Baseball and Softball (Care of the Young Athlete)

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Baseball and softball are extremely popular
among America’s youth. Injuries are common because of the large number of
athletes participating. While most injuries are acute, there are specific
overuse injuries that commonly affect young ball players. Most of these injuries
can be prevented.

The following is information from the American
Academy of Pediatrics (AAP) about how to prevent baseball and softball injuries.
Also included is an overview of common injuries.

Injury prevention and safety tips

  • Sports physical exam.
    Athletes should have a preparticipation physical evaluation (PPE) to
    make sure they are ready to safely begin the sport. The best time for a
    PPE is about 4 to 6 weeks before the beginning of the season. Athletes
    also should see their doctors for routine well-child checkups.

  • Fitness. Athletes should
    maintain a good fitness level during the season and off-season.
    Preseason training should allow time for general conditioning and sport-
    specific conditioning. Also important are proper warm-up and cool-down

  • Technique. Athletes should
    learn and practice safe techniques for performing the skills that are
    integral to their sport. For example, baseball and softball players
    should avoid headfirst slides, and run bases with a helmet and
    break-away bases. Athletes should work with coaches and athletic
    trainers on achieving proper technique.

  • Equipment. Safety gear
    should fit properly and be well maintained.

    • Protective eyewear.
      Glasses or goggles should be made with polycarbonate or a
      similar material. The material should conform to the standards
      of the American Society for Testing and Materials. Batting
      helmets and catcher’s masks with face masks also are

    • Shoes with rubber
      (not metal) spikes

    • Pads (knee and shin

    • Athletic supporters
      and cups for boys

    • For catchers:
      helmets with face guards, throat guards, knee-saver pads, and
      chest protectors (Note: Chest protectors cannot prevent direct
      trauma to the heart. See “Commotio cordis.”)

    • For batters:
      batting helmets, face guards

    • Safety baseballs
      (Softer balls decrease overall injury from getting struck by the
      ball in addition to lowering the risk of commotio cordis.)

  • Environment

    • Heat. Proper
      hydration and scheduling practices and games during cooler times
      of the day can prevent heat-related illness and dehydration.
      (See “Heat-related illnesses.”)

    • Lightning.
      Guidelines should be in place to postpone play until a safer
      time. Play should be stopped for 30 minutes after the last
      strike if lightning is detected within a 6-mile radius (follow
      the 5 second per mile rule). A safe area (buildings with metal
      pipes or well-grounded wires) should be identified ahead of
      time. No one should stand under the bleachers or other
      non-grounded structures.

    • The field. A safe
      playing field is free of debris; holes and uneven surfaces
      should be repaired. The infield and pitcher’s mounds
      should be raked and smoothed regularly. Evening games should be
      well lit. Breakaway bases should be used to reduce injuries from
      sliding. A runner’s base placed to the right of the first
      base foul line in the runner’s lane is one way to help
      prevent collisions at first base. Safety screens should be in
      place to protect the dugouts from balls and thrown bats.

  • Emergency plan. Teams
    should develop and practice an emergency plan so that team members know
    their roles in emergency situations. The plan would include first aid
    and emergency contact information. All members of the team should
    receive a written copy each season. Parents also should be familiar with
    the plan and review it with their children.

Common injuries

General treatment for acute injuries

Rest, ice, compression, and elevation is the
first step in treating an acute injury accompanied by pain and swelling.
Athletes should stop playing and apply ice directly to the injured area for
20 minutes. After icing, an ACE bandage can be used to limit swelling. The
injured area should be raised above the heart to limit swelling.

Shoulder injuries

Shoulder impingement is an
overuse injury that causes achy pain on the front or side of the shoulder.
The pain is felt most when the arm is overhead or extended to the side.
Shoulder impingement is common in young athletes with weak upper back and
shoulder muscles. Off-season stretching of the back of the shoulder and
strengthening of the shoulder blade and core muscles can help prevent these

Baseball pitchers and other high-volume
throwers (for example, catchers) are at risk for Little League
an irritation to the growth plate in the humerus bone
of the shoulder. Limiting the number of pitches a player can throw during a
practice or game can help prevent these types of overuse injuries (pitch
count guidelines based on age are published by USA Baseball). Any athlete
who has shoulder pain for more than 7 to 10 days should see a doctor.

Elbow injuries

Elbow injuries are very common in baseball
players, especially pitchers, and include Little League
(irritation of the growth plate of the humerus bone of
the elbow). As with shoulder injuries, limiting the number of pitches a
player throws during a practice or game can help prevent overuse

Ankle injuries

Ankle injuries often occur as a result of
uneven playing fields or sliding into bases, or from improper
rehabilitation/protection after injury. Fields should be well maintained and
breakaway bases should be used. Use of ankle braces and ankle exercises that
strengthen and improve balance of the ankles may prevent repeat injury.

Eye injuries

Eye injuries typically occur from contact
with the ball, bat, or a finger. Any injury that affects vision or is
associated with swelling or blood inside the eye should be evaluated by an
ophthalmologist. Athletes should also stay a safe distance away from any
player swinging a bat or playing catch. The AAP recommends that children
involved in organized sports wear appropriate protective eyewear.

Heat-related illnesses

Athletes who are dizzy or confused, or
complain of a headache, are most likely suffering from heat exhaustion or
heat stroke. Any athlete suspected of having heat illness should immediately
be removed from play, cooled by any means available, and transported by
emergency medical services (call 911).

Heat-related illnesses can be prevented when
athletes are given adequate time to get used to exercising in the heat
(usually takes 1 to 2 weeks). Drinking water or a sports drink before,
during, and after training, as well as avoiding stimulants including
caffeine, can also help.

Commotio cordis

Sudden death as a result of a significant
impact to the chest is known as commotio cordis. The usual cause is impact
from a baseball, lacrosse ball, or puck, or a direct blow in football or
hockey. Recognition and resuscitation alone are rarely successful; however,
if available an automated external defibrillator can successfully
resuscitate athletes with this condition.


Baseball and softball injuries can be prevented
when fair play is encouraged and the rules of the game are enforced. Also,
athletes should use the appropriate equipment and safety guidelines should
always be followed.