Recreational Injury Interventions

Baseball & Softball


Baseball is one of the most popular sports in the United States, and has increased in popularity in other countries as well. Approximately, 4.8 million children between the ages of 5 to 14 participate annually in organized and recreational baseball and softball, Committee on Sports Medicine and Fitness, 2001. There are, however, risks involved when playing the game of baseball. It has been reported that baseball is accountable for the largest number of sports-related fatalities in children ages, 5 to 14 years old, Viano et al, 2000. Of these fatalities, the most common catastrophic impact injury results from contact with a ball or bat. Deaths have occurred from intracranial bleeding that results from an impact to the head and from blunt chest impacts.

Overall 2% to 8% of participants per year experience an injury while playing baseball, Committee on Sports Medicine and Fitness, 2001. An estimated 162,000 children ages 5 to 14 years were treated in emergency departments for baseball, softball, and tee-ball injuries in 1995, Committee on Sports Medicine and Fitness, 2001. Of these 162,000 injuries the number of injuries increased with age and peaked at 12 years. Additionally, 26% were fractures, 37% were contusions and abrasions, and the remainder were strains, sprains, concussions, internal injuries, and dental injuries. Between 1973 and 1995, 88 deaths were reported and of these deaths 68 were due to baseball impact injuries, Viano et al, 2000.

One study evaluted 25 individuals, ages 3 to 19, who had died from sports-related chest impacts and found that 18 of the 25 people had been playing baseball or softball when the fatal impact occurred, Viano et al, 2000. Children ages 5 to 15 years seem particularly vulnerable to blunt chest impacts because their thoraces may be more elastic and more easily compressed.

Some studies have examined the effectiveness of chest protectors and other protective equipment for prevention of baseball relted injuries. Viano et al, 2000 used a biomechanical surrogate or model to evaluate the effectiveness of five different chest protectors that are currently manufactured for use by baseball players while batting. They reported that the majority of these chest protectors did not consistently provide reduction in the risk or commotio cordis which is death that results from blunt chest trauma, Viano et al, 2000.

The American Academy of Pediatrics recently updated its 1994 policy statement on baseball and softball injuries in children and also provided recommendations for safe training practices and the appropriate use of protective equipment, Committee on Sports Medicine and Fitness, 2001. The number of catastrophic events in baseball and softball have not increased over the years, leading pediatricians to classify baseball and softball as a relatively safe sport. Batting helmets, helmets, masks, and chest and neck protectors for all catchers, rubber spikes, polycarbonate eye protectors, low-impact NOCSAE-approved baseball and softballs, fencing on dugouts, break-away bases, and elimination of the on-deck circle are measures that can be implemented to minimize potentially serious and catastrophic injuries in baseball and softball. Additionally, developmentally appropriate rule modifications (such as the avoidance of head-first sliding) should be implemented for children younger than 10 years.

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