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Softball injuries. Aetiology and prevention.

Over 40 million individuals nationally participate in organised softball leagues, playing an estimated 23 million games per year in the United States. It has also been estimated that softball causes more injuries leading to emergency room visits in the United States than any other sport. Between 1983 and 1989, over 2.6 million injuries were documented through selected emergency rooms throughout the United States. In addition, the potential costs of these injuries can be staggering, therefore, prevention is of utmost importance. Prior to implementation of any preventative measures, the aetiology and distribution of injuries must be ascertained. Softball-related injuries can be grouped into 3 categories: (a) sliding-related injuries--the most common injury scenario; (b) collision-related injuries; and (c) falls sustained by the player. Various preventative approaches have been utilised to reduce the incidence of these recreational sports injuries and the associated health care costs. In regard to sliding-related injuries, breakaway bases have been utilised and have been found to reduce sliding-related injuries by approximately 98%. In reference to collision injuries, deformable walls and padded back stops and field maintenance have been found to prevent the majority of injuries secondary to collisions and falls. In addition, better coaching techniques as well as stretching and conditioning programmes have all been found to benefit players in the prevention of their injuries. As physicians, trainers and individuals involved with sporting activities, it is imperative that we turn and focus our attention on prevention. The cornerstone to diminished injuries and subsequent prevention of an injury is a safer environment for the recreational softball player to participate in.

Athletic Injuries↗

Instability and impingement in the athlete's shoulder.

The competitive athlete who participates in a sport requiring overhead motion depends on a shoulder with optimal function. An acute episode of injury or a gradual onset of symptoms in the shoulder can affect the athlete's ability to perform. An understanding of shoulder anatomy and function is essential, and an accurate diagnosis of the underlying pathology is critical for planning treatment options. The correct diagnosis may be less clear when the athlete presents with an insidious onset of shoulder pain. A detailed history and physical examination, as well as an evaluation of the overhead motion and onset of pain, is important when the diagnosis of instability or impingement is considered. Rehabilitation of the rotator cuff often succeeds in alleviating symptoms and restoring function. Surgery is considered when symptoms and diminished function persist despite appropriate nonoperative treatment. Operative repair or reconstruction must be anatomical in nature. Postoperative rehabilitation is equally important in this setting, and a motivated athlete helps to ensure success.

Athletic Injuries↗

Fast pitch softball injuries.

The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision injuries. Coaches should be cognisant of overtraining, vary day-to-day training routines to decrease repetitive musculoskeletal stress, focus on motor skills with equal emphasis on speed and efficiency of movement, and use drills that reinforce sport-specific, decision making processes to minimise mental mistakes. Conditioning programs that emphasise a combination of power, acceleration, flexibility, technical skill, functional capacity and injury prevention are recommended. Due to the limited body of knowledge presently available on this sport, a greater focus on injury surveillance would provide a clearer picture of injury causation and effective management procedures, leading toward safer participation and successful player development.

Adolescent↗

Osseous manifestations of elbow stress associated with sports activities.

The radiographic manifestations of musculoskeletal stress at the elbow associated with racket and throwing sports are reported in 29 symptomatic amateur, juvenile, and professional athletes. Five major categories of stress are identified: diffuse, humeral shaft, medial tension, lateral compression, and extension stress. The osseous changes produced by these stresses include bony hypertrophy, loose bodies, traction spur formation, osteochondral and humeral shaft fractures in the adult, and epiphyseal and apophyseal hypermaturity or avulsion in the youngster.

Adolescent↗

Avulsion fracture of the sublime tubercle of the ulna: a newly recognized injury in the throwing athlete.

OBJECTIVE: The purpose of this report is to describe the imaging features in three cases of avulsion injury of the sublime tubercle of the ulna that occurred in throwing athletes. CONCLUSION: Avulsion fracture of the sublime tubercle of the ulna is a potential cause of chronic medial elbow pain in the throwing athlete. This entity is best evaluated with a combination of plain radiographs and coronal MR images, particularly gradient-echo images that show the continuity of the avulsed fragment with the ulnar collateral ligament.

Adult↗

Differences in saccadic latency and express saccades between skilled and novice ball players in tracking predictable and unpredictable targets at two visual angles.

The purpose of the study was to investigate saccadic latency and percentage of express saccades involved in predictable tasks between skilled and novice ball players. Participants performed four different tasks, including time and direction unpredictable task, time predictable task, direction predictable task, and time and direction predictable task at the visual angles of 10 and 20 degrees. Skilled ball players had shorter mean saccadic latency than novice players on direction and time and direction predictable tasks. The percentage of express saccades of skilled ball players was higher than that of novice players on the latter. Saccadic latency was shorter in the 10 degrees condition in time and direction unpredictable task and time predictable task than for 20 degrees. These results suggested that predictive ability might be one of the general characters distinguishing skilled ball athletes from novices in visuomotor performance. The prediction might reduce the mean difference in the saccadic latency at various visual angles.

Adult↗

Effects of three combinations of plyometric and weight training programs on selected physical fitness test items.

To determine the effects of prescribed training programs on 5 physical fitness test items, each of 50 high school boys participated for 10 wk. in one of three programs (wrestling, softball, and plyometrics; weight training; and weight training and plyometrics). (a) On the sit-ups, 40-yd. dash, vertical jump, and pull-ups, each group improved significantly from pre- to posttest. (b) On the shuttle run, none of the groups improved significantly from pre- to posttest. (c) On the vertical jump, groups had a significant effect, but the interaction was nonsignificant. No effects were significant.

Baseball↗

Perceptual information for batting can be extracted throughout a ball's trajectory.

Studies of batters' eye movements have demonstrated that batters do not (or cannot) maintain fixation on the ball throughout its trajectory. In addition, the velocity of a pitched ball, together with the limitations of human reaction time, seems to imply that only the first portions of the ball's trajectory provide information to batters. We prevented nine experienced fast pitch softball players from viewing the ball during the first, middle, or last third of its trajectory and found that seeing the first third of the ball's trajectory is not as critical as had been thought: batters are very good at making do with whichever two-thirds of the ball's trajectory is visible. The results demonstrate the importance of peripheral vision and indicate that batters can extract perceptual information for batting throughout the flight of the ball.

Baseball↗

Timing of coincidence anticipation by NCAA division I softball athletes.

After visual screening, 44 NCAA Division I softball athletes qualified to participate in this study conducted at the 1993 National Invitational Championship Tournament to assess anticipation of coincidence of these athletes. A full-swing batting motion was used to intercept a stimulus apparently moving at 45 or 70 mph, using the Bassin Anticipation Timer. Scores were recorded as early or late after each subject swung a standardized bat which interrupted a photoelectric beam when each of 20 randomly administered slow or fast simulated pitches was presented. Analyses of variance of AE, CE, and VE showed athletes swung significantly early on the 45-mph and late on the 70-mph simulated pitch speed. More specifically, less AE and CE error was recorded at the slow speed; athletes were more consistent (VE) in response to the fast speed. Results supported prior findings in which simulated-pitch speeds were similar to the present ones. Runway length, simulated-pitch speed, and the degree of swing simulation were suggested as variables to consider in similar investigations.

Acceleration↗

Speed and accuracy in the learning of a complex motor skill.

The effect of emphasizing speed or accuracy on the learning of a high speed-high accuracy skill, the fastpitch softball pitch was investigated. 26 10- and 11-yr.-old girls were randomly assigned to two groups receiving feedback on speed of throwing or accuracy of throwing during a 6-wk. training. Measurements of speed and accuracy were made and recorded on all participants at each practice session and a videotape of their pitching technique was also made at each session. Data were subjected to 2 x 3 (2 groups by 3 testing times) repeated-measures analyses of variance. The speed group threw faster and with better technique during the study and was able to maintain speed and accuracy in the reversed test condition.

Analysis of Variance↗

Dynamic visual acuity and coincidence-anticipation timing by experienced and inexperienced women players of fast pitch softball.

This study examined the relationship between dynamic visual acuity and coincidence-anticipation timing in 16 inexperienced and 16 experienced women's fast pitch softball players. Pearson-product correlations indicated a low relationship between dynamic visual acuity and coincidence-anticipation timing. The correlations for dynamic visual acuity and coincidence anticipation between experienced and inexperienced dynamic visual acuity were not significant. A significant difference was found between the mean dynamic visual acuity of the two groups, i.e., experienced players had better dynamic visual acuity than inexperienced players. Analysis of variance of constant errors, variable errors, and absolute errors of coincidence anticipation indicated no significant differences between groups or across the three accuracy scores. The interaction between experience and accuracy was not significant.

Achievement↗