Baseball players' heads getting attention

Philadelphia Phillies Domonic Brown (9) is out at home plate on the throw after sliding into New York Yankees catcher Francisco Cervelli in the third inning of a spring exhibition baseball game in Clearwater, Fla., Thursday, March 13, 2014. The play came on Darin Ruf's double to the left field corner. (AP Photo/Kathy Willens)

The smell of the grass, the crack of the bat and the roar of the crowd… baseball season is back. As spring training gets into full swing, a new Major League baseball rule takes effect. Though contact will still be allowed at home plate, baserunners will no longer be allowed to intentionally run into a catcher.

The rule is intended to protect players from injuries, especially head injuries. Concussions in sports have become a hot topic, now that there is overwhelming evidence suggesting long-term neurological damage from head trauma while playing sports.

As a neurologist and epilepsy specialist, I have seen hundreds of sports-related head injuries over my career. In the United States alone, 1-4 million people experience a sports-related head injury each year (Giza et al. 2013). Even though baseball is generally considered a “non-contact sport,” head injuries in baseball account for nearly 20 percent of all competitive sports-related head injuries (Beyer et al. 2012).

In addition to a home plate collision, batters, catchers, and umpires are all at risk of getting beaned with a fastball. About half of all concussions in high school and collegiate baseball players are due to wayward pitches that hit the batter's helmet (Athiviraham et al. 2012).

It comes as no surprise that the speed of a pitch may be related to its ability to cause a concussion. A video review of 10 foul balls that struck a catcher or umpire’s facemask showed the baseball was traveling at a median speed of 84 mph when it caused a concussion (Beyer et al. 2012). However, the National Operating Committee on Standards for Athletic Equipment (NOCSAE) tests face guards at only 70 mph (Beyer et al. 2012). Players stealing bases, colliding with teammates, walls, and spectator seats are other potential causes of concussions.

Baseball is not always top of mind when people think of sports-related head trauma, but now with modern medical research, the facts indicate it is a dangerous sport that can cause long-term damage. For example, Ryan Freel, a baseball player notorious for his all-out play and many concussions, died of an apparent suicide in 2012 (NYT 2012). At autopsy, he was diagnosed with chronic traumatic encephalopathy, a type of dementia thought secondary to repeated head injuries. Freel is the first Major League Baseball player with chronic traumatic encephalopathy, which is more often associated with contact sports like American football and boxing (Mail Online 2013).

These health risks do not only take place in the Majors; they can happen at any level of play, even Little League. Here are a few tips for parents to help their kids stay safe:

  • Always make sure the player is wearing a proper helmet in practice and during games.
  • If players exhibit any symptoms or signs of concussion, such as headache, unsteadiness, confusion or abnormal behavior, they should be removed from the game to minimize risk of further injury (Giza et al. 2013).
  • Players should not return to play until they have had an appropriate medical examination and concussion management (Giza et al. 2013).

Although it is impossible to completely stop collisions and head trauma in sports, there are ways to minimize the risk. Major League Baseball has taken a step in the right direction to improve the safety of America’s favorite pastime.

Dr. Andrew Wilner is a locum tenens physician with CompHealth and the author of “Bullets and Brains.”  Dr. Wilner is a one-of-a-kind journalist-neurologist who keeps a keen eye on neurological progress from perches in his home of Fall River, Massachusetts, across America as a locum tenens physician, and the Philippines where he conducts medical missions.


Associated Press. Ryan Freel, concussion-plagued baseball player, dies at 36. New York Times, December 24, 2012.

Athiviraham A, Bartsch A, Mageswaran P et al. Analysis of baseball-to-helmet impacts in major league baseball. The American Journal of Sports Medicine 2012;40:2808-2814.

Beyer JA, Rowson S, Duma SM. Concussions experienced by major league baseball catchers and umpires: Field data and experimental baseball impacts. Annals of Biomedical Engineering 2012;40:150-159.

Giza CC, Kutcher JS, Ashwal S et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports. Neurology 2013;80:2250-2257.

Mail Online. Concussion-plagued baseball star who committed suicide becomes first major leaguer diagnosed with degenerative brain disease. December 16, 2013.

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