Dr. Weaver recently read an article in this month’s issue of The Journal of the American Academy of Orthopaedic Surgeons and took the time to share the highlights with his patients below:
The surge in popularity of softball among youth and collegiate athletes brings both excitement and challenges. With over 340,000 high school female athletes and 21,000 collegiate participants in 2021-2022, it’s now the fourth most popular female sport. Additionally, recreational men’s softball leagues are very popular with weekend warriors. Unfortunately, the increased engagement has led to a rise in injuries, necessitating a closer look at patterns and preventive measures.
Epidemiology: Softball, played by over two million females annually, exhibits an injury prevalence of 38-40%. Emergency departments nationwide reported 511,117 softball injuries between 2010 and 2019. Common injuries include head/neck, upper extremity, and foot/ankle injuries, with most being sprains, strains, or contusions.
Upper Extremity Injuries: Comprising 33% of softball injuries, upper extremity injuries often result from ball contact or the pitching mechanism. The windmill pitch, unique to softball, imposes specific stresses on the elbow and shoulder, making it critical to understand its phases and impact on musculature.
Shoulder Injuries: Softball pitchers face unique challenges, with biceps brachii activation during the delivery phase reaching 38%, potentially leading to issues like proximal biceps tendinitis and superior labral tears. Shoulder injuries, particularly related to glenohumeral internal rotation deficits, are common. The key is understanding the balance between velocity and injury risk.
Elbow and Forearm Injuries: While studies on softball-related elbow injuries are limited compared to baseball, ulnar neuritis and forearm stress fractures are associated with the windmill pitch. More research is needed to understand the prevalence and pathology of elbow injuries in underhand pitchers.
Injury Prevention (Upper Extremity): Pitch count recommendations and off-season programs can mitigate overuse injuries. Shoulder pain and fatigue, along with decreased range of motion, correlate with increasing pitch counts. Strengthening and conditioning, especially the hip-lumbopelvic complex, are crucial for injury prevention.
Lower Extremity Injuries: Constituting 30% of softball injuries, foot and ankle injuries, often occurring during running and sliding, are prevalent. Knee injuries are more frequent in softball than baseball, with noncontact sprains and strains being common. ACL injuries, although low in percentage, have a significant impact due to surgery and prolonged rehabilitation.
Injury Prevention (Lower Extremity): Preventive measures such as breakaway bases and first base double bags reduce the force sustained by the foot during sliding, emphasizing the importance of implementing safety equipment.
Head and Neck Injuries: Over 30% of pediatric softball injuries involve the head and neck. Facial fractures, especially in the midface, are common. The heightened awareness of concussions is crucial, and research indicates that female athletes, although more likely to wear protective equipment, are at an increased risk for concussions compared to males.
Injury Prevention (Head and Neck): Protective headgear for batters and catchers is mandated, but defensive players, especially pitchers, lack such regulations. The implementation of safety equipment, such as masks for players over 12 years old, is recommended.
Conclusion: As softball’s popularity grows, understanding injury patterns and implementing effective preventive measures become paramount. Unique aspects like the windmill pitch, ball-contact injuries, and lack of consensus on regulations contribute to specific injury patterns in young female athletes. Further research is essential to define pathology and refine prevention strategies for a safer and more enjoyable softball experience.