Monday, May 25, 2015

Protecting pitchers: what J.A. Happ's injury means to MLB

Last night, former Phillies pitcher J.A. Happ was struck in the head by a line drive while pitching for the Toronto Blue Jays.

Protecting pitchers: what J.A. Happ's injury means to MLB

Last night, former Phillies pitcher J.A. Happ was struck in the head by a line drive while pitching for the Toronto Blue Jays.

This morning, Happ is in stable condition and undergoing tests at Bayfront Medical Center in St. Petersburg, Fla.

Perhaps most troubling, however, were this morning’s reports and headlines that referred to Happ as the latest pitcher to sustain such an injury. He is the fourth MLB pitcher to be struck in the head since September. What can the league do to prevent or lessen the likelihood of further instances?

“Major League Baseball has looked very closely at this,” says Michael Ciccotti, M.D., team physician for the Phillies and president of the MLB Team Physician’s Association. “What players are most at risk? How can we protect those players, and how can we most appropriately diagnose these injuries when they occur?”

Some of this involves ImPACT testing and other concussion evaluation techniques. Dr. Ciccotti says as research improves and doctors learn more and more about treating concussions, standard protocols can be developed for recovery time and return to play. But if a batter wears a protective helmet to protect himself from 90+ mile-per-hour fastballs, why wouldn’t a pitcher do the same for protection from batted balls traveling even faster?

“Protective helmets are being considered for players beyond the batter,” confirms Dr. Ciccotti. “Researchers are looking to develop something that is comfortable and appealing to the ballplayer, but still offers protection to the player.”

According to an ESPN report, MLB officials indicate that nothing is imminent in regards to the league approving protective headgear for pitchers. MLB could mandate such changes in the minor leagues, but would require the approval of the players’ union to do so in the majors. The likeliest outcome is that anything MLB approves would be implemented on a voluntary basis. There are no rules against a pitcher or other player wearing additional padding with a standard baseball hat.

The idea of getting whacked in the head with a line drive is obviously an unintended consequence of the sport. But what types of injuries can result from such an insult?

“Any contact sport—boxing match, football, soccer, rugby—can generate tremendous impact to the skull,” adds Ciccotti. “A baseball hit back at you at such high velocity does generate a unique force that can leads to all types of injuries.”

Some pitchers are lucky—if we can use that term—to escape from such instances with a mild concussion. Last fall, Oakland’s Brandon McCarthy sustained a fractured skull, epidural hemorrhage and a brain contusion on a nearly identical play to last night’s.

Doctors also keep an eye out for eye injuries, nasal or oral injuries and of course, anything impacting the skull.

As the Blue Jays and J.A. Happ await test results today, baseball continues to work towards solving an increasingly troublesome situation.  


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Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
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Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
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