incidence of injury in high school softball and baseball players. Design: Cohort study. Setting: Greenville, South Carolina, high schools. Patients or Other Participants: Softball and baseball players (n = 247) from 11 high schools. Main Outcome Measure(s): Injury rates, locations, types; initial or subsequent injury; practice or game setting; positions played; seasonal trends. Results: The overall incidence injury rate was 4.5/1000 athlete-exposures (AEs), with more injuries overall in softball players (5.6/1000 AEs) than in baseball players (4.0/1000 AEs). Baseball players had a higher initial injury rate (75.9/1000 AEs) than softball players (66.4/1000 AEs): rate ratio (RR) = 0.88, 95% confidence interval (CI) = 0.4, 1.7. The initial injury rate was higher than the subsequent injury rate for the overall sample (P < .0001) and for softball (P < .0001) and baseball (P < .001) players. For both sports, the injury rate during games (4.6/1000 AEs) was similar to that during practices (4.1/1000 AEs), RR = 1.22, 95% CI = 0.7, 2.2. Softball players were more likely to be injured in a game than were baseball players (RR = 1.92, 95% CI = 0.8, 4.3). Most injuries (77%) were mild (3.5/1000 AEs). The upper extremity accounted for the highest proportion of injuries (63.3%). The incidence of injury for pitchers was 37.3% and for position players was 15.3%. The rate of injury was highest during the first month of the season (7.96/1000 AEs). Conclusions: The incidence of injury was low for both softball and baseball. Most injuries were minor and affected the upper extremity. The injury rates were highest in the first month of the season, so prevention strategies should be focused on minimizing injuries and monitoring players early in the season.
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Hodgins, Justin L., David P. Trofa, Steve Donohue, Mark Littlefield, Michael Schuk, and Christopher S. Ahmad. "Forearm Flexor Injuries Among Major League Baseball Players: Epidemiology, Performance, and Associated Injuries." American Journal of Sports Medicine 46, no. 9 (June 13, 2018): 2154–60. http://dx.doi.org/10.1177/0363546518778252.
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Background: Despite evidence highlighting the importance of the forearm flexor muscles of elite baseball players, no studies have reported on the epidemiology of flexor strains and their associated outcomes. Purpose: To examine the incidence, associated injuries, and outcomes associated with forearm flexor injuries among major and minor league baseball players. Study Design: Cohort study; Level of evidence, 3. Methods: Injury data attributed to forearm flexor injuries among Major League Baseball (MLB) and minor league teams between 2010 and 2014 were obtained from the professional baseball Health and Injury Tracking System. This analysis included the number of players injured, seasonal timing of injury, days spent on the disabled list (DL), preinjury performance data, and subsequent injuries. Results: A total of 134 and 629 forearm flexor injuries occurred in MLB and the minor leagues, respectively. The mean player age was 28.6 and 22.8 years in the MLB and minor leagues, respectively. The mean time spent on the DL for MLB players was 117.0 days, as opposed to 93.9 days in the minor leagues ( P = .272). Interestingly, pitcher performance declined in all categories examined leading up to the season of injury, with significant differences in walks plus hits per inning pitched ( P = .04) and strike percentage ( P = .036). Of MLB players with a forearm injury, subsequent injuries included 50 (37.3%) shoulder, 48 (35.8%) elbow, and 24 (17.9%) forearm injuries. Among injured minor league players, subsequent injuries included 170 (27.0%) shoulder, 156 (24.8%) elbow, and 83 (13.2%) forearm injuries. These rates of subsequent injuries were significantly higher compared with the rates of injuries sustained among players without forearm injuries in both leagues ( P < .001). Finally, 26 (19.4%) MLB and 56 (8.9%) minor league players required an ulnar collateral ligament reconstruction, rates that were significantly higher compared with players without a flexor strain ( P < .001). Conclusion: Flexor-pronator injuries are responsible for considerable time spent on the DL for elite players in MLB and the minor leagues. The most significant findings of this investigation illustrate that a flexor strain may be a significant risk factor for subsequent upper extremity injuries, including an ulnar collateral ligament tear.
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Esquivel, Amanda, Michael T. Freehill, Frank C. Curriero, Kevin L. Rand, Stan Conte, Thomas Tedeschi, and Stephen E. Lemos. "Analysis of Non-Game Injuries in Major League Baseball." Orthopaedic Journal of Sports Medicine 7, no. 12 (December 1, 2019): 232596711988849. http://dx.doi.org/10.1177/2325967119888499.
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Background: Numerous studies have investigated injuries and treatments in the baseball athlete. The majority of these studies have focused on the throwing shoulder and elbow. However, more recent literature is reporting injuries to other regions in this cohort, including the knee, head, hip, and hamstring. Purpose/Hypothesis: The purpose of the current study was to determine the number and type of injuries in Major League Baseball (MLB) and Minor League Baseball (MiLB) players that do not occur during the actual game but are related to baseball participation. Our hypothesis was that there would be a substantial number of injuries that occurred in professional baseball players during non-game situations. Study Design: Descriptive epidemiological study. Methods: Deidentified, anonymous data were collected from the 2011 through 2016 seasons from the MLB Health and Injury Tracking System (HITS) medical record database. All injuries that were identified as a primary diagnosis and resulted in at least 1 day out of play from both MLB and MiLB were examined. Injuries were categorized as occurring during the game (“game” injuries) or not during the game. A “non-game” injury was defined as occurring at any time other than during the scheduled game from the first to last pitch. Results: There were 51,548 total injuries in MLB and MiLB players from 2011 to 2016, almost 40% of which were attributed to non–game-related injuries (n = 19,201; 37.2%). The remainder occurred during a game (n = 32,347; 62.8%). A significantly greater percentage of non-game injuries were season ending (10.8%) compared with the percentage of game-related season-ending injuries (8.4%) ( P < .0001). Pitchers had significantly more non–game-related injuries than game-related injuries ( P < .0001). Conclusion: A large number of injuries occur in professional baseball outside of actual games. MiLB players, specifically pitchers, are particularly at risk for these types of injuries. It is feasible that the overall injury rate in professional baseball players could be reduced by analyzing these injuries in more detail to develop prevention strategies.
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Erickson, Brandon J., Peter N. Chalmers, John Zajac, Terrance Sgroi, Jonathan James Eno, David W. Altchek, Joshua S. Dines, and Struan H. Coleman. "Do Professional Baseball Players With a Higher Valgus Carrying Angle Have an Increased Risk of Shoulder and Elbow Injuries?" Orthopaedic Journal of Sports Medicine 7, no. 8 (August 2019): 232596711986673. http://dx.doi.org/10.1177/2325967119866734.
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Background: There are many risk factors for shoulder and elbow injuries in professional baseball pitchers. The elbow carrying angle has not been studied as a potential risk factor. Purpose/Hypothesis: The aim of this study was to determine whether elbow carrying angle is a risk factor for shoulder or elbow injuries in professional baseball pitchers. We hypothesized that pitchers with a higher elbow carrying angle would be less likely to sustain an injury during the season than pitchers with a lower elbow carrying angle. Study Design: Cohort study; Level of evidence, 2. Methods: All professional pitchers for a single baseball club during the 2018 season had the carrying angle of both elbows measured at spring training by a single examiner. The pitchers were followed prospectively throughout the season. Shoulder and elbow injuries were recorded prospectively. Results: A total of 52 pitchers (21 [40%] Major League Baseball and 31 [60%] Minor League Baseball) were included. During the season, 23 (44%) pitchers became injured. The mean carrying angle in the throwing arm was 12.5° ± 4.2° versus 9.9° ± 2.8° in the nonthrowing arm ( P < .001). Comparing the injured and noninjured groups, there were no differences in level of play ( P = .870), throwing hand dominance ( P = .683), batting hand dominance ( P = .554), throwing-side carrying angle ( P = .373), nonthrowing-side carrying angle ( P = .773), or side-to-side difference in carrying angle ( P = .481). Conclusion: The elbow carrying angle was not associated with an injury risk during a single season in professional baseball pitchers.
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Confino, Jamie Erica, James N. Irvine, Christopher S. Ahmad, and Thomas Sean Lynch. "Early Sports Specialization is Associated with Increased Upper Extremity Injuries and Fewer Games Played in Major League Baseball Players." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0039. http://dx.doi.org/10.1177/2325967119s00399.
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Objectives: Early sport-specialization has been shown to place athletes at risk for increased injuries and decreased sporting performance in various sporting populations. However, the effect of sport-specialization has not been studied in professional baseball. The purpose of this investigation is to determine if single-sport athletes that specialize in baseball at a young age have a greater predisposition to overuse injury, burnout, and decreased performance compared to multiple-sport athletes. We hypothesized that MLB players who played multiple sports in high school would experience fewer injuries necessitating time on the Disabled List (DL), play more games, and have a longer career compared to athletes that played only baseball in high school. Methods: First and second-round MLB draft picks from 2008 to 2016 that played in at least one professional (minor or major league) game were included in this study. Athletes who participated in one or more sports in high school in addition to baseball were considered multi-sport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and MiLB, number of days on the Disabled List (DL) for each injury, number of games played in MLB and MiLB, and whether the athlete was still active were collected from publically available records. Results: Seven hundred forty-seven athletes were included in this study, of which 240 (32%) were multi-sport and 506 (68%) were single-sport athletes. Multi-sport athletes played in significantly more total professional baseball games on average (362.8 vs. 300.8, p < 0.01) as well as more major league games (95.9 vs. 71.6, p = 0.04) than single-sport athletes. Meanwhile, single-sport athletes had a significantly higher number of upper extremity injuries than multi-sport athletes (136 vs. 55, p < 0.01, Table I). Single-sport pitchers also had a higher number of shoulder and elbow injuries than multi-sport pitchers and, once injured, were more likely to have recurrent elbow injuries (86 vs. 27, p < 0.01; 33% vs. 17% recurrence). Conclusion: Professional baseball players who participated in multiple sports during high school played in more MLB games and sustained fewer upper extremity injuries than players who specialized in baseball before high school. Professional pitchers who specialized by the time they were in high school had a significantly higher chance of sustaining recurrent elbow injuries compared to those who were multi-sport athletes in high school. MLB players with a history of multi-sport participation were more likely to avoid overuse injuries and had greater longevity and level of performance compared to those that limited their sport participation to baseball during high school. [Table: see text]
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Rothermich, Marcus A., Stan A. Conte, Kyle T. Aune, Glenn S. Fleisig, E. Lyle Cain, and Jeffrey R. Dugas. "Incidence of Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players." Orthopaedic Journal of Sports Medicine 6, no. 4 (April 1, 2018): 232596711876465. http://dx.doi.org/10.1177/2325967118764657.
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Background: Recent reports have highlighted the progressive increase in the incidence of ulnar collateral ligament (UCL) injuries to the elbow in baseball players of all levels. However, knowledge of the incidence and other epidemiological factors regarding UCL injuries, specifically in college baseball players, is currently lacking. Purpose: To evaluate, over a period of 1 year, the incidence of UCL injuries requiring surgery in National Collegiate Athletic Association (NCAA) Division I baseball programs. Study Design: Descriptive epidemiology study. Methods: A total of 155 Division I collegiate baseball programs agreed to participate in the study. Demographics (position, year, background [location of high school]) for all players on these rosters were obtained from public websites. At the conclusion of the 2017 collegiate baseball season, the athletic trainer for each program entered anonymous, detailed information on injured players through an electronic survey into a secured database. Results: All 155 teams enrolled in the study completed the electronic survey. Of the 5295 collegiate baseball players on these rosters, 134 underwent surgery for an injured UCL (2.5% of all eligible athletes), resulting in a team surgery rate of 0.86 per program for 1 year. These 134 players came from 88 teams, thus 56.8% of the study teams underwent at least 1 surgery during the year. The surgery rate was 2.5 per 100 player-seasons for all players and was significantly higher among pitchers (4.4/100 player-seasons) than nonpitchers (0.7/100 player-seasons). The surgery rate was also significantly higher in underclassmen (3.1/100 player-seasons among freshmen and sophomores) than upperclassmen (1.9/100 player-seasons among juniors and seniors) (incidence rate ratio, 1.7; 95% CI, 1.1-2.4). Players from traditionally warm-weather states did not undergo UCL surgery at a significantly different rate from players from traditionally cold-weather states (2.7/100 player-seasons vs 2.1/100 player-seasons, respectively). Nearly half of surgeries (48.5%) were performed during the baseball season. Conclusion: The incidence of UCL surgeries in NCAA Division I collegiate baseball players represents substantial morbidity to this young athletic population. Risk factors for injuries requiring surgery include being a pitcher and an underclassman. Awareness of these factors should be considered in injury prevention programs. Furthermore, this initial study can serve as a foundation for tracking these surgical injuries in future years and then identifying trends over time.
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Erickson, Brandon J., Peter N. Chalmers, John D’Angelo, Kevin Ma, Dana Rowe, and Christopher S. Ahmad. "Do Injury Rates in Position Players Who Convert to Pitchers in Professional Baseball Differ From Players Who Have Always Been Pitchers?" Orthopaedic Journal of Sports Medicine 9, no. 10 (October 1, 2021): 232596712110509. http://dx.doi.org/10.1177/23259671211050963.
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Background: There are some professional baseball players who begin their career as a position player and later convert to a pitcher; injury rates in these players are unknown. Purpose: To compare injury rates of professional baseball players who started their career as position players and converted to pitchers with a control group of pitchers who have been only pitchers throughout their professional career. Hypothesis: Injury rates would be lower in the conversion players. Study Design: Cohort study; Level of evidence, 3. Methods: All players who began their professional baseball career as position players and converted to pitchers between 2011 and 2018 were included. All injuries that occurred after they converted to pitchers were included. The conversion players were matched 1 to 1 with a control group of pitchers who entered professional baseball as pitchers and never changed position. Injury rates were compared between groups. The performance between groups was also compared. Results: Overall, 221 players were identified who converted from position players to pitchers. There were significantly more injuries per year in the control pitcher group (0.8 ± 0.9) than in the conversion pitcher group (0.7 ± 0.9; P = .015). Injuries in the control group resulted in 61 ± 112 days missed per injury, while injuries in the conversion player group resulted in 54 ± 102 days missed per injury ( P = .894). Injury characteristics differed between groups. However, in both groups, most of the injuries were related to pitching or throwing, were noncontact or gradual overuse injuries, and involved the upper extremity. Converted pitchers had lower pitcher usage, with fewer games and innings pitched ( P < .001), with significantly worse statistics for walks plus hits per inning pitched ( P = .018). Conclusion: Professional baseball players who convert from position players to pitchers are injured at lower rates than control pitchers. Conversion pitchers have lower pitcher usage, which may contribute to their reduced injury rates.
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Ramkumar, Prem, Salvatore Frangiamore, Grant Jones, Lonnie Soloff, Keshia Pollack, Frank Curriero, Mark Schickendantz, and Travis Frantz. "Epidemiology of Acromioclavicular Joint Injuries in Professional Baseball." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (July 1, 2020): 2325967120S0041. http://dx.doi.org/10.1177/2325967120s00416.
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Objectives: Shoulder injuries account for a large portion of all recorded injures in professional baseball. Much is known about other shoulder pathologies in the overhead athlete, but the incidence and impact of acromioclavicular (AC) joint injuries in this population is unknown. The purpose of this study was to examine the incidence, rates, and characteristics of AC joint injuries in professional baseball, and determine the impact on time missed. Methods: The Major League Baseball Health and Injury Tracking System (HITS) was used to compile records of all major and minor league player from 2011-2017 with documented AC joint injuries. These injuries were classified as acute (sprain or separation) or chronic (AC joint arthritis or distal clavicular osteolysis), and associated data included laterality, date of injury, player position, activity, mechanism of injury, length of return to play (RTP), and need for surgical intervention. Results: A total of 312 AC joint injuries (183 MiLB, 129 MLB; range 39-60 per year) were recorded (acute n=201, 64.4%; chronic n=111, 35.6%). A total of 81% of acute injuries resulted in time missed with an average RTP of 22.8 days whereas 59% of chronic injuries resulted in days missed with an average RTP of 32.2 days (p<0.001). Acute injuries occurred most commonly in outfielders (42.7%), followed by infielders (27.3%). Chronic injuries were seen in higher proportions among pitchers and catchers (45.5-56.4% chronic injuries). Acute AC injuries occurred most often while playing defense (n=100; 49.8%) in the infield or outfield (n=138; 68.7%), with 63.2% the result of a contact injury. Chronic AC joint injuries were most commonly with throwing or pitching (n=48; 43.2%) and non-contact injuries (n=79; 71.2%). Conclusion: Acute AC joint injuries are contact injuries occurring most commonly among infielders and outfielders that result in more than 3 weeks missed before return to play whereas chronic AC joint injuries occur more commonly in pitchers and catchers from repetitive overhead activity. Knowledge of these data can better guide expectation management in this elite population to better elucidate the prevalence of two common injury patterns in the acromioclavicular joint.
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Howard, Daniel R., Michael B. Banffy, and Neal S. ElAttrache. "Hamstring Injuries in Major League Baseball Pitchers: Implications in Graft Selection for Ulnar Collateral Ligament Reconstruction." American Journal of Sports Medicine 47, no. 2 (December 13, 2018): 444–50. http://dx.doi.org/10.1177/0363546518815689.
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Background: Hamstring tendons are commonly harvested as autograft for ulnar collateral ligament reconstruction. There is no consensus in the literature whether the hamstring tendon should be harvested from the ipsilateral (drive) leg or contralateral (landing) leg of baseball pitchers undergoing ulnar collateral ligament reconstruction. Hamstring injuries commonly occur in baseball players, but there are no reports on their incidence specifically among Major League Baseball (MLB) pitchers, nor are there reports on whether they occur more commonly in the drive leg or the landing leg. Hypothesis: Hamstring injuries occur more commonly in the landing legs of MLB pitchers. Study Design: Descriptive epidemiology study. Methods: MLB pitchers who sustained hamstring injuries requiring time spent on the disabled list were identified from publicly available sources over 10 seasons. Demographics of the pitchers and injury and return-to-sport data were collected. Hamstring injuries to the drive leg were compared with injuries to the landing leg. Results: Sixty-five pitchers had 78 disabled list stints due to hamstring injuries over 10 seasons. The landing leg was injured in 67.9% of cases, and the most common mechanism of injury was pitching. There were no significant differences in demographics between pitchers who sustained drive leg and landing leg injuries. There was no significant difference in mechanism of injury or time to return to sport between pitchers who sustained drive leg and landing leg injuries. Conclusion: The landing leg is more commonly injured than the drive leg among MLB pitchers who sustain hamstring injuries. There is no difference in time to return to sport between pitchers who sustain drive leg and landing leg injuries. More research is required to determine whether there is a difference in performance or future injury between hamstring tendons harvested from the drive leg and the landing leg for ulnar collateral ligament reconstruction among pitchers.
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Rothermich, Marcus A., Stan A. Conte, Glenn S. Fleisig, E. Lyle Cain, and Jeffrey R. Dugas. "Incidence Of Elbow Ulnar Collateral Ligament Surgery In Collegiate Baseball Players." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0031. http://dx.doi.org/10.1177/2325967119s00310.
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Objectives: Recent studies in the literature have highlighted the progressive increase in the incidence of ulnar collateral ligament (UCL) injuries to the elbow in baseball players of all levels. However, knowledge of the incidence and other epidemiological factors regarding UCL injuries, specifically in college baseball players, is currently lacking. In 2016, we launched a prospective, multi-year study to evaluate the incidence of UCL injuries requiring surgery in National Collegiate Athletic Association (NCAA) Division I baseball programs. Methods: We invited 157 Division I collegiate baseball programs after the 2017 season, and 155 agreed to participate in the study. After the 2018 season, all 297 programs were invited and 294 participated. At the conclusion of the 2017 and 2018 collegiate baseball seasons, the athletic trainer for each program entered anonymous, detailed information on injured players through an electronic survey into a secured database. Results: We obtained a 100% completion rate in the first two years of this ongoing study (155/155 respondents in the first year, 294/294 in the second year). Of the 5,364 collegiate baseball players tracked in Year 1 (2016-2017), 134 underwent surgery for an injured UCL, resulting in a team surgery rate of 0.86 per program. In Year 2 (2017-2018), there were 230 surgeries reported from 10,019 players tracked, resulting in a team surgery rate of 0.78 per program. A majority of schools experienced at least one surgery during both years (56.8% in Year 1, 50.7% in Year 2). Pitchers experience a vast majority of the surgical injuries (85.8% in Year 1, 84.3% in Year 2). Underclassmen made up 65.7% of surgeries in Year 1, which fell slightly to 56.1% in Year 2. Nearly half of the surgeries occurred during an ongoing baseball season in Year 1 (48.5%), but this fell in Year 2 to 41.3%. In both years, a non-significant majority of players were from warm-weather states (65.4% in Year 1, 52.9% in Year 2). Revision surgical rates remained nearly constant with 3.0% revision surgeries in Year 1 compared with 2.6% revisions in Year 2. Interestingly, the percentage of UCL repairs with internal brace augmentation rose from 9.5% in Year 1 to 19.9% of all procedures in Year 2. Conclusion: The incidence of UCL surgeries in NCAA Division I collegiate baseball players represents substantial morbidity to this young athletic population. This multi-year prospective study has been established to assess the incidence of surgical UCL injuries in collegiate baseball. Also, importantly, with multiple years of data we will identify trends in the demographics of players undergoing surgery and in surgical details over time. Awareness of these factors should be considered in injury prevention programs in the future.
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Hosey, Robert G., and James C. Puffer. "Baseball and Softball Sliding Injuries." American Journal of Sports Medicine 28, no. 3 (May 2000): 360–63. http://dx.doi.org/10.1177/03635465000280031301.
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We prospectively observed seven softball and three baseball Division I collegiate teams to study the incidence of sliding injuries, the types of injuries resulting from the sliding technique, and the amount of time lost from participation. Slides were categorized as either feet- or head-first on the basis of the leading part of the body during the slide. Slides were further stratified depending on whether a diveback technique was performed. We recorded 37 injuries in 3889 slides in 637 games and 7596 athlete game exposures. The overall incidence of sliding injuries was 9.51 per 1000 slides and 4.87 per 1000 game exposures. Softball players had a significantly higher incidence of sliding injuries (12.13 per 1000 slides) than did baseball players (6.01 per 1000 slides). In baseball, the injury rate was higher for feet-first slides (7.31 per 1000 slides) than for head-first slides (3.53 per 1000 slides) or divebacks (5.75 per 1000 divebacks). In softball, injury rates were higher for head-first slides (19.46 per 1000 slides) than for feet-first slides (10.04 per 1000 slides) or divebacks (7.49 per 1000 divebacks). The majority of injuries sustained were minor, with only four (11%) injuries causing the athlete to miss more than 7 days of participation.
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Jobe, Frank W., and James P. Bradley. "Rotator Cuff Injuries in Baseball." Sports Medicine 6, no. 6 (December 1988): 378–87. http://dx.doi.org/10.2165/00007256-198806060-00004.
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Treihaft, Marc M. "Neurologic Injuries in Baseball Players." Seminars in Neurology 20, no. 02 (2000): 187–94. http://dx.doi.org/10.1055/s-2000-9827.
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Queale, W. S., T. D. Bennett, G. S. Smith, and E. G. McFarland. "EPIDEMIOLOGY OF COLLEGE BASEBALL INJURIES." Medicine & Science in Sports & Exercise 33, no. 5 (May 2001): S81. http://dx.doi.org/10.1097/00005768-200105001-00466.
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McFarland, Edward G., and Mike Wasik. "Epidemiology of Collegiate Baseball Injuries." Clinical Journal of Sport Medicine 8, no. 1 (January 1998): 10–13. http://dx.doi.org/10.1097/00042752-199801000-00003.
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Stovak, Mark, Amit Parikh, and Anne T. Harvey. "Baseball and Softball Sliding Injuries." Clinical Journal of Sport Medicine 22, no. 6 (November 2012): 501–4. http://dx.doi.org/10.1097/jsm.0b013e3182580d05.
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Marshall, S. W. "Injuries in Youth Baseball--Reply." JAMA: The Journal of the American Medical Association 290, no. 2 (July 9, 2003): 194—a—195. http://dx.doi.org/10.1001/jama.290.2.194-b.
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Green, Gary, John D’Angelo, Jon Coyles, Ian Penny, John G. Golfinos, and Alex Valadka. "Association Between a Rule Change to Reduce Home Plate Collisions and Mild Traumatic Brain Injury and Other Injuries in Professional Baseball Players." American Journal of Sports Medicine 47, no. 11 (July 23, 2019): 2704–8. http://dx.doi.org/10.1177/0363546519861525.
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Background: Improved player safety is an important goal of professional baseball. Prevention of mild traumatic brain injury (concussion) is an area of emphasis because of the potential for long-term as well as short-term sequelae. Hypothesis: A rule change can lower the incidence of concussions and other injuries in professional baseball. Study Design: Cohort study; Level of evidence, 3. Methods: This study included a retrospective review of data entered concurrently into professional baseball’s electronic medical record system. All minor and major league teams are required to use this system. All injuries are captured by creation of a new record in the system at the time of the injury. All active minor and major league players from 2011 to 2017 were included. The 30 major league clubs have 1200 roster players and play 162 games per season. The approximately 200 minor league clubs have about 7500 active players and play 56 to 144 games annually that combine for approximately 330,000 athlete-exposures per season. Before the 2014 season, Major League Baseball, in conjunction with its players association, instituted a rule limiting home plate collisions between base runners and catchers that applied to both Major League Baseball and Minor League Baseball. All concussions and other injuries at home plate from 2011 to 2017 were analyzed by mechanism and player position. Results: From 2011 to 2013, an annual mean of 100 injuries occurred from home plate collisions in the minor and major leagues, resulting in a mean loss of 2148 days annually. After the rule change, there was a mean 55 home plate collision injuries with 936 days lost per season ( P < .0001 for injuries and days lost). A mean 11 concussions attributed to these collisions occurred annually in the minor and major leagues before the rule change, as compared with 2.3 per year after ( P = .0029). There were no major league concussions from these collisions after the rule change. The mean annual number of days missed because of concussions at home plate dropped from 276 before 2014 to 36 per year after 2014 ( P = .0001). Conclusion: This rule change was associated with significant reductions in the numbers of concussions and other injuries caused by collisions at home plate as well as significant decreases in time lost from play.
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Damrow, Derek, Xue-Cheng Liu, and Shayne Fehr. "MUSCULOSKELETAL INJURIES AND RELATED BIOMECHANICS FOR YOUTH BASEBALL PITCHING." Journal of Musculoskeletal Research 18, no. 02 (June 2015): 1530001. http://dx.doi.org/10.1142/s021895771530001x.
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An estimated 3 million youth participate in youth baseball. The purpose of this review is to highlight musculoskeletal development and specific throwing-related injuries in youth baseball players, as well as the current knowledge of pitching biomechanics, which are closely intertwined with the both arm development and injuries. Methods: A systematic literature review was conducted to highlight musculoskeletal development, throwing-related injuries and pitching mechanics. Results: Youth athletes are actively going through skeletal maturation which includes the formation of new bone at the epiphyseal plate, increasing muscle mass and/or strength, and morphological changes in tendons and ligaments. These processes setup youth pitchers to sustain throwing injuries at their shoulder and elbow in ways that differ from their adult counterparts. Faulty pitching biomechanics may also cause throwing injuries. Deviation from proper mechanics at any point can cause injuries in the shoulder and elbow. Conclusion: Many musculoskeletal changes occur during the development of a youth baseball player. Some of these changes are beneficial for improving throwing performance, but also predispose the athlete to injury. Improper biomechanics may be related to the throwing-related injuries that are seen in youth baseball players.
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Li, Xinning, Hanbing Zhou, Phillip Williams, John J. Steele, Joseph Nguyen, Marcus Jäger, and Struan Coleman. "The epidemiology of single season musculoskeletal injuries in professional baseball." Orthopedic Reviews 5, no. 1 (February 22, 2013): 3. http://dx.doi.org/10.4081/or.2013.e3.
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The aim of this descriptive epidemiology study was to evaluate the injury incidence, pattern and type as a function of position in one professional baseball organization for one complete season. The study was carried out in a major academic center. Participants were all major/minor league baseball players playing for one professional organization. The disabled/injury list of one single professional baseball organization (major and minor league players) was reviewed for all of the injuries and the number of total days missed secondary to each injury. All injuries were categorized into major anatomic zones that included: shoulder, elbow, wrist/hand, back, abdomen/groin, hip, knee, and ankle/foot. The data was further stratified based on the injury type and the number of days missed due to that particular injury and a statistical analysis was performed. In pitchers, elbow injuries (n=12) resulted in 466 days missed. In catchers, wrist injuries (n=4) resulted in 89 days missed. In position players, abdominal/groin injuries (n=16) resulted in 318 days missed and shoulder injuries (n=9) resulted in 527 days missed. Overall, 134 players were injured and a total of 3209 days were missed. Pitchers had 27 times and 34 times the rate of days missed due to elbow injuries compared to position players and all players, respectively. Abdominal and groin injuries caused the pitchers to have 5.6 times and 6.4 times the rate of days missed than the position and all players, respectively. Both elbow and abdominal/groin injuries are the most disabling injury pattern seen in pitchers. Among the position players, shoulder injuries resulted in the most days missed and knee injuries resulted in the highest rate of days missed in both pitchers and catchers.
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Reinold, Michael M., Leonard C. Macrina, Glenn S. Fleisig, Kyle Aune, and James R. Andrews. "Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates." Sports Health: A Multidisciplinary Approach 10, no. 4 (June 8, 2018): 327–33. http://dx.doi.org/10.1177/1941738118779909.
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Background: Emphasis on enhancing baseball pitch velocity has become popular, especially through weighted-ball throwing. However, little is known about the physical effects or safety of these programs. The purpose of this study was to examine the effects of training with weighted baseballs on pitch velocity, passive range of motion (PROM), muscle strength, elbow torque, and injury rates. Hypothesis: A 6-week weighted ball training program would result in a change in pitching biomechanical and physical characteristics. Study Design: Randomized controlled trial. Level of Evidence: Level 1. Methods: During the baseball offseason, 38 healthy baseball pitchers were randomized into a control group and an experimental group. Pitch velocity, shoulder and elbow PROM, shoulder strength, elbow varus torque, and shoulder internal rotation velocity were measured in both groups. The experimental group then performed a 6-week weighted ball throwing program 3 times per week using balls ranging from 2 to 32 ounces while the control group only used a 5-ounce regulation baseball. Both groups performed a strength training program. Measurements were then repeated after the 6-week period. Injuries were tracked over the 6-week training program and the subsequent baseball season. The effect of training with a weighted ball program was assessed using 2-way repeated-measures analysis of variance at an a priori significance level of P < 0.05. Results: Mean age, height, mass, and pretesting throwing velocity were 15.3 ± 1.2 years (range, 13-18 years), 1.73 ± 0.28 m, 68.3 ± 11 kg, and 30.3 ± 0.7 m/s, respectively. Pitch velocity showed a statistically significant increase (3.3%) in the experimental group ( P < 0.001). There was a statistically significant increase of 4.3° of shoulder external rotation in the experimental group. The overall injury rate was 24% in the experimental group. Four participants in the experimental group suffered elbow injuries, 2 during the training program and 2 in the season after training. No pitchers in the control group were injured at any time during the study. Conclusion: Performing a 6-week weighted ball throwing program increased pitch velocity. However, the program resulted in increased shoulder external rotation PROM and increased injury rate. Clinical Relevance: Although weighted-ball training may increase pitch velocity, caution is warranted because of the notable increase in injuries and physical changes observed in this cohort.
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Dowling, Brittany, Michael P. McNally, Ajit M. W. Chaudhari, and James A. Oñate. "A Review of Workload-Monitoring Considerations for Baseball Pitchers." Journal of Athletic Training 55, no. 9 (September 1, 2020): 911–17. http://dx.doi.org/10.4085/1062-6050-0511-19.
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Because of the unique demands of a pitch, baseball players have the greatest percentage of injuries resulting in surgery among high school athletes, with a majority of these injuries affecting the shoulder and elbow due to overuse from throwing. These injuries are believed to occur because of repeated microtrauma to soft tissues caused by the repetitive mechanical strain of throwing. Researchers and practitioners have suggested that baseball pitchers' workloads are a significant risk factor for injury in adolescent players, resulting in lost time and slowing of performance development. The purpose of our review was to investigate the current research relative to monitoring workload in baseball throwers and discuss techniques for managing and regulating cumulative stress on the arm, with a focus on preventing injury and optimizing performance in adolescent baseball pitchers.
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Confino, Jamie, James N. Irvine, Michaela O’Connor, Christopher S. Ahmad, and T. Sean Lynch. "Early Sports Specialization Is Associated With Upper Extremity Injuries in Throwers and Fewer Games Played in Major League Baseball." Orthopaedic Journal of Sports Medicine 7, no. 7 (July 2019): 232596711986110. http://dx.doi.org/10.1177/2325967119861101.
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Background: Single-sport athletes who specialize in baseball at a young age may have a greater predisposition to overuse injury, burnout, and decreased career longevity when compared with multiple-sport athletes. The effect of sport specialization has not been studied in professional baseball players. Hypothesis: Major League Baseball (MLB) players who played multiple sports in high school would experience fewer injuries, spend less time on the disabled list, play more games, and have a longer career than athletes who played only baseball in high school. Study Design: Descriptive epidemiology study. Methods: First- and second-round MLB draft picks from 2008 to 2016 who played in at least 1 professional game were included in this study. Athletes who participated in 1 or more sports in addition to baseball during high school were considered multisport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and Minor League Baseball, number of days on the disabled list for each injury, number of games played in both leagues, and whether the athlete was still active were collected from publicly available records. Results: A total of 746 athletes were included in this study: 240 (32%) multisport and 506 (68%) single sport. Multisport athletes played in significantly more mean total games (362.8 vs 300.8; P < .01) as well as more mean MLB games (95.9 vs 71.6; P = .04) than single-sport athletes. There was no difference in the mean number of seasons played in the major leagues (1.8 vs 1.6; P = .15) or minor league (5.25 vs 5.20; P = .23) between multisport and single-sport athletes. Single-sport athletes had a significantly higher prevalence of upper extremity injuries compared with multisport athletes (136 [63%] vs 55 [50%]; P = .009). Single-sport pitchers also had a higher prevalence of shoulder and elbow injuries (86 vs 27; P = .008) and were more likely to have recurrent elbow injuries (33% vs 17% recurrence; P = .002) compared with multisport pitchers. Conclusion: Professional baseball players who participated in multiple sports in high school played in more major league games and experienced lower rates of upper and lower extremity injuries than players who played only baseball in high school.
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Norton, Ryan, Christopher Honstad, Rajat Joshi, Matthew Silvis, Vernon Chinchilli, and Aman Dhawan. "Risk Factors for Elbow and Shoulder Injuries in Adolescent Baseball Players: A Systematic Review." American Journal of Sports Medicine 47, no. 4 (April 9, 2018): 982–90. http://dx.doi.org/10.1177/0363546518760573.
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Background: The incidence of shoulder and elbow injuries among adolescent baseball players is on the rise. These injuries may lead to surgery or retirement at a young age. Purpose: To identify independent risk factors for elbow and shoulder injuries in adolescent baseball players. A secondary aim was to determine whether the literature supports the Major League Baseball and USA Baseball Pitch Smart guidelines. Study Design: Systematic review. Methods: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing MEDLINE, SPORTDiscus, and Web of Science. Because of study heterogeneity, a quantitative synthesis was not performed. A qualitative review was performed on 19 independent risk factors for elbow and shoulder injuries in adolescent baseball players. Level of evidence was assigned per the Oxford Centre for Evidence-Based Medicine Working Group, and risk of bias was graded per the Newcastle-Ottawa Scale. Results: Twenty-two articles met criteria for inclusion. Of the 19 independent variables that were analyzed, age, height, playing for multiple teams, pitch velocity, and arm fatigue were found to be independent risk factors for throwing arm injuries. Pitches per game appears to be a risk factor for shoulder injuries. Seven independent variables (innings pitched per game, showcase participation, games per year, training days per week, pitch type, shoulder external rotation, and shoulder total range of motion) do not appear to be significant risk factors. The data were inconclusive for the remaining 6 variables (weight, months of pitching per year, innings or pitches per year, catching, shoulder horizontal adduction, and glenohumeral internal rotation deficit). Conclusion: The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.
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Camp, Christopher L., Frank C. Curriero, Keshia M. Pollack, Stephanie W. Mayer, Andrea M. Spiker, John D’Angelo, and Struan H. Coleman. "The Epidemiology and Effect of Sliding Injuries in Major and Minor League Baseball Players." American Journal of Sports Medicine 45, no. 10 (May 12, 2017): 2372–78. http://dx.doi.org/10.1177/0363546517704835.
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Background: Although sliding occurs frequently in professional baseball, little is known about the epidemiology and effect of injuries that occur during sliding in this population of elite athletes. Purpose: To describe the incidence and characteristics of sliding injuries, determine their effect in terms of time out of play, and identify common injury patterns that may represent appropriate targets for injury prevention programs in the future. Study Design: Descriptive epidemiologic study. Methods: All offensive sliding injuries occurring in Major League Baseball (MLB) and Minor League Baseball (MLB) that resulted in time out of play during a span of 5 seasons (2011-2015) were identified. In addition to player demographics, data extracted included time out of play, location on field where injury occurred, level of play, treatment (surgical vs nonsurgical), direction of slide (head vs feet first), body region injured, and diagnosis. Descriptive statistics were used to describe the distribution of these injuries, and injury rates were calculated per slide. Results: From 2011 to 2015, 1633 injuries occurred as a result of a slide. The total number of days missed per season was 4263. Surgical intervention was required for 134 (8.2%) injuries, and the mean days missed was 66.5 for players treated surgically and 12.3 days for players treated nonoperatively ( P < .001). MLB players were more likely than MiLB players to require surgical intervention (12.3% vs 7.5%, P = .019). Injuries to the hands/fingers represented 25.3% of all injuries and 31.3% of those requiring surgery. Although the majority of injuries occurred at second base (57%), the per-slide injury rate was similar across all bases ( P = .991). The estimated overall frequency of injury in MLB was once per every 336 slides, and the rate of injury for head- and feet-first slides was 1 in 249 and 413 slides, respectively ( P = .119). Conclusion: Injuries occurring while sliding in professional baseball result in a significant amount of time out of play for these elite athletes. Injuries occurring at second base and those occurring to the hands and fingers were most prevalent and may be an appropriate target for future injury prevention programs.
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Cascia, Nicole, Tim L. Uhl, and Carolyn M. Hettrich. "Return to Play Following Nonoperative Treatment of Partial Ulnar Collateral Ligament Injuries in Professional Baseball Players: A Critically Appraised Topic." Journal of Sport Rehabilitation 28, no. 6 (August 1, 2019): 660–64. http://dx.doi.org/10.1123/jsr.2018-0110.
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Clinical Scenario: Ulnar collateral ligament (UCL) injuries are highly prevalent in professional baseball players with the success of operative management being well known in the literature. Return to play (RTP) rates following nonoperative management of partial UCL injuries in professional baseball players are not well established in the literature. With a UCL tear being a potential career-ending injury, it is imperative that the best treatment option is provided to these throwing athletes. There is an increase in the incidence of UCL surgical rates and a lack of general agreement on nonoperative treatment of partial UCL injuries as reported by the American Shoulder and Elbow Surgeons in 2017. There is also a lack of clarity on when to initiate rehabilitation, which may be due to the limited amount of studies reporting success of RTP rates and time to RTP following conservative interventions of partial UCL injuries. Evidence on the RTP rates seen following conservative management of partial UCL tears injuries can help guide health care providers in deciding on the best treatment option for professional baseball athletes who desire to return to their athletic careers. These rates of RTP will add valuable objective input when determining if conservative management is the best choice. To determine the current evidence, inclusion criteria for the literature search consisted of RTP rates following conservative treatment in professional baseball players between inception and 2018. Clinical Question: Is there evidence for successful RTP rates in professional baseball players following conservative treatment of a UCL injury? Summary of Key Findings: Three retrospective studies met the inclusion criteria and were included. Of those, 2 reported RTP rates following a nonoperative rehabilitation program of a UCL injury, whereas 1 reported RTP rates after injection therapy in subjects who attempted a trial of conservative treatment. All 3 studies considered location and grade of UCL tear. Successful RTP rates (66%–100%) were reported in professional baseball players following nonoperative treatment of partial UCL injuries. Clinical Bottom Line: Current evidence supports high success with RTP rates up to 100% after nonoperative treatment of grade 1 UCL injuries in professional baseball players and between 66% and 94% for a grade 2 and above. Strength of Recommendation: There is level C evidence for high RTP rates following nonoperative treatment of partial UCL injuries in professional baseball players.
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Okoroha, Kelechi R., Stan Conte, Eric C. Makhni, Vincent A. Lizzio, Christopher L. Camp, Bernard Li, and Christopher S. Ahmad. "Hamstring Injury Trends in Major and Minor League Baseball: Epidemiological Findings From the Major League Baseball Health and Injury Tracking System." Orthopaedic Journal of Sports Medicine 7, no. 7 (July 2019): 232596711986106. http://dx.doi.org/10.1177/2325967119861064.
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Background: Hamstring strains are the most common injury for professional baseball players and can result in significant time on the disabled list. To date, no study has reported the current trends in hamstring strains in professional baseball. Hypothesis: Professional baseball players would have an increased incidence of hamstring strains from 2011 through 2016. Study Design: Descriptive epidemiology study. Methods: Injury data were prospectively collected from 2011 through 2016 for every Major League Baseball (MLB) and Minor League Baseball (MiLB) team and was recorded in the MLB Health and Injury Tracking System. Data collected for this study included date of injury, activity during injury, time lost, primary injury or reinjury status, and imaging findings as well as player demographic information related to level of play, age, and position for all hamstring injury events. Injury rates were reported as hamstring injuries per number of games. Results: From 2011 to 2016, there were 2633 hamstring strains in professional baseball players. The rate of hamstring strains increased in MLB from a low of 1 injury every 39 games in 2011 to a high of 1 injury every 30 games in 2016. In MiLB, there were 2192 hamstring strains, with 1 injury every 35 games in 2011 compared with 1 injury every 30 games in 2016. The majority of injuries occurred in the infielder positions (37.5%) and resulted from base running (>50%), most commonly from home to first base. The most common hamstring injury was a grade 2 injury to the distal biceps femoris. The mean time missed after a hamstring injury was 14.5 days. Grade 3 and grade 2 hamstring strains resulted in significantly more days missed compared with grade 1 injuries ( P = .005 and P = .002, respectively). The rate of recurrent hamstring injuries was 16.3% for MLB and 14.2% for MiLB. Recurrent hamstring injuries resulted in more time lost than primary injuries (mean, 16.4 vs 14.5 days, respectively; P = .02). A total of 42 injuries were treated with platelet-rich plasma, and 19 were treated with surgery. The number of injuries treated with platelet-rich plasma increased in successive years. Conclusion: The rate of hamstring strains in professional baseball players has increased over the past 6 years and has resulted in a significant loss of playing time. Study results indicated that these injuries are affected by injury characteristics, position played, running to first base, seasonal timing, and history of hamstring injuries.
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Camp, Christopher L., Dean Wang, Alec S. Sinatro, John D’Angelo, Struan H. Coleman, Joshua S. Dines, Stephen Fealy, and Stan Conte. "Getting Hit by Pitch in Professional Baseball: Analysis of Injury Patterns, Risk Factors, Concussions, and Days Missed for Batters." American Journal of Sports Medicine 46, no. 8 (May 16, 2018): 1997–2003. http://dx.doi.org/10.1177/0363546518773048.
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Background: Although batters are frequently hit by pitch (HBP) in baseball, the effect of HBP injuries remains undefined in the literature. Purpose: To determine the effect of HBP injuries in terms of time out of play, injury patterns resulting in the greatest time out of play, and the value of protective gear such as helmets and elbow pads. Study Design: Descriptive laboratory study. Methods: Based on the Major League Baseball (MLB) Health and Injury Tracking System, all injuries to batters HBP during the 2011-2015 MLB and Minor League Baseball (MiLB) seasons were identified and analyzed. Video analysis was performed on all HBP events from the 2015 MLB season. Multivariate stepwise regression analysis was utilized to determine the predictive capacity of multiple variables (velocity, pitch type, location, etc) on injury status and severity. Results: A total of 2920 HBP injuries resulted in 24,624 days missed (DM) over the 5 seasons. MLB HBP injuries occurred at a rate of 1 per 2554 plate appearances (1 per 9780 pitches thrown). Mean DM per injury were 8.4 (11.7 for MLB vs 8.0 for MiLB, P < .001). Surgery was required for 3.1% of MLB injuries and 1.2% of MiLB injuries ( P = .005). The most common body regions injured were the hand/fingers (n = 638, 21.8%), head/face (n = 497, 17.0%), and elbow (n = 440, 15.7%), and there were 146 (5.0%) concussions. Injury rates and mean DM correlated with velocity in a near linear fashion. Players hit in the head/face (odds ratio, 28.7) or distal upper extremity (odds ratio, 6.4) were more likely to be injured than players HBP in other locations. Players with an unprotected elbow missed 1.7 more days (95% CI, –4.1 to 7.6) than those with an elbow protector ( P = .554) when injured after being HBP. Conclusion/Clinical Relevance: Although HBP injuries occur infrequently in the course of normal play, they collectively represent a significant source of time out of play. The most common body regions injured include the hands/fingers and head/face, and batters hit in these locations are significantly more likely to be injured. After contusions, concussions were the most common injury diagnosis.
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Hamano, Noritaka, Hitoshi Shitara, Tsuyoshi Tajika, Tsuyoshi Ichinose, Tsuyoshi Sasaki, Takuro Kuboi, Daisuke Shimoyama, et al. "Relationship between upper limb injuries and hip range of motion and strength in high school baseball pitchers." Journal of Orthopaedic Surgery 29, no. 1 (January 1, 2021): 230949902110033. http://dx.doi.org/10.1177/23094990211003347.
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We aimed to examine the relationship between hip range of motion (ROM) and abduction strength and throwing-related shoulder/elbow injuries in high school baseball pitchers. The study included 135 baseball pitchers. We asked them to fill out a questionnaire at the checkups, that included the dominant arm and the years of baseball experience. To avoid a confirmation bias, the examiners were blinded to the participants’ hand dominance. All players underwent physical function measurements, such as height, weight, shoulder and hip strength, and shoulder and hip ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the patient had been aware of in the past 3 years. The results of injured and non-injured pitchers were compared. Eighty-five pitchers had experienced a shoulder or elbow injury in the past 3 years. The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation ROM on the dominant side, the hip abduction strength on the non-dominant side, and the hip abduction strength on the dominant side were significantly lower in the injured group than in the non-injured group. The results may contribute to reducing the incidence of these injuries.
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Lucasti, Christopher J., Myles Dworkin, William J. Warrender, Brian Winters, Steven Cohen, Michael Ciccotti, and David Pedowitz. "Ankle and Lower Leg Injuries in Professional Baseball Players." American Journal of Sports Medicine 48, no. 4 (March 2020): 908–15. http://dx.doi.org/10.1177/0363546520902135.
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Background: Ankle and lower leg injuries are very common in sports, and numerous studies have discussed their diagnosis and management. Our study differs in that we report lower leg injuries in professional baseball players spanning the 2011-2016 seasons by utilizing a comprehensive injury surveillance system developed by Major League Baseball (MLB). Purpose: To determine the injury characteristics of ankle and lower leg injuries in professional baseball players during the 2011-2016 seasons by utilizing the MLB injury surveillance system. Study Design: Descriptive epidemiology study. Methods: Our study is a descriptive epidemiological evaluation through a retrospective review of injury data from the MLB Health and Injury Tracking System (HITS) since its implementation in 2010. We included any professional baseball player (MLB and Minor League Baseball [MiLB]) who was identified as having an ankle or lower leg injury between January 1, 2011, and February 28, 2017. Results: Over the study period, there were a total of 4756 injuries, of which 763 (16%) occurred in MLB players and 3993 (84%) occurred in MiLB players. The mean number of days missed for all players was 27.8 ± 141.4 days, with a median of 3 days. From 2011 through 2016, it was estimated that there were 414,912 athlete exposures (AEs) in MLB and 1,796,607 AEs in MiLB. Of the 4756 injuries recorded, 550 (12%) took place during the MLB regular season, and 3320 (70%) took place during the MiLB regular season. Injuries in MLB players, however, were 1.7 times more likely to require surgery ( P < .001). Additionally, rates of injury to the lower leg were stratified by position, with infield players experiencing injuries at a 1.6 times greater rate than any other position ( P < .001). Conclusion: In conclusion, this is the only epidemiological study to focus primarily on ankle and lower leg injuries in professional baseball players, utilizing an injury surveillance system developed by MLB.
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Saper, Michael G., Lauren A. Pierpoint, Wei Liu, R. Dawn Comstock, John D. Polousky, and James R. Andrews. "Epidemiology of Shoulder and Elbow Injuries Among United States High School Baseball Players: School Years 2005-2006 Through 2014-2015." American Journal of Sports Medicine 46, no. 1 (October 19, 2017): 37–43. http://dx.doi.org/10.1177/0363546517734172.
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Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies. Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States. Study Design: Descriptive epidemiological study. Methods: Baseball-related injury data were obtained from the National High School Sports-Related Injury Surveillance Study using High School RIO (Reporting Information Online), an Internet-based sports injury surveillance system. Athletic trainers from high schools across the country uploaded data regarding athlete-exposures (AEs) (defined as practice or game participation) and shoulder and elbow injuries from the school years 2005-2006 through 2014-2015. Results: A total of 241 shoulder injuries and 150 elbow injuries occurred during 1,734,198 AEs during the study period, for an overall shoulder injury rate of 1.39 per 10,000 AEs and an overall elbow injury rate of 0.86 per 10,000 AEs. The overall rates of injury were higher in competitions compared with practices for shoulders (rate ratio, 1.44; 95% CI, 1.11-1.85) and elbows (rate ratio, 2.15; 95% CI, 1.56-2.96). The majority of shoulder (39.6%) and elbow (56.9%) injuries were sustained by pitchers, and most injuries were chronic and caused by overuse. Position players were more likely to sustain injuries by contact with the playing surface or apparatus. For pitchers, muscle strains were the most common shoulder injuries (38.7%), while ligament sprains were the most common elbow injuries (42.7%). The majority of pitchers with shoulder (70.8%) and elbow (64.6%) injuries returned to play within 21 days. Among pitchers, a higher proportion of elbow injuries (11.4%) resulted in medical disqualification compared with shoulder injuries (5.6%). Among pitchers, the majority of shoulder (89.2%) and elbow (96.4%) injuries were managed nonsurgically. Conclusion: Shoulder and elbow injury rates and patterns in high school baseball players differed between field positions (pitchers vs position players) and by type of exposure (practice vs competition). This study suggests several areas of emphasis for targeted injury prevention interventions, most notably limiting fatigue and preventing overuse injuries.