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Making the Diamond Less Rough

Sports medicine specialist shares baseball, softball safety tips

When they think about high-contact sports — which have a higher risk of injury — most people think of sports like football, rugby, hockey, or soccer. By comparison, baseball and softball seem like relatively safe sports.

Yet, according to SafeUSA, even though baseball and softball are not considered "contact" sports, they are associated with a large number of injuries. Hospital emergency departments treat more than 95,000 baseball-related injuries and 30,000 softball-related injuries among players under age 15 each year. 

SafeUSA is an alliance of public agencies and private organizations whose programs include research, service, training, communications, and policy development related to injury and violence prevention. They estimate that more than 33 million people in the United States participate in organized baseball and softball leagues. Nearly 6 million of these players are 5 to 14 years old. 

The number of injuries among adults is also high, with as many as 8 percent of players sustaining injuries each year. 

"An injury to a young player should be taken seriously," says Jeffrey M. Mjaanes, MD, a pediatric sports medicine specialist at Rush. "Helmets, protective gear, pitching limits and common sense can protect against many injuries." 

To help your child avoid injuries while playing baseball or softball, follow these safety tips from the American Academy of Pediatrics, the Centers for Disease Control and Prevention (CDC), the Consumer Product Safety Commission, and other sports and health organizations. (Note: These tips apply to adult ball players, too.)

  • Take your child to a physician for a physical exam before he or she starts a training program or plays competitive baseball or softball. The physician can help assess any special injury risks your child may have.
  • Make sure your child wears all the required safety gear every time he or she plays and practices.
  • Insist that your child wear a helmet when batting, waiting to bat or running the bases. Helmets should have eye protectors —  either safety goggles or face guards. Not wearing a helmet increases the risk of suffering a concussion.
  • Shoes with molded cleats are recommended (most youth leagues prohibit the use of steel spikes). If your child is a catcher, he or she will need additional safety gear: a catcher's mitt, face mask, throat guard, long-model chest protector and shin guards.
  • If your child is a pitcher, make sure pitching time is limited. Little League mandates time limits and requires rest periods for young pitchers. If you have questions regarding pitching limits, please ask your sports medicine physician for recommendations.
  • Insist that your child warm up and stretch before playing.
  • Teach your child not to play through pain. If your child is injured, see your physician. Follow all the physician's orders for recovery, and get his or her okay before your child returns to play.
  • Make sure first aid is available at all games and practices.
  • Talk to and watch your child's coach. Coaches should enforce all the rules of the game, encourage safe play and understand the special injury risks that young players face. In particular, make sure your child's coach teaches players how to avoid injury when pitching, dodge a ball pitched directly at them and slide (for example, not allowing young players to slide head first).
  • Above all, keep baseball and softball fun. Putting too much focus on winning can make your child push too hard and risk injury.

Is it serious?

Besides more obvious signs of serious injury, like blood or broken and misaligned joints and bones, one way to determine if an injury is serious is if there is persistent pain.

"Any athlete who has pain that lasts more than 48 to 72 hours should be evaluated by a professional," says Mjaanes. 

Commonly missed injuries that usually present as chronic pain and can be potentially career-damaging include:

  • Stress fractures of the spine
  • Growth plate injuries of the arm bones ('Little League shoulder' and 'Little League elbow')
  • Bone/cartilage damage to the elbow (osteochondral fractures)
  • Elbow ligament damage ('Tommy John's injury'). 

"The bottom line: Listen to your child," says Mjaanes. "Do not ignore pain — if they say it hurts and it affects their game, have it checked out. Usually, the earlier we detect a problem, the faster we can return the athlete to competition." 

Getting back in the game

It helps to wait before returning to the field. "A basic rule of thumb is that an injured athlete — child, teen or adult — can return to play when they have full, pain-free range of motion and at least 85 percent of full strength," says Mjaanes.

When it comes to concussion, Mjaanes recommends proceeding with caution. If a child goes back on the field before fully recovering from a concussion, getting another concussion can have devastating effects.

"In terms of head injuries, the child must have returned to baseline mental status and be completely symptom-free before playing again," he says. "Another caveat would be that they pose no further risk of serious injury to themselves or others by playing." 

Read more about sports-related concussion and how Mjaanes and his colleagues at the Chicago Sports Concussion Clinic at Rush evaluate and treat head injuries in athletes of all ages.

Being prepared: Staying in shape

Another important way to prevent injuries is to have good fitness and health habits.

"It's important that young athletes maintain their cardiovascular fitness in the off-season so they are in great shape to hit the season running," says Mjaanes. "This is especially important in baseball and softball, which are not as aerobically challenging as other sports such as soccer or basketball," he says. 

"To maintain fitness I suggest at least 30 minutes of sustained aerobic activity daily (such as biking, jogging, running, rowing); light-moderate resistance training; observing a low-fat, low-calorie, nutritious diet; and rest - getting 9 to 10 hours of sleep." 

Avoiding injury in other summer activities

You do not have to be on a baseball diamond to get hurt. Make sure your child wears safety gear and follows safety rules during informal baseball and softball games, too. 

"Remember that it's also important to wear helmets for many other summer activities," says Mjaanes. "Protect your head when riding a bike, roller skating, skateboarding, or when engaged in any activity that has the potential for a collision."

Always consult your child's physician for more information about keeping your young athlete safer.