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Fast Pitch Softball Injuries

Sports Medicine volume 31, pages 61–73 (2001)Cite this article

Abstract

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 ≈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-today 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.

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Table I

References

  1. Janda DH, Hankin FM, Wojtys EM. Softball injuries, cost, cause, and prevention. Am Fam Phys 1986; 33: 143–4

    CAS  Google Scholar 

  2. Janda DH, Wild DE, Hensinger RN. Softball injuries: aetiology and prevention. Sports Med 1992; 13: 285–91

    PubMed  CAS  Article  Google Scholar 

  3. Love RM, Carman N, Carmichael S, et al. Sport-related dental injury claims to the New Zealand Accident Rehabilitation and Compensation Insurance Corporation, 1993–1996: analysis of the 10 most common sports, excluding rugby union. N Z Dent J 1998; 94: 146–9

    PubMed  CAS  Google Scholar 

  4. Rivera MA, Ramirez-Marrero RA, Rivas CA, et al. Perfil antropometrico y fisiologico de atletas puertorriquenos: softbol femenino [Anthropometric and physiologic profile of Puerto Rican athletes: female softball]. P R Health Sci J 1994; 13: 255–60

    PubMed  CAS  Google Scholar 

  5. Schievink WI, Atkinson JLD, Bartleson JD, et al. Traumatic internal carotid artery dissections caused by blunt softball injuries. Am J Emerg Med 1998; 16: 179–82

    PubMed  CAS  Article  Google Scholar 

  6. Janda DH, Wojtys EM, Hankin FM, et al. A three-phase analysis of the prevention of recreational softball injuries. Am J Sports Med 1990; 18: 632–5

    PubMed  CAS  Article  Google Scholar 

  7. Kneer ME, McCord CL. Softball. Dubuque (IA): Win C Brown, 1966: 55–71

    Google Scholar 

  8. Loosli AR, Requa RK, Garrick JG, et al. Injuries to pitchers in women’s collegiate fast-pitch softball. Am J Sports Med 1992; 20: 35–7

    PubMed  CAS  Article  Google Scholar 

  9. National Collegiate Athletic Association Injury Surveillance System, 1997–98. Indianapolis (IN): NCAA, 1999

  10. Powell JW, Barber-Foss KD. Traumatic brain injury in high school athletes. JAMA 1999; 282: 958–63

    PubMed  CAS  Article  Google Scholar 

  11. Shesser R, Smith M, Ellis P, et al. Recreational softball injuries. Am J Emerg Med 1985; 3: 199–202

    PubMed  CAS  Article  Google Scholar 

  12. Wheeler BR. Ankle fractures in slow-pitch softball: the Army experience. Mil Med 1987; 152: 626–8

    PubMed  CAS  Google Scholar 

  13. Rice EA, Hutchinson JL, Lee M. A brief history of physical education. New York (NY): Ronald Press, 1969: 188–256

    Google Scholar 

  14. Hackensmith CW. History of physical education. New York (NY): Harper & Row, 1966: 453–5

    Google Scholar 

  15. Amateur Softball Association of American Annual Report. Oklahoma City (OK): ASA, 1999

  16. Barrentine SW, Fleisig GS, Whiteside JA, et al. Biomechanics of windmill softball pitching with implications about injury mechanisms at the shoulder and elbow. J Orthop Sports Phys Ther 1998; 28 (6): 405–14

    PubMed  CAS  Google Scholar 

  17. Maffet MW, Jobe FW, Pink MM, et al. Shoulder muscle firing patterns during the windmill softball pitch. Am J Sports Med 1997; 25: 369–74

    PubMed  CAS  Article  Google Scholar 

  18. Armstrong KL. A quest for a market: a profile of the consumers of a professional women’s basketball team and the marketing implications. Women Sport Phys Act J 1999; 8: 103–26

    Google Scholar 

  19. Clarke KS, Buckley WE. Women’s injuries in collegiate sports: a preliminary comparative overview of three seasons. Am J Sports Med 1980; 8 (3): 187–91

    PubMed  CAS  Article  Google Scholar 

  20. Janda DH, Wojtys EM, Hankin FM, et al. Softball sliding injuries. JAMA 1988; 259: 1848

    PubMed  CAS  Article  Google Scholar 

  21. Loosli AR, Requa RK, Ross W et al. Injuries in slow-pitch softball. Phys Sportsmed 1988; 16: 110–8

    Google Scholar 

  22. Wheeler BK. Slow-pitch softball injuries. Am J Sports Med 1984; 12: 237–40

    PubMed  CAS  Article  Google Scholar 

  23. Larrison WI, Hersh PS, Kunzweiler T, et al. Sports-related ocular trauma. Ophthalmology 1990; 97: 1265–9

    PubMed  CAS  Google Scholar 

  24. Lubahn JD, Lister GD. Familial radial nerve entrapment syndrome: a case report and literature review. J Hand Surg 1983; 8: 297–9

    CAS  Google Scholar 

  25. Manske PR. Compression of the radial nerve by the tricep muscle. J Bone Joint Surg 1977; 59A: 835–6

    PubMed  CAS  Google Scholar 

  26. Mitsunaga MM, Niacin K. High radial nerve palsy following strenuous muscular activity. Clin Orthop 1988; 234: 234–9

    Google Scholar 

  27. Nakamichi K, Tachibana S. Radial nerve entrapment by the lateral head of the triceps. J Hand Surg 1991; 17: 69–70

    Google Scholar 

  28. Sinson G, Zager EL, Kline DG. Windmill pitcher’s radial neuropathy. Neurosurgery 1994; 34: 1087–90

    PubMed  CAS  Article  Google Scholar 

  29. Wilson SAK. Neurology. Baltimore (MD): Williams & Wilkins, 1940

    Google Scholar 

  30. Gregersen HN. Fractures of the humerus from muscular violence. Acta Orthop Scand 1971; 42: 506–12

    PubMed  CAS  Article  Google Scholar 

  31. Jewett AD, Brukner PD. Fifth metacarpal stress fracture in a female softball pitcher. Clin J Sport Med 1997; 7: 220–1

    Article  Google Scholar 

  32. Krishnamurthy DP Fracture ofthe humerus. Injury 1981; 12: 437

    PubMed  CAS  Google Scholar 

  33. Linn RM, Kriegshauser LA. Ball thrower’s fracture of the humerus. A case report. Am J Sports Med 1991; 19: 194–7

    PubMed  CAS  Article  Google Scholar 

  34. Reed WJ, Mueller RW. Spiral fracture of the humerus in a ball thrower. Am J Emerg Med 1998; 16: 306–8

    PubMed  CAS  Article  Google Scholar 

  35. Tanabe S, Nakahira J, Bando E, et al. Fatigue fracture of the ulna occurring in pitchers of fast-pitch softball. Am J Sports Med 1991; 19: 317–21

    PubMed  CAS  Article  Google Scholar 

  36. Wilmoth CL. Recurrent fracture of the humerus due to sudden extreme muscular action. J Bone Joint Surg 1930; 12: 168–9

    Google Scholar 

  37. Cavallo RJ, Speer KP. Shoulder instability and impingement in throwing athletes. Med Sci Sports Exerc 1998; 30 Suppl. 4: S18–25

    Google Scholar 

  38. Kibler WB. Shoulder rehabilitation: principles and practice. Med Sci Sports Exerc 1998; 30 Suppl. 4: S40–50

    Google Scholar 

  39. Lyons PM, Orwin JF. Rotator cuff tendinopathy and subacromial impingement syndrome. Med Sci Sports Exerc 1998; 30 Suppl. 4: S 12–7

    Google Scholar 

  40. Turnbull JR. Acromioclavicular joint disorders. Med Sci Sports Exerc 1998; 30 Suppl. 4: S26–32

    Google Scholar 

  41. Zarins B, Andrews JR, Carson WG. Injuries to the throwing arm. Philadelphia (PA): WB Saunders, 1985

    Google Scholar 

  42. Kuschner SH, Lane CS. Recurrent fracture of the humerus in a softball player. Am J Orthop 1999; 28: 654–6

    PubMed  CAS  Google Scholar 

  43. Way MC. Effects of a thermoplastic foot orthosis on patellofemoral pain in a collegiate athlete: a single-subject design. J Orthop Sports Phys Ther 1999; 29: 331–8

    PubMed  CAS  Google Scholar 

  44. Lipscomb AB, Ibrahim AA. Acute peroneal compartment syndrome in a well conditioned athlete: report of a case. Am J Sports Med 1977; 5: 154–7

    PubMed  CAS  Article  Google Scholar 

  45. Branch T, Partin C, Chamberland P, et al. Spontaneous fracture of the humerus during pitching. A series of 12 cases. Am J Sports Med 1992; 20: 468–70

    PubMed  CAS  Article  Google Scholar 

  46. Waddington DV, McNitt AS, Landschoot PJ. Constructing and maintaining safe playing surfaces. In: Hoerner EF, Cosgrove FA, editors. International Symposium on Safety in Base ball/Softball. West Conshohocken (PA): American Society for Testing and Materials, 1997: 107–13

    Chapter  Google Scholar 

  47. Nadeau MT, Brown T, Boatman J, et al. The prevention of softball injuries: the experience at Yokota. Mil Med 1990; 155: 3–5

    PubMed  CAS  Google Scholar 

  48. Adair RK. The physics of baseball. Physics Today 1995; 48: 26–31

    Article  Google Scholar 

  49. Giacobbe PA, Scarton HA, Lee YS. Dynamic hardness (SDH) of baseball and softballs. In: Hoemer EF, Cosgrove FA, editors. International Symposium on Safety in Baseball/Softball. West Conshohocken (PA): American Society for Testing and Materials, 1997: 47–50

    Chapter  Google Scholar 

  50. Hosey RG, Puffer JC. Baseball and softball sliding injuries. Incidence, and the effect of technique in collegiate baseball and softball players. Am J Sports Med 2000; 28: 360–3

    PubMed  CAS  Google Scholar 

  51. Corzatt RD, Groppel JL, Pfaustsch E, et al. The biomechanics of head-first versus feet-first sliding. Am J Sports Med 1984; 12: 229–32

    PubMed  CAS  Article  Google Scholar 

  52. Neer CS. Impingement lesions. Clin Orthop 1983; 173: 70–7

    PubMed  Google Scholar 

  53. Bunn W. Scientific principles of coaching. Englewood Cliffs (NJ): Prentice-Hall, 1955

    Google Scholar 

  54. Sendre RA, Keating TM, Hornak JE, et al. Use of the Hollywood impact base and standard stationary base to reduce sliding and base-running injuries in baseball and softball. Aim J Sports Med 1994; 22: 450–3

    CAS  Article  Google Scholar 

  55. Amateur Softball Association of America official rule book. Oklahoma City (OK): ASA, 1999

  56. Caraway PM, Baker SW. Soil and turf properties governing playing quality. Int Turfgrass See Res J 1993; 7: 192–200

    Google Scholar 

  57. McNitt AS, Waddington DV, Middour RO. Traction measurements on natural turf surfaces. In: Hoerner EF, editors. International Symposium on Injuries in American Football. West Conshohocken (PA): American Society for Testing and Materials, 1996: 145–55

    Google Scholar 

  58. Meister K. Injuries to the shoulder in the throwing athlete. Am J Sports Med 2000; 28: 265–75

    PubMed  CAS  Google Scholar 

  59. Reilly DT, Burstein AH. The elastic and ultimate properties of compact bone tissue. J Biomech 1975; 8: 393–405

    PubMed  CAS  Article  Google Scholar 

  60. Olson JR, Hunter GR. Biomechanics and anatomic analysis and conditioning techniques for the windmill style fast pitch in softball. J Appl Res Coach Athl 1987; 2: 115–25

    Google Scholar 

  61. Howell SM, Imobersteg AM, Seger DH, et al. Clarification of the role of the supraspinatus muscle in shoulder function. J Bone Joint Surg 1986; 68A: 398–404

    PubMed  CAS  Google Scholar 

  62. Poppen NK, Walker PS. Normal and abnormal emotion of the shoulder. J Bone Joint Surg 1976; 58A: 195–201

    PubMed  CAS  Google Scholar 

  63. Werner SL. Selected kinematic and kinetic parameters of the windmill softball pitch [unpublished thesis]. Bloomington (IN): Indiana University, 1987

    Google Scholar 

  64. DiCicco JD, Mehlman CT, Urse JS. Fracture of the shaft of the humerus secondary to muscular violence. J Orthop Trauma 1993; 7: 90–3

    PubMed  CAS  Article  Google Scholar 

  65. Mutoh Y, Mori T, Suzuki Y, et al. Stress fractures of the ulna in athletes. Am J Sports Med 1982; 10: 365–7

    PubMed  CAS  Article  Google Scholar 

  66. Rettig AC. Stress fracture of the ulna in an adolescent tournament tennis player. Am J Sports Med 1983; 11: 103–6

    PubMed  CAS  Article  Google Scholar 

  67. Tullos HS, King JW. Throwing mechanism in sports. Orthop Clin North Am 1973; 4: 709–20

    PubMed  CAS  Google Scholar 

  68. Weseley MS, Barenfield PA. Ball thrower’s fracture of the humerus. Six case reports. Clin Orthop 1969; 64: 153–6

    PubMed  CAS  Google Scholar 

  69. Hollander DB, Meyers MC, LeUnes AD. Psychological aspects of overtraining: implications for youth sport coaches. J Sport Behav 1995; 18: 3–20

    Google Scholar 

  70. Kuipers H. How much is too much? Performance aspects of overtraining. Res Q Exerc Sport 1996; 67: 65–9

    Google Scholar 

  71. Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med Sci Sports Exerc 2000; 32: 317–31

    PubMed  CAS  Article  Google Scholar 

  72. Bruin G, Kuipers H, Keizer HA, et al. Adaptation and overtraining in horses subjected to increased training loads. J Appl Physio 1994; 76: 1908–13

    CAS  Google Scholar 

  73. Brooks CH, Revell WJ, Heatley FW. A quantitative histological study of the vascularity of the rotator cuff tendon. J Bone Joint Surg 1992; 74B: 151–3

    CAS  Google Scholar 

  74. McArdle WD, Katch VL, Katch, FI. Exercise physiology: energy, nutrition and human performance. Philadelphia (PA): Williams & Wilkins, 1995

    Google Scholar 

  75. Moseley HE, Goldie I. The arterial pattern of the rotator cuff and the shoulder. J Bone Joint Surg 1970; 45B: 780–9

    Google Scholar 

  76. Puddu G, Scala A, Cerullo G, et al. Achilles tendon injuries. In: Renstrom A, editor. Clinical practice of sports injury and care. Boston (MA): Blackwell, 1994: 188–216

    Google Scholar 

  77. Armitage-Johnson S. Year-round physical preparation for the collegiate softball athlete. Nat Stren Cond Assoc J 1993; 15: 40–2

    Article  Google Scholar 

  78. Greene B, Tani CL, McKeon K. A three-dimensional kinematic comparison of pitching techniques between male and female fast-pitch softball players. In: Barabas A, Fabian G, editors. Biomechanics in Sports XII: Proceedings of the 12th Symposium of the International Society of Biomechanics in Sports. Budapest, Hungary: International Society of Biomechanics, 1995: 224–6

    Google Scholar 

  79. Landmark R, Petersen MM. Fracture of the humerus in ball throwers. Scand J Med Sci Sports 1995; 5: 57–60

    PubMed  CAS  Article  Google Scholar 

  80. Spaulding TD. Shoulder maladaptations in female fast pitch softball pitchers [unpublished thesis]. Reno (NV): University of Nevada, 1998

    Google Scholar 

  81. Lotem M, Fried A, Levy M, et al. Radial palsy following muscular effort. J Bone Joint Surg 1971; 53: 500–6

    CAS  Google Scholar 

  82. Norkus SA, Meyers MC. Ulnar neuropathy of the elbow. Sports Med 1994; 17: 189–99

    PubMed  CAS  Article  Google Scholar 

  83. Bell MJ, Baker SW, Caraway PM. Playing quality of sports surfaces: a review. J Sports Turf Res Inst 1985; 61: 26–45

    Google Scholar 

  84. Committee on Sports Medicine and Fitness. Risk of injury from baseball and softball in children 5 to 14 years of age. Pediatrics 1994; 4: 690–2

    Google Scholar 

  85. Chao SL, Miller M, Teng SW. A mechanism of spiral fracture of the humerus: a report of 129 cases following the throwing of hand grenades. J Trauma 1971; 11: 602–5

    PubMed  CAS  Article  Google Scholar 

  86. McBryde AM. Stress fractures in athletes. J Sports Med 1975; 3: 212–7

    PubMed  Article  Google Scholar 

  87. Pascale MS, Grana WA. Stress fractures of the ulna. Orthopedics 1988; 11: 830–2

    Google Scholar 

  88. Fry RW, Norton AR, Keast D. Overtraining in athletes: an update. Sports Med 1991; 12: 32–65

    PubMed  CAS  Article  Google Scholar 

  89. Morgan WP, Brown DR, Raglin JS, et al. Psychological monitoring of overtraining and staleness. Br J Sports Med 1987; 21: 107–14

    PubMed  CAS  Article  Google Scholar 

  90. Stone MH, Keith RE, Kearney JT, et al. Overtraining: a review of the signs, symptoms and possible causes. J Appl Sport Sci Res 1991; 5: 35–50

    Google Scholar 

  91. Foster C, Lehman M. Overtraining syndrome. In: Guten GN, editor. Running Injuries. Philadelphia (PA): WB Saunders, 1997: 173–88

    Google Scholar 

  92. Smith LL, Miles M. Exercise-induced muscle injury and inflammation. In: Garret WE, Kirkendall DT, editors. Applied sports science. Media (PA): Williams & Wilkins, 1999

    Google Scholar 

  93. Kibler WB, Chandler TJ. Musculoskeletal and orthopedic considerations. In: Kreider RB, Fry AC, O’Toole ML, editors. Overtraining in sports. Champaign (IL): Human Kinetics, 1998: 169–92

    Google Scholar 

  94. Engelhorn R. Speed and accuracy in the learning of a complex motor skill. Percept Mot Skills 1997; 85: 1011–7

    PubMed  CAS  Article  Google Scholar 

  95. Fitts PM. The information capacity of the human motor system in controlling the amplitude of movement. J Exp Psych 1954; 46: 381–91

    Article  Google Scholar 

  96. Jensen B. Pretask speed training and movement complexity. Res Q Exerc Sport 1976; 47: 657–67

    CAS  Google Scholar 

  97. Sage G, Hornak J. Progressive speed practice in learning a continuous motor skill. Res Q Exerc Sport 1978; 49: 190–6

    CAS  Google Scholar 

  98. Southard D. Changes in limb striking pattern: effects of speed and accuracy. Res Q Exerc Sport 1989; 60: 348–56

    PubMed  CAS  Google Scholar 

  99. Henry FM. Individual differences in motor learning and performance. In: Smith L, editor. Psychology of Motor Learning. Chicago (IL): Athletic Institute, 1970: 243–56

    Google Scholar 

  100. Heiderscheit BC, McLean KP, Davies GJ. The effects of isokinetic versus plyometric training on the shoulder internal rotators. J Orthop Sport Phys Ther 1996; 23: 125–33

    CAS  Google Scholar 

  101. Stone W, Kroll W. Sports Conditioning and Weight Training: Program for Athletic Competition. Boston (MA): Allyn & Bacon, 1987: 197–8

    Google Scholar 

  102. Fleck S, Kraemer W. Designing resistance training program. Champaign (IL): Human Kinetics, 1987

    Google Scholar 

  103. Sain J, Andrews JR. Proper pitching techniques. In: Zarins B, Andrews J, Carson W, editors. Injuries to the throwing arm. Philadelphia (PA): WB Saunders, 1985

    Google Scholar 

  104. National Electronic Injury Surveillance System. Washington, DC: Consumer Products Safety Commission, 1992; 15: 2

  105. Bradley JP, Tibone JE. Electromyographic analysis of muscle action about the shoulder. Orthop Clin North Am 1991; 10: 789–805

    CAS  Google Scholar 

  106. Dillman CJ, Fleisig GS, Andrews JR. Biomechanics of pitching with emphasis upon shoulder kinematics. J Orthop Sports Phys Ther 1993; 18: 402–8

    PubMed  CAS  Google Scholar 

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Acknowledgements

Conclusions drawn from or recommendations based on the data provided by the National Collegiate Athletic Association are those of the authors based on analyses and evaluations of the authors and do not represent the views of the officers, staff or membership of the NCAA.

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  1. Human Performance Research Center, Department of Sports and Exercise Sciences, West Texas A&M University, POB 60216, Canyon, Texas, 79016, USA

    Michael C. Meyers

  2. Department of Health and Human Performance, University of Houston, Houston, Texas, USA

    Barrett R. Brown & Joel A. Bloom

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Meyers, M.C., Brown, B.R. & Bloom, J.A. Fast Pitch Softball Injuries. Sports Med 31, 61–73 (2001). https://doi.org/10.2165/00007256-200131010-00005

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Keywords

  • Rotator Cuff
  • Injury Rate
  • Tendinitis
  • Pitching Motion
  • National Collegiate Athletic Association