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Common softball injuries and recommended treatments

Baseball and softball may be similar sports, but the injury data differs quite a bit.

Common softball injuries and recommended treatments

Team West pitcher Jazmine Ayala in action Wednesday. Team Southeast from McLean, Virginia was defeated 9-0 by Team West from Tucson, Ariz., in the 2013 Little League World Series Championship game Wednesday night Aug. 14, 2013 in Portland. (AP Photo/The Oregonian, Ross William Hamilton)
Team West pitcher Jazmine Ayala in action Wednesday. Team Southeast from McLean, Virginia was defeated 9-0 by Team West from Tucson, Ariz., in the 2013 Little League World Series Championship game Wednesday night Aug. 14, 2013 in Portland. (AP Photo/The Oregonian, Ross William Hamilton)

Baseball and softball may be similar sports, but the injury data differs quite a bit. Let’s see what the research says.

Injury statistics

A 2007 paper in the Journal of Athletic Training looked at softball injuries from 1988-2004 using the NCAA injury surveillance system. Over the 16 years of data collection, the rate of injury was 1.6 times higher in games than in practices (4.3 versus 2.7 injuries per 1000 athlete-exposures).

  • Preseason injury rates were more than double the regular season injury rates.
  • Postseason injury rates were lower than preseason and in-season rates.
  • 43% of injuries occurred to the lower extremity while 33% were to the upper extremity.  
  • For game injuries, ankle sprains and knee internal derangements accounted for 19% of all injuries.
  • Concussions accounted for 6% of all game injuries and players were 3 times more likely to sustain a concussion and 2 times more likely to suffer a knee internal derangement in a game versus practice.

Of the three mechanisms of injury, contact with something other than another player accounted for 51% of all game injuries followed by non-contact at  27%. Sliding was the highest mechanism for game injuries at 27% while only accounting for a small percentage of practice injuries. Non-contact injuries accounted for 55% of all practice injuries.

When looking at injury severity, more than 22% of all game and practice injuries required time missed from participation of 10 days or more. Knee internal derangements and ankle ligament sprains accounted for the majority of injuries requiring time away from sports (30.4%).

In games, the base runner, batter, pitcher, and catcher were the positions with the highest risk of injury. (62.3%)

Upper Extremity

Upper extremity injuries are significantly less common in softball than baseball. This is likely due to the underhand pitching motion for softball which places less stress on the shoulder and elbow. Although injuries such as rotator cuff and labral tears do occur, they are not common in softball. The majority of upper extremity injuries are traumatic injuries to the shoulder wrist and hand such as fractures and dislocations. These traumatic injuries should be evaluated by your athletic trainer who will refer to a sports medicine physician for more server injuries such as dislocations and fractures. Minor injuries such as sprains and strains are usually treated with rest, rehabilitation, and taping/bracing if needed.

Lower Extremity

Ankle sprains and knee internal derangements are the most common softball injuries. Combined, they account for more than 22% of all injuries requiring 10+ days away from participation. Ankle sprains are the most common injury in softball and are usually the result of sliding into a base. The majority of ankle sprains are minor injuries and can be treated conservatively. Treatment can involve a short time off from play (if needed) with rehabilitation consisting of regaining range of motion/flexibility, strength, and balance. All of this should be done under the guidance of an athletic trainer or physical therapist.

Knee internal derangements are the second most common injury and consist primarily of meniscal tears and ACL tears. Whereas ACL injuries require a surgical consult and are almost always season ending, some athletes are able to finish their season with meniscal tears if they are only mildly symptomatic. Once again, a consultation with an orthopedic surgeon should be made to discuss the severity of the injury and treatment options.

Other injuries

Softball has almost twice as many concussions during games as baseball. This is likely due to the shorter distance to the pitching mound and the smaller infield.  The shorter pitching distances may place batters at increased risk of being hit by a pitch. The smaller infield places the players closer to the batter giving less time to react in order to avoid being hit by a batted ball. The smaller infield may also increase the risk of contact with another player. As we have learned from contact sports such as football and hockey, concussions are serious injuries and should be treated as such. An evaluation by a sports medicine clinician trained in concussion assessment should be performed in order to develop an appropriate treatment plan. This may include time away from the classroom as well as from the playing field.

Unlike baseball, lower extremity injuries account for the majority of both minor and severe injuries in softball. As with any injury, players should be evaluated by a sports medicine specialist and an appropriate plan of care should be developed. 
Read more Sports Doc for Sports Medicine and Fitness.
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
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