Baseball

Pediatr Emerg Care 2000 Jun;16(3):215-20

Sports-Specific Concerns in the Young Athlete: Baseball

Yen KL, Metzl JD.

Department of Pediatrics, New York Presbyterian Hospital, New York, USA.

The sport of baseball is played by millions of children across America and around the world. Although generally considered a safe activity, it is estimated that there are over 100,000 acute baseball injuries yearly in the 5- to 14-year age range in the United States, many of which present to the emergency department. Acute injuries often involve ball impact to the face and hands; baseball is the leading cause of sport-related eye injury. Ball impact particularly to the chest results in a small but steady number of fatalities each year, many of which are widely publicized events. In addition to acute injury, many young baseball players are affected by chronic and acute conditions of the elbow. In this article, we review the history, epidemiology, and common injury patterns that are specific to baseball. Case reports are included, as well as a section on the physical examination of the elbow.

Am J Sports Med 2000 May-Jun;28(3):385-91

Sex-Related Injury Patterns Among Selected High School Sports
Powell JW, Barber-Foss KD.
Med Sports Systems, Iowa City, Iowa, USA.

This cohort observational study was undertaken to test the hypothesis that the incidence of injuries for girls participating in high school sports is greater than that for boys. From 1995 through 1997, players were included in our study if they were listed on the school's varsity team roster for boys' or girls' basketball, boys' or girls' soccer, boys' baseball, or girls' softball. Injuries and opportunities for injury were recorded daily. Certified athletic trainers reported injury and exposure data. Based on 39,032 player-seasons and 8988 reported injuries, the injury rates per 100 players for softball (16.7) and for girls' soccer (26.7) were higher than for baseball (13.2) and boys' soccer (23.4). The knee injury rates per 100 players for girls' basketball (4.5) and girls' soccer (5.2) were higher than for their male counterparts. Major injuries occurred more often in girls' basketball (12.4%) and soccer (12.1%) than in boys' basketball (9.9%) and soccer (10.4%). Baseball players (12.5%) had more major injuries than softball players (7.8%). There was a higher number of surgeries, particularly knee and anterior cruciate ligament surgeries, for female basketball and soccer players than for boys or girls in other sports.

Percept Mot Skills 2000 Feb;90(1):319-25

Injuries Due to School Sports Accidents in 4 to 13-yr.-old Children

Kingma J, Ten Duis HJ.

Department of Surgery, University Hospital Groningen, The Netherlands.

505 kindergarten and primary school children from 4 to 13 years of age were treated for school sports injuries during the period 1990-1997. The incidence of injuries increased statistically significantly from .5 per 1,000 children 4- to 5-yr.-old to 4.8 injured children per 1,000 in 12- to 13-yr.-old. 59% of the injuries involved upper extremities; 35% of these were in the wrist region. 33.5% of the injuries were of the lower extremities, with 50% being of the feet and 36.4% of the ankle. Accidental falls were the main situation (53%) in which school sport accidents occurred. Nearly 65% of these accidental falls occurred at the ground level; the remaining accidents (35%) occurred when the child was working on an apparatus, e.g., parallel bars, balancing beam, side horse. The 4- to 5-yr.-old children were the most vulnerable to accidental fall (67%). A statistically significant increase in injuries in ball sports was observed from 4- to 5-yr.-olds (0%) to the 12- to 13-yr.-olds (28%).

Arthroscopy 2000 Jan-Feb;16(1):35-40

Arthroscopic Findings in the Overhand Throwing Athlete:

Evidence for Posterior Internal Impingement of the Rotator Cuff

Paley KJ, Jobe FW, Pink MM, Kvitne RS, ElAttrache NS.

Centinela Hospital Medical Center, Inglewood, California 90301, USA.

SUMMARY: The purpose of this article is to describe the outcome of an arthroscopic examination and the pathology in symptomatic shoulders of 41 professional overhand throwing athletes. With the arm in the position of the relocation test, 100% of the subjects had either contact between the rotator cuff undersurface and the posterosuperior glenoid rim or osteochondral lesions. Other key findings included undersurface cuff fraying in 93%, posterosuperior labral fraying in 88%, and anterior labral fraying in 36% of the subjects. This study supports the concept of impingement of the posterior cuff undersurface with the posterosuperior glenoid rim in the overhand throwing athlete with shoulder pain.

Pediatrics 1996 Sep;98(3 Pt 1):445-8

Baseball Injuries: A Little League Survey

Pasternack JS, Veenema KR, Callahan CM.

Department of Emergency Medicine, University of Rochester School of Medicine & Dentistry, New York 14642, USA.

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 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; and 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.

Sports Med 1988 Dec;6(6):378-87

Rotator cuff injuries in baseball. Prevention and rehabilitation.

Jobe FW, Bradley JP.
Kerlan Jobe Orthopedic Clinic, Inglewood, California.

Rotator cuff and ligamentous capsule injuries are common in the young baseball player. In order to understand these injuries, it is important to first appreciate the delicate balance between shoulder mobility and stability as well as the biomechanics of throwing. This background information makes it easy to see how shoulder injuries are really part of a progressive continuum beginning with instability leading to subluxation, and later impingement, which can result in a rotator cuff tear. A detailed and precise history and physical is crucial in determining where a patient might be on the continuum. An accurate evaluation will also help appropriately place a patient in one of the following 4 groups: pure impingement, anterior instability due to trauma with secondary impingement, anterior stability due to a hyperelasticity with secondary impingement, and pure anterior instability. A kinesiological repair is the initial treatment of choice. It is the best preventative or early treatment available, and consists of a specific strengthening program. If this fails (as in only 5 to 10% of the cases), an anatomical repair is instituted. There are 4 basic guidelines when doing this surgery: (a) maintain muscle attachments and proprioceptive fibers; (b) do not shorten the capsule significantly; (c) build up the anterior labrum; and (d) regain full range of motion quickly through abduction splinting and rehabilitation. A postoperative rehabilitation program is then diligently adhered to, as it is at least as important as the surgery itself.