Concussions twice as likely in softball vs baseball players, study shows

2014-04-02 16:29:09 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the blog.

Flickr/chemisti Flickr/chemisti

I learned from a recent study that girls who play fast-pitch softball are at a higher risk of concussion than boys who play high school baseball. That same study also showed that softball pitchers also suffer fewer shoulder and elbow injuries than baseball players.

You may be as surprised as I was to learn the reasons why. I spoke with Barry Howell of WAKR, who was filling in for Ray Horner.

Below is an audio file and transcript of our discussion.

BARRY HOWELL: We're going to stop by right now and talk to our favorite man - our favorite director of sports medicine and clinical co-director at the center for sports medicine at Akron Children's Hospital - Dr. Joe Congeni is on the line with us.

Dr. Joe - (we're discussing) Jonathon and I both played baseball in little league. I played Hot Stove into high school.

Of course there are the common injuries when it comes to baseball and softball including rounding third and you don't quite hit the bag correctly. Or maybe you plant wrong going around the bases or you go to slide into home plate and get caught. In my case, playing the outfield, you step in a pothole in the process of trying to catch a fly ball.

Dr. Joe Congeni Dr. Joe Congeni

Are these are common injuries? What are the most common problems that you see as a doctor when it comes to youth baseball and softball?

I'm guessing ankles and shoulders and such.

DR. CONGENI: Yeah. You know all those mechanisms you talked about were discussed in this article. An article came out that compared the injuries in softball and baseball.

Gosh I feel so bad when we have a March like we just finished. That's just not the time for playing softball and baseball.

But yesterday, April Fool's Day, we had a beautiful day and you saw a lot of high schools out there playing baseball and softball again on a nice day. Hopefully April will be better so kids can begin to play.

One of things they were looking at comparing and contrasting was boys baseball versus girls playing fast pitch softball. Two points came out of the article that grabbed my attention.

One I kind of knew going in (reading the article) and it's one I'm asked about the most.

There are a lot more shoulder and upper extremity issues in baseball and a lot less in softball.

A lot of people who watch both of those sports at the high school level say why (do you guys) look at pitch counts in the guys in baseball?

When they are a starter in a game they have to sit 4 days before you let them pitch again.

If you watch closely in softball, girls can pitch a game, pitch the next day and pitch both games of a double header. What's going on here?

I think the study reflects that there are a lot less shoulder injuries and elbow injuries in pitchers in softball than there are in pitchers in baseball. The reason for that is simply the fast pitch motion. The windmill motion of fast pitch softball is a lot different.

It's not that we don't care about them (the softball players). By study we've seen there's not as much of a strain on the shoulder and the elbow in pitchers in softball as there is in baseball.

BARRY HOWELL: I'll tell you just from personal experience we learn at an early age how to throw three quarter side arm, side arm, submarine - that type of stuff. It's really hard to do. Have you ever tried to pitch a fast pitch ball? It ain't easy to do.

DR. CONGENI: Yeah. If you have a daughter and you try to teach her the mechanics of that -- it's not the easiest thing to do either.

It's somewhat protective to the shoulder and the elbow. So from the standpoint of the high school setting we don't have guidelines of only this many pitches or anything.

The one way that girls start to break down - if they pitch year round - they get a lot more back injuries and other things like that.

The recommendation nationally from the American Academy of Pediatrics is to take at least one season of the year off - fall or winter.

Most of the time in the spring you want to be playing, but (what happens) if girls pitch year round they (may) get other injuries just not the shoulder and the elbow. So that was one big difference.

The other one surprised me Barry. Looking at the last 10 years of data, softball has almost twice as many concussions as baseball does. That was really a surprise to me.

Overall baseball is not at all up there with football or even soccer or basketball when it comes to concussions, but softball had twice as many.

There were a few reasons they gave in this article as to their hypotheses as to why.

One is there's a significantly shorter distance between the pitching mound and the batter's box so kids get hit by pitches. That's one thing.

The infield is significantly smaller so there are kids in the base path who are at more risk of getting hit by the ball. Also, there is a lot more risk of contact because the infield is smaller. Those are felt to be the reasons why. But, it did surprise me (that there are) twice as many concussions in girls softball than in boys baseball.

BARRY HOWELL:  When you're talking concussion do you mean getting hit upside the head with a line drive?

DR. CONGENI: There's a whole bunch of mechanisms -- a whole bunch of reasons why -- including plays at the plate, plays at second base, knees to the head, hit by a pitched ball and hit by a batted ball.

All of those things are amplified on a very shortened field. If you see the softball games -- it's a very small infield versus the high school infield for baseball.

That's the reason why they think there's double the number of concussions. That number did surprise me out of this study.

BARRY HOWELL:  I was thinking when you brought up the shoulder injury - that pitching is one thing.

But I'm thinking too, when I was growing up we were taught that when you're headed home and you want to score that run - you're going to lower your head and you're going to Pete Rose that doggone catcher.

DR. CONGENI: Well interestingly, in the offseason, there was a lot of talk about trying to eliminate that play at the plate. I think they kind of backed off of that. They're going to keep an eye on that a little bit longer. You're right, there's definitely some contact in baseball but overall baseball isn't thought to be a contact sport. Luckily the concussion numbers are down.

BARRY HOWELL: Well especially when you've got helmets flying coming into home plate and you know you've got guys booking it down first base trying to beat out the throw and they lose their helmets that way.

You wouldn't ever think about that kind of stuff in baseball and softball, but according to Dr. Joe Congeni from Akron Children's Hospital we have injuries to look out for in baseball and softball.

DR. CONGENI: That's why studies help us because you don't know until you do research and the research was a little bit of an eye opener.

Enjoy that good weather and some baseball and softball. And boy, right out our window -- if you've seen Canal Park -- they've made some great changes. People are going to have to get over and see Canal Park this year.

BARRY HOWELL: Eat a hot dog and watch out for those line drives. Dr. Joe Congeni from Akron Children's Hospital, thank you so much for your time.

DR. CONGENI: Thanks Barry. Keep up the good work this week.

BARRY HOWELL: We plan on doing it. (We're) waiting for Ray to come back on Friday. He will be here for the Indians home opener - speaking of baseball.

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