Shoulder Injuries in US High School Baseball and Softball Athletes, 2005–2008

Abstract

WHAT'S KNOWN ON THIS SUBJECT:Baseball and softball are common high school sports with a risk for injury. WHAT THIS STUDY ADDS:Gender differences were found in baseball and softball shoulder injuries.abstract OBJECTIVE: The objective of this study was to determine factors that are involved in shoulder injury rates among high school athletes who participate in organized baseball and softball. METHODS:Baseball-and softball-related injury data were collected during the 2005-2008 academic years from ϳ74 nationally representative high schools via High School Reporting Information Online. RESULTS:Certified athletic trainers reported 91 baseball shoulder injuries and 40 softball shoulder injuries during 528 147 and 399 522 athlete exposures, respectively. The injury rate was 1.72 injuries per 10 000 athlete exposures for baseball and 1.00 injuries per 10 000 athlete exposures for softball. Muscle strain/incomplete tears were the most common injuries in both baseball (30.8%) and softball (35.0%). In practices, throwing, not including pitching, caused more than half of softball injuries (68.2%) as compared with competition injuries (23.5%; injury proportion ratio [IPR]: 2.90 [95% confidence interval (CI): 1.17-7.15]; P ϭ .015), whereas pitching was the most common mechanism in causing shoulder injuries during baseball practice (41.9%) compared with competitions (25.6%; IPR: 1.64 [95% CI: 0.88 -3.04]; P ϭ .17). Eighty-one percent of the baseball shoulder injuries and 82.5% of the softball shoulder injuries were new. Ten percent of baseball athletes and 5.3% of softball athletes sustained injuries that required surgery (IPR: 1.40 [95% CI: 0.32-6.10]; P ϭ .93). Injuries that were sustained while the athlete was on the pitcher's mound were significantly more likely to result in surgery than any other field position (IPR: 2.64 [95% CI: 1.65-4.21]; P ϭ .0061). Injured baseball players were more than twice as likely to be pitchers. CONCLUSIONS:Although rates and patterns of shoulder injuries are similar between baseball and softball players, injury rates and patterns differ between field positions within each sport, as well as by injury severity and the athletes' year in school.

Shoulder Injuries Among US High School Athletes, 2005/2006–2011/2012

“…37 Although the large majority of athletes with shoulder injuries in our study did not require surgery in their management, boys were almost twice as likely as girls to require surgery for their shoulder injury, which is consistent with previous studies. 14,28,29 Boys' football and boys' wrestling were, as expected, the sports with the highest overall number of injuries requiring surgery. Of note, boys' basketball and boys' football had the highest percentage of injuries requiring surgical management, a finding that needs to be replicated in further epidemiologic investigations because it has not been noted in previous studies.…”

“…28 Approximately 40% of all shoulder injuries resulted in return to play within 1 week, which is consistent with other studies. 14,28,29 At the other extreme, our study is the first to report sport-specific rates of medical disqualification secondary to injury, with more than 10% of shoulder injuries resulting in medical disqualification for the season or for an athlete' s career in the sports of boys' basketball and boys' soccer.…”

“…6 Short-term effects of shoulder injuries include pain and reduction in athletic participation, whereas long-term effects can result in lifelong shoulder pain, instability, and osteoarthritis. 7 Previous epidemiologic surveys of shoulder injuries in athletes have focused on their occurrence in specific sports, [8][9][10][11][12][13][14][15][16][17] the mechanics of shoulder injuries in repetitive throwing sports, [18][19][20][21] risk factors of specific body part injuries (including shoulder) in specific sports, 5,[22][23][24][25] and diagnosis of particular types of shoulder injuries. 6,[26][27][28] One previous study investigated all shoulder injuries among high school athletes during 2 academic years.…”

Baseball and Softball

“…8 Over 2 million girls between the ages of 12 and 18 compete in fast pitch softball annually. The National Federation of State High School Associations 2009-2010 participation data counted 473 503 baseball players (ages [14][15][16][17][18] and 393 578 softball athletes. 9 …”

“…Comprehensive data also come from the high school level reporting systems using certified athletic trainers to record the key injury-related information on this 14-to 18-year-old population. [14][15][16] …”