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PubMed1997

Ventricular fibrillation following blunt chest trauma from a baseball.

OBJECTIVE: Baseball injuries account for a significant number of sports-related fatalities in children. We present a case of a 12-year-old male who died after being struck in the chest by a high velocity baseball propelled from a pitching machine. We examine the pathophysiology of blunt chest trauma, discuss possible explanations for the development of arrhythmias, review baseball-related fatalities, and suggest injury prevention strategies. DESIGN: A case report and review of the literature. SETTING: A pediatric emergency department (ED) in an urban, tertiary care, general hospital. PATIENTS: One case report. INTERVENTIONS: Advanced pediatric life support interventions, including emergency thoracotomy, direct cardiac massage, and direct cardiac defibrillation. RESULTS: The patient remained unresponsive to extraordinary therapy and died. CONCLUSIONS: Blunt trauma to either the chest or head accounts for the majority of baseball-related deaths. This case was similar to other reports of cardiac arrest following blunt chest trauma from a baseball. The patient had no prior medical problems, collapsed immediately, had no pathological findings on direct visualization, remained unresponsive despite rapid and maximal treatment, and died. Direct blows to the chest can stimulate inherently excitable cardiac tissue producing arrhythmias, particularly ventricular fibrillation, that are difficult to treat. A child's unique anatomy provides minimal protection to the underlying thoracic organs. The key to reducing the risk of injury lies in always complying with accepted safety rules, and in developing appropriate chest protection and safer baseballs.

Adolescent↗
PubMed1998

Epidemiology of collegiate baseball injuries.

OBJECTIVE: We sought to establish injury incidence, onset, location, type, and severity for a collegiate baseball team. The second objective was to compare the number of musculoskeletal problems for which baseball players sought treatment with those that resulted in time lost or modified participation. METHODS: This was a prospective, epidemiologic study. A complaint was defined as any evaluation by a player to the medical staff that required either evaluation or treatment. An injury was defined as any complaint that resulted in altered participation or time lost from practice or game participation. Participants were Division I collegiate baseball team with one athletic trainer and one academic sports medicine specialist. All members of the collegiate baseball team were studied over a 3-year period to determine the overall incidence of injury per 1,000 exposures (A-E) to practice or participation, injuries sustained over 3 years by collegiate baseball players. RESULTS: Overall there were 277 complaints and 52 injuries (19%). The A-E rate was 5.83. Forty-six percent of the injuries occurred in practice and 54% in games. Seventy-three percent of the injuries resulted in < 7 days lost from sport, and 25% resulted in > 21 days lost participation. The most common origin of injury was strains (23%), sprains (19%), and contusions (17%). Fifty-eight percent of the injuries were to the upper extremity, 15% to the trunk/back, and 27% to a lower extremity. Upper extremity injuries accounted for 75% of the total time lost from the sport. When divided by position, the shoulder injuries occurred in pitchers (69%), infielders (19%), and outfielders (12%). Rotator cuff tendinitis was the most frequent complaint, was the most frequent injury, and resulted in the most time lost from the sport. CONCLUSIONS: Defining injury as time lost or as altered participation underestimates the frequency with which players seek evaluation and treatment. Injuries are divided widely across anatomic site, but upper extremity injuries cause the most time lost from the sport. Further study of the origin and prevention of upper extremity injuries in baseball is warranted.

Adult↗
PubMed1989

Comparative patterns of smokeless tobacco usage among major league baseball personnel.

The purpose of this study was to survey major league baseball personnel in order to determine the prevalence, cultural distribution and factors influential in, and the level of knowledge of individuals regarding the harmful effects of smokeless tobacco usage. During the 1987 preseason/season, 25 of 26 baseball teams in the American and National Leagues participated in the survey. The players (46%) "dipped" or "chewed" more than the managers/coaches (35%) followed by the trainers (30%). Current usage of smokeless tobacco was highest among Caucasian athletes (50%) followed by Hispanic athletes (33%) and then Black athletes (30%). Among the baseball players surveyed who currently use smokeless tobacco, 58% started during the ages 18 to 22. This study indicates that although baseball personnel are fully aware of the harmful effects of smokeless tobacco usage, current use of smokeless tobacco in major league baseball is high. Additionally, baseball personnel start "dipping" or "chewing" smokeless tobacco at an early age and continue this practice for long periods.

Adult↗
PubMed2006

Predicting zygoma fractures from baseball impact.

The purpose of this study is to develop injury risk functions that predict zygoma fracture based on baseball type and impact velocity. Zygoma fracture strength data from published experiments were mapped with the force exerted by a baseball on the orbit as a function of ball velocity. Using a normal distribution, zygoma fracture risk functions were developed. Experimental evaluation of these risk functions was performed using six human cadaver tests and two baseballs of different stiffness values. High speed video measured the baseball impact velocity. Post test analysis of the cadaver skulls was performed using CT imaging including three-dimensional reconstruction as well as autopsy. The developed injury risk functions accurately identify the risk of zygoma fracture as a result of baseball impact. The experimental results validated the zygoma risk functions at the lower and upper levels. The injuries observed in the post test analysis included fractures of the zygomatic arch, frontal process and the maxilla, zygoma suture, with combinations of these creating comminuted, tripod fractures of the zygoma. Tests with a softer baseball did result in injury but these had fewer resulting zygoma bone fragments and occurred at velocities 50% higher than the major league ball.

Baseball↗
PubMed2006

Direction of spin axis and spin rate of the pitched baseball.

In this study, we aimed to determine the direction of the spin axis and the spin rate of pitched baseballs and to estimate the associated aerodynamic forces. In addition, the effects of the spin axis direction and spin rate on the trajectory of a pitched baseball were evaluated. The trajectories of baseballs pitched by both a pitcher and a pitching machine were recorded using four synchronized video cameras (60 Hz) and were analyzed using direct linear transform (DLT) procedures. A polynomial function using the least squares method was used to derive the time-displacement relationship of the ball coordinates during flight for each pitch. The baseball was filmed immediately after ball release using a high-speed video camera (250 Hz), and the direction of the spin axis and the spin rate (omega) were calculated based on the positional changes of the marks on the ball. The lift coefficient was correlated closely with omegasinalpha (r = 0.860), where alpha is the angle between the spin axis and the pitching direction. The term omegasinalpha represents the vertical component of the velocity vector. The lift force, which is a result of the Magnus effect occurring because of the rotation of the ball, acts perpendicularly to the axis of rotation. The Magnus effect was found to be greatest when the angular and translational velocity vectors were perpendicular to each other, and the break of the pitched baseball became smaller as the angle between these vectors approached 0 degrees. Balls delivered from a pitching machine broke more than actual pitcher's balls. It is necessary to consider the differences when we use pitching machines in batting practice.

Acceleration↗
PubMed1994

Tibia fractures produced from the impact of a baseball bat.

Forty-seven patients presented during a 1-year period with fractures of the extremities produced by the impact of a baseball bat. This represented an increase of fourfold in fractures associated with baseball bat trauma as compared with the previous year. Those patients with tibia fractures were retrospectively reviewed in terms of associated soft-tissue injuries, fracture pattern, and fracture healing. Potential force generated and kinetic energy transferred when a baseball bat strikes the tibia were calculated mathematically to provide correlation with clinical observations. Tibia fractures produced by baseball bats represented 10% of all tibia fractures presenting from July 1990-July 1991. Of these 11 tibia fractures, 3 developed compartment syndrome, necessitating fasciotomy and subsequent skin grafting, and 1 developed osteomyelitis, which eventually resulted in amputation. One patient had superficial skin blistering that required a delay in definitive fracture care of 11 days and subsequent skin grafting. There was one nonunion and three delayed unions requiring additional operative intervention. This incidence of compartment syndrome (27%) is nine times higher than the overall incidence, at this institution, of compartment syndrome (3%) in tibia fractures produced by other mechanisms. The maximum potential kinetic energy produced during the impact of a baseball bat is 515 kg/m2/s2: 25% higher than that produced by a 9-mm bullet fired at a distance of 6 ft (407 kg/m2/s2). The potential force transmitted from a bat to the tibia at the time of collision is 8,000 lb, three times that of the bullet (626 lb).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

Sports-specific concerns in the young athlete: baseball.

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.

Adolescent↗
PubMed2003

High-speed video analysis of head-first and feet-first sliding techniques in collegiate baseball players.

OBJECTIVE: To determine the method of sliding that propels the baseball athlete to the desired base in the shortest amount of time. To assess the athlete's perception of the quickest, safest, and preferred sliding technique. DESIGN: A single occasion with repeated measures design was used. The independent variable was slide type, and the dependent variable was time. SETTING: The study was conducted in October 2000 at the University of Kentucky baseball complex. PARTICIPANTS: Twenty collegiate baseball players. INTERVENTIONS: High-speed video (to 1/200th of second) analysis of 20 collegiate baseball players performing 3 trials each of both head-first and feet-first sliding techniques. Additionally, each participant was asked to complete a sliding survey. MAIN OUTCOME MEASURES: The videotape of each slide performed was reviewed separately (using the same viewing equipment) by 2 of the study investigators. Slide type and time were recorded for each slide. RESULTS: There was no significant difference between head-first versus feet-first slide times (P = 0.357). The average time for feet-first slides was 3.67 seconds, while that for head-first was 3.65 seconds. Sixty-eight percent of the players felt that head-first slides were faster than feet-first slides. Seventy-four percent identified the feet-first slide as the technique they most used, while 90% of the athletes perceived the feet-first technique to be safer. CONCLUSIONS: On average, head-first and feet-first sliding techniques employed at the end aspect of base running propel the baseball player to the base in similar times. The head-first sliding technique is perceived to be faster and more dangerous.

Adult↗
PubMed2005

Modeling deformation behavior of the baseball.

Regulating ball response to impact is one way to control ball exit velocity in baseball. This is necessary to reduce injuries to defensive players and maintain the balance between offense and defense in the game. This paper presents a model for baseball velocity-dependent behavior. Force-displacement data were obtained using quasi-static compression tests to 50% of ball diameter (n = 70 baseballs). The force-displacement curves for a very stiff baseball (Model B) and a softer type (Model C) were characterized by a Mooney-Rivlin model using implicit finite element analysis (ANSYS software, version 6.1). Agreement between experimental and numerical results was excellent for both Model B (C(10) = 0, C(01) = 3.7e(6) Pa) and Model C (C(10) = 0, C(01) = 2.6e(6) Pa). However, this material model was not available in the ANSYS/LSDYNA explicit dynamic software (version 6.1) used to quantify the transient behavior of the ball. Therefore the modeling process was begun again using a linear viscoelastic material. G(infinity), the long-term shear modulus of the material, was determined by the same implicit FEA procedure. Explicit FEA was used to quantify the time-dependent response of each ball in terms of instantaneous shear modulus (G0) and a decay term (beta). The results were evaluated with respect to published experimental data for the ball coefficient of restitution at five velocities (13.4-40.2 ms(-1)) and were in agreement with the experimental values. The model forms the basis for future research on baseball response to impact with the bat.

Baseball↗
PubMed2005

Smokeless tobacco use among professional baseball players: survey results, 1998 to 2003.

OBJECTIVE: The use of smokeless tobacco (ST) (snuff and chewing tobacco) has long been associated with baseball in the USA. This article reviews six years of survey data from major and minor league baseball players to evaluate trends in tobacco use and quitting patterns over time in order to gain insight into the effects of past interventions and to document continued intervention needs. METHOD: Surveys were distributed by athletic trainers to major and minor league professional baseball players during spring training session in the six years from 1998 to 2003. The surveys were anonymous and identified only by team, level of league, and other self reported demographic data. RESULTS: ST use among professional baseball players remains much higher than among young males in the general population, and use is most prevalent among white non-Hispanic players. There was a significant decrease in ST use among minor league players from 1998 to 2003, with seven day self reported use declining from 31.7% in 1998 to 24.8% in 2003. No significant year to year changes were observed for major league players. Major league players' self reported past week use rates, estimated at 35.9% in 1998 and at 36% in 2003, were consistently higher than those of minor league players. Self reported prevalence of past month cigarette and cigar smoking was much lower than ST use for both major and minor league players. CONCLUSIONS: Six years of survey data confirm a continuing high use of ST among professional baseball players. Results suggest that the effects of the broad spectrum ST control efforts launched over the past decade may have been stronger among minor than major league players. Stronger policy interventions at the major league level and multi-level efforts, including programmes to increase the use of effective quitting aids and assistance, at both levels of play are needed. Future research is needed to further clarify changes in ST practices among professional players and set policy intervention directions.

Adolescent↗
PubMed2005

Baseball injuries.

OBJECTIVE: To identify the frequency of injury in youth baseball, risk factors for these injuries, and possible prevention measures to reduce the frequency or severity of these injuries. DATA SOURCES: Information was collected from all known epidemiologic and intervention studies published in the peer-reviewed medical and scientific literature as it applies to youth baseball injuries. MAIN RESULTS: The frequency and severity of youth baseball injuries have remained relatively consistent over time. Risk factors for many injuries have been understudied and the study designs used for much of this research have been less than optimal. Several effective prevention measures have been identified, such as batting helmets, face shields, softer baseballs, and breakaway bases. CONCLUSIONS: Baseball is a relatively safe sport compared to many contact sports, but injuries do still occur. Future research should focus on determining the optimum pitching motion for both arm safety and performance, as well as systematically studying other potential safety improvements such as restrictions against breaking pitches.

Athletic Injuries↗
PubMedDate not supplied

Infraspinatus muscle atrophy in professional baseball players.

BACKGROUND: Infraspinatus muscle atrophy has been observed in athletes who stress their upper extremities in an overhead fashion. The majority of such case reports have been in volleyball players, with far fewer cases reported in baseball players. HYPOTHESIS: Infraspinatus muscle atrophy occurs to a notable degree in professional baseball players. STUDY DESIGN: Retrospective cohort study. METHODS: At the end of the 1999 baseball season, data were collected from all Major League Baseball teams in regards to players affected with infraspinatus muscle atrophy. RESULTS: Twelve of the 1491 major league professional baseball players were identified as having appreciable infraspinatus muscle atrophy. There was an increased prevalence of the muscle atrophy in professional pitchers (10 of 494, 4%) compared to position players (2 of 997, 0.2%) (P <0.001). Among affected pitchers, the atrophy was identified more frequently in starting pitchers (8 of 10) compared to relief pitchers (2 of 10) (P = 0.036), pitchers who had played for more years at the major league level (8.7 +/- 4.9 versus 5.2 +/- 4.0) (P = 0.017), and pitchers who had thrown for more innings at the major league level (971.4 +/- 784.4 versus 485.0 +/- 594.6) (P <0.001). CONCLUSION: Infraspinatus atrophy was identified in 4.4% of major league starting pitchers and occurred in those pitchers who pitched for more years and innings during their major league career.

Adult↗
PubMed2004

Ulnar collateral ligament reconstruction in high school baseball players: clinical results and injury risk factors.

BACKGROUND: The incidence of ulnar collateral ligament injury has increased in baseball, especially at the high school level. HYPOTHESIS: Ulnar collateral ligament injury in high school baseball players is associated with overuse, high-velocity throwing, early throwing of breaking pitches, and improper warm-ups. STUDY DESIGN: Retrospective cohort study. METHODS: Follow-up physical examination and questionnaire data were collected at an average of 35 months after ulnar collateral ligament reconstruction from 27 former high school baseball players. Six potential risk factors were evaluated: year-round throwing, seasonal overuse, event overuse, throwing velocity more than 80 mph, throwing breaking pitches before age 14, and inadequate warm-ups. RESULTS: Overall, 74% returned to baseball at the same or higher level. Patients averaged 3 potential risk factors, and 85% demonstrated at least one overuse category. Of the pitchers, the average self-reported fastball velocity was 83 mph, and 67% threw breaking pitches before age 14. CONCLUSIONS: The success rate of ulnar collateral ligament reconstruction in high school baseball players is nearly equal to that in more mature groups of throwers. Overuse of the throwing arm and throwing breaking pitches at an early age may be related to their injuries. Special attention should be paid to elite-level teenage pitchers who throw with high velocity.

Adolescent↗
PubMed1995

[A study on the effects of physical load on high school baseball players during midsummer games].

This study attempted to measure the physical load on high school baseball players during games played under extremely hot and humid conditions in the summer. The factors used to determine physical load were the following: body weight, oral temperature, blood pressure, heart rate, and serum biochemical elements. These were measured before and after the game. One hundred twenty-six baseball players from 7 high schools participated in this study. All the games were played under conditions of high temperature 34 degrees Celsius dry-bulb, 26 degrees Celsius wet-bulb, 41 degrees Celsius black-globe, 30 degrees WBGT, which are likely to cause heat-related illnesses. The results were as follows. 1) The physical load of baseball players during the game showed a 1.8 percent decrease in average body weight due to perspiration, a 0.35 degrees C increase in oral temperature and an increase in the heart rate. Examination of the serum biochemical elements showed that muscle deviation ferment changed due to muscular activity and blood condensed due to perspiration. The physical load levels of baseball players were influenced more by extreme heat than by exercise during the game. 2) The group of starting players showed higher body weight loss, oral temperature, heart rate, blood condensation and muscle deviation ferment levels than the group of players on the bench due to the difference in the length of exposure to summer heat and the amount of physical exertion. The changes in physical load levels during the game for the group of starting players were greater than those for the group for players on the bench. 3) Considering the changes in body weight, blood condensation and muscle deviation ferment, we can say that physical loads of players differed according to their positions, the pitcher having the greatest load, followed in descending order by the catcher, infielders, and outfielders. It has been recommended that high school baseball players should take different kinds of rest depending on their positions in order to recover from fatigue as soon as possible after a game.

Adolescent↗
PubMed2005

Vascular changes of the hand in professional baseball players with emphasis on digital ischemia in catchers.

BACKGROUND: Repetitive trauma to the hand is a concern for baseball players. The present study investigated the effects of repetitive trauma and the prevalence of microvascular pathological changes in the hands of minor league professional baseball players. In contrast to previous investigators, we documented the presence of abnormalities in younger, asymptomatic individuals. METHODS: Thirty-six baseball players on active minor league rosters underwent a history and physical examination of both hands as well as additional specialized tests, including Doppler ultrasound, a timed Allen test, determination of digital brachial pressure indices, and ring sizing of fingers. Data were compared between gloved hands and throwing hands, hitters and nonhitters, and players at four different positions (catcher [nine subjects], outfielder [seven subjects], infielder [five subjects], and pitcher [fifteen subjects]). RESULTS: Digital brachial indices in the ring fingers of the gloved (p < 0.05) and throwing hands (p < 0.02) of catchers were significantly diminished compared with those in all other players. Doppler testing showed a significantly greater prevalence of abnormal flow in the ulnar artery at Guyon's canal when catchers were compared with other position players (p < 0.01). Doppler abnormalities were significantly more common in the gloved hand compared with the throwing hand (p < 0.05). Seven of nine catchers (and only catchers) were found to have index finger hypertrophy (average change, two ring sizes; p < 0.01); the hypertrophy occurred at the proximal phalanx and the proximal interphalangeal joint of the gloved hand. Catchers had a significantly higher prevalence of subjective hand symptoms (specifically, weakness in the gloved hand) compared with pitchers and infielders/outfielders (44% compared with 7% and 17%, respectively; p < 0.05). CONCLUSIONS: Microvascular changes are present in the hands of otherwise healthy professional baseball players in all positions, with a significantly higher prevalence in catchers, prior to the development of clinically important ischemia. Repetitive trauma resulting from the impact of the baseball also leads to digital hypertrophy in the index finger of the gloved hand of catchers. Gloves currently used by professional catchers do not adequately protect the hand from repetitive trauma.

Adult↗
PubMed2004

Impact injuries in baseball : prevalence, aetiology and the role of equipment performance.

Baseball has one of the highest impact injury rates of all sports. These injuries are primarily attributed to impact by a ball after it has been hit, pitched or thrown. This paper will review the incidence and causal factors for impact injuries in baseball. Attention is given to the design and material properties of bats, in light of evidence suggesting balls hit into the infield from metal bats can reach velocities potentially lethal to defensive players. The distribution of bat mass along the long axis of the implement appears a major factor in the greater performance potential of metal bats over wooden bats of equal length and mass. The dynamic behaviour of baseballs has also been implicated in the severity of head and chest injuries experienced by players. Balls of greatly reduced stiffness have been introduced for junior play, but debate still remains over their performance and impact characteristics. The behaviour of the ball during high-speed impact with the bat has been the subject of relatively limited research, and the effect of manipulating baseball material properties to decrease batted-ball velocity is unclear. The value of batting helmets is evident in the observed reduction of head injuries in baseball, but the use of protective vests to decrease the incidence and severity of cardio-thoracic trauma appears to be contraindicated.

Athletic Injuries↗
PubMed1994

Do right-handers live longer? An updated assessment of baseball player data.

In support of the argument that left-handedness is a marker for decreased survival fitness, in 1991 Coren and Halpern gave considerable weight to the results of their 1988 study in which right-handed baseball players were described as having lived about eight months longer than their left-handed peers. In their 1993 unsuccessful attempt to replicate this study, Fudin and colleagues cited certain difficulties with the sources of these data that led them to recommend a comprehensive third study which included only reliable data from the two current editions of the major sources of information on Major League baseball players, i.e., the 1993 editions of The Baseball Encyclopedia and Total Baseball. Following this suggestion, we measured the life spans of all baseball players, i.e., right-, left-, and mixed-handed players, for whom reliable data were available (N = 5441) and found that the relationship between handedness and longevity was not significant. Unlike Halpern and Coren we noted that right-handed players could be described as having lived about eight months less than their left-handed peers.

Aged↗
PubMed1999

Relationship between static and dynamic foot postures in professional baseball players.

STUDY DESIGN: Observational study of static and dynamic foot postures in professional baseball players. BACKGROUND: Throughout the course of a professional baseball season, running, cutting, and sprinting activities can produce a breakdown in players' foot function, causing overuse injuries. OBJECTIVES: To investigate the relationship between static and dynamic foot postures; to determine the occurrence of abnormal foot postures in professional baseball players and the incidence of overuse injuries in the lower extremity; and to compare the foot postures of pitchers to those of positional players. METHODS AND MEASURES: The foot postures of 74 professional baseball players were evaluated at rest and during gait. Measures of static foot posture were obtained with a goniometer and included the subtalar neutral position, forefoot/rearfoot position, ankle joint dorsiflexion, tibial angle in standing, and calcaneal angle in standing. The FootTrak motion analysis system provided measures of dynamic foot posture (rearfoot supination and pronation) during the stance phase of gait. A questionnaire was completed by players who reported previous lower extremity injuries. The chi-square statistic was used to determine the associations between forefoot position (varus or valgus) and the amount of foot pronation during gait. RESULTS: The forefoot varus and calcaneal valgus in standing was significantly associated with the maximum pronation during the stance phase of gait. Of the 65 players who demonstrated excessive pronation (> 8 degrees), 28 (43%) also reported a previous lower extremity injury. No statistically significant difference occurred, however, between injured and uninjured players with respect to the mean values of static or dynamic foot posture. In addition, foot postures were not associated with a player's position. CONCLUSIONS: Selected measures of static rearfoot and forefoot postures may have value in predicting dynamic rearfoot movement during the stance phase of gait. Excessive pronation in the baseball players we studied was not found to be a significant contributing factor in the development of overuse injuries.

Baseball↗