Elbow Injuries in Professional Baseball: Epidemiological Findings From the Major League Baseball Injury Surveillance System

2017 ◽  
Vol 45 (10) ◽  
pp. 2319-2328 ◽  
Author(s):  
Michael G. Ciccotti ◽  
Keisha M. Pollack ◽  
Michael C. Ciccotti ◽  
John D’Angelo ◽  
Christopher S. Ahmad ◽  
...  

Background: Elbow injuries cause significant disability for the throwing athlete. Scant data are available on the distribution and characteristics of these injuries in elite baseball players. No study exists that focuses solely on the epidemiological characteristics of elbow injuries in professional baseball players using a comprehensive injury surveillance system. Hypothesis: Professional baseball players have a high occurrence of elbow injuries influenced by factors including length of time playing, time period within the annual baseball season, and specific position played. Study Design: Descriptive epidemiological study. Methods: Data on elbow injuries occurring during the 2011-2014 seasons were collected from Major League Baseball’s Health Injury and Tracking System, a comprehensive injury surveillance system. Each specific type of elbow injury was evaluated with respect to overall injury rate, years as a professional player, mechanism of injury, treatment, average time lost, and return to play. Results: During the study period, 3185 elbow injuries (n = 430 Major League; n = 2755 Minor League) occurred. The mean number of days missed and percentage requiring surgery were similar between Major and Minor League players. Overall, 20.0% (650/3185) of the injuries required surgical treatment. Pitchers were the most likely to incur an elbow injury (40.0% of injured athletes were pitchers), were the most likely to require surgery (34.2% of injured pitchers required surgery), and had the greatest mean number of days missed when treated nonsurgically (33.2 days). Medial injuries composed 42.1% (1342/3185) of all elbow injuries. Of all elbow surgeries performed during the study period, the highest percentage involved ligaments (372/650; 57.2%). Conclusion: Elbow injuries are a considerable source of disability in professional baseball players. Pitchers are most likely to incur these injuries, are most likely to require surgery, and have the highest mean number of days missed when treated nonsurgically. The most common injuries involve the medial elbow, with ligament injuries most often requiring surgery. This study represents the only investigation to date using a comprehensive injury surveillance system to examine elbow injuries in professional baseball players. It provides a basis for injury prevention and treatment recommendations, establishes the most thorough framework for determining elbow injury risk, and focuses continued research on elbow injury prevention in the elite baseball player.

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0028
Author(s):  
Christopher Lucasti ◽  
Myles Dworkin ◽  
William Warrender ◽  
David Pedowitz ◽  
Brian Winters ◽  
...  

Category: Ankle, Sports, Trauma Introduction/Purpose: The purpose of this study was to determine the injury characteristics of ankle and lower leg injuries in professional baseball players during the 2011-2016 seasons by utilizing the Major League Baseball (MLB) injury surveillance system. Methods: Our study is a descriptive epidemiological evaluation through a retrospective review from the MLB Health and Injury Tracking System (HITS) since its implementation in 2011. We included any professional baseball player (Major League and Minor League) who was identified as having an ankle or lower leg injury from January 1, 2011 through February 28th, 2017.Over the study period there were a total of 4,756 injuries of which 763 (16.0%) occurred in the Major League and 3,993 (84.0%) occurred in the Minor League. Results: The average number of days missed for all players was 27.8 days (+/-141.4 days) with a median of 3 days. From 2011 through 2016 it was estimated that there were 414,912 athlete exposures (AEs) in Major League Baseball and 1,796,607 AEs in the Minor Leagues. Of the 4,756 injuries recorded, 550 (11.6%) took place during the Major League regular season and 3,320 (69.8%) took place during the Minor League regular season. Major League injuries, however, were 1.7 times more likely to require surgery (p < .001). Additionally, rates of injury to the lower leg were stratified by position with infield players experiencing injuries at a 1.6 times greater rate than any other position (p < .001). Conclusion: In conclusion, the data from this study represents the only epidemiological study to focus primarily on lower leg injuries in professional baseball players utilizing an injury surveillance system developed by MLB.


2020 ◽  
Vol 48 (4) ◽  
pp. 908-915 ◽  
Author(s):  
Christopher J. Lucasti ◽  
Myles Dworkin ◽  
William J. Warrender ◽  
Brian Winters ◽  
Steven Cohen ◽  
...  

Background: Ankle and lower leg injuries are very common in sports, and numerous studies have discussed their diagnosis and management. Our study differs in that we report lower leg injuries in professional baseball players spanning the 2011-2016 seasons by utilizing a comprehensive injury surveillance system developed by Major League Baseball (MLB). Purpose: To determine the injury characteristics of ankle and lower leg injuries in professional baseball players during the 2011-2016 seasons by utilizing the MLB injury surveillance system. Study Design: Descriptive epidemiology study. Methods: Our study is a descriptive epidemiological evaluation through a retrospective review of injury data from the MLB Health and Injury Tracking System (HITS) since its implementation in 2010. We included any professional baseball player (MLB and Minor League Baseball [MiLB]) who was identified as having an ankle or lower leg injury between January 1, 2011, and February 28, 2017. Results: Over the study period, there were a total of 4756 injuries, of which 763 (16%) occurred in MLB players and 3993 (84%) occurred in MiLB players. The mean number of days missed for all players was 27.8 ± 141.4 days, with a median of 3 days. From 2011 through 2016, it was estimated that there were 414,912 athlete exposures (AEs) in MLB and 1,796,607 AEs in MiLB. Of the 4756 injuries recorded, 550 (12%) took place during the MLB regular season, and 3320 (70%) took place during the MiLB regular season. Injuries in MLB players, however, were 1.7 times more likely to require surgery ( P < .001). Additionally, rates of injury to the lower leg were stratified by position, with infield players experiencing injuries at a 1.6 times greater rate than any other position ( P < .001). Conclusion: In conclusion, this is the only epidemiological study to focus primarily on ankle and lower leg injuries in professional baseball players, utilizing an injury surveillance system developed by MLB.


2017 ◽  
Vol 46 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Michael G. Saper ◽  
Lauren A. Pierpoint ◽  
Wei Liu ◽  
R. Dawn Comstock ◽  
John D. Polousky ◽  
...  

Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies. Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States. Study Design: Descriptive epidemiological study. Methods: Baseball-related injury data were obtained from the National High School Sports-Related Injury Surveillance Study using High School RIO (Reporting Information Online), an Internet-based sports injury surveillance system. Athletic trainers from high schools across the country uploaded data regarding athlete-exposures (AEs) (defined as practice or game participation) and shoulder and elbow injuries from the school years 2005-2006 through 2014-2015. Results: A total of 241 shoulder injuries and 150 elbow injuries occurred during 1,734,198 AEs during the study period, for an overall shoulder injury rate of 1.39 per 10,000 AEs and an overall elbow injury rate of 0.86 per 10,000 AEs. The overall rates of injury were higher in competitions compared with practices for shoulders (rate ratio, 1.44; 95% CI, 1.11-1.85) and elbows (rate ratio, 2.15; 95% CI, 1.56-2.96). The majority of shoulder (39.6%) and elbow (56.9%) injuries were sustained by pitchers, and most injuries were chronic and caused by overuse. Position players were more likely to sustain injuries by contact with the playing surface or apparatus. For pitchers, muscle strains were the most common shoulder injuries (38.7%), while ligament sprains were the most common elbow injuries (42.7%). The majority of pitchers with shoulder (70.8%) and elbow (64.6%) injuries returned to play within 21 days. Among pitchers, a higher proportion of elbow injuries (11.4%) resulted in medical disqualification compared with shoulder injuries (5.6%). Among pitchers, the majority of shoulder (89.2%) and elbow (96.4%) injuries were managed nonsurgically. Conclusion: Shoulder and elbow injury rates and patterns in high school baseball players differed between field positions (pitchers vs position players) and by type of exposure (practice vs competition). This study suggests several areas of emphasis for targeted injury prevention interventions, most notably limiting fatigue and preventing overuse injuries.


2019 ◽  
Vol 7 (7) ◽  
pp. 232596711986110 ◽  
Author(s):  
Jamie Confino ◽  
James N. Irvine ◽  
Michaela O’Connor ◽  
Christopher S. Ahmad ◽  
T. Sean Lynch

Background: Single-sport athletes who specialize in baseball at a young age may have a greater predisposition to overuse injury, burnout, and decreased career longevity when compared with multiple-sport athletes. The effect of sport specialization has not been studied in professional baseball players. Hypothesis: Major League Baseball (MLB) players who played multiple sports in high school would experience fewer injuries, spend less time on the disabled list, play more games, and have a longer career than athletes who played only baseball in high school. Study Design: Descriptive epidemiology study. Methods: First- and second-round MLB draft picks from 2008 to 2016 who played in at least 1 professional game were included in this study. Athletes who participated in 1 or more sports in addition to baseball during high school were considered multisport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and Minor League Baseball, number of days on the disabled list for each injury, number of games played in both leagues, and whether the athlete was still active were collected from publicly available records. Results: A total of 746 athletes were included in this study: 240 (32%) multisport and 506 (68%) single sport. Multisport athletes played in significantly more mean total games (362.8 vs 300.8; P < .01) as well as more mean MLB games (95.9 vs 71.6; P = .04) than single-sport athletes. There was no difference in the mean number of seasons played in the major leagues (1.8 vs 1.6; P = .15) or minor league (5.25 vs 5.20; P = .23) between multisport and single-sport athletes. Single-sport athletes had a significantly higher prevalence of upper extremity injuries compared with multisport athletes (136 [63%] vs 55 [50%]; P = .009). Single-sport pitchers also had a higher prevalence of shoulder and elbow injuries (86 vs 27; P = .008) and were more likely to have recurrent elbow injuries (33% vs 17% recurrence; P = .002) compared with multisport pitchers. Conclusion: Professional baseball players who participated in multiple sports in high school played in more major league games and experienced lower rates of upper and lower extremity injuries than players who played only baseball in high school.


2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988849
Author(s):  
Amanda Esquivel ◽  
Michael T. Freehill ◽  
Frank C. Curriero ◽  
Kevin L. Rand ◽  
Stan Conte ◽  
...  

Background: Numerous studies have investigated injuries and treatments in the baseball athlete. The majority of these studies have focused on the throwing shoulder and elbow. However, more recent literature is reporting injuries to other regions in this cohort, including the knee, head, hip, and hamstring. Purpose/Hypothesis: The purpose of the current study was to determine the number and type of injuries in Major League Baseball (MLB) and Minor League Baseball (MiLB) players that do not occur during the actual game but are related to baseball participation. Our hypothesis was that there would be a substantial number of injuries that occurred in professional baseball players during non-game situations. Study Design: Descriptive epidemiological study. Methods: Deidentified, anonymous data were collected from the 2011 through 2016 seasons from the MLB Health and Injury Tracking System (HITS) medical record database. All injuries that were identified as a primary diagnosis and resulted in at least 1 day out of play from both MLB and MiLB were examined. Injuries were categorized as occurring during the game (“game” injuries) or not during the game. A “non-game” injury was defined as occurring at any time other than during the scheduled game from the first to last pitch. Results: There were 51,548 total injuries in MLB and MiLB players from 2011 to 2016, almost 40% of which were attributed to non–game-related injuries (n = 19,201; 37.2%). The remainder occurred during a game (n = 32,347; 62.8%). A significantly greater percentage of non-game injuries were season ending (10.8%) compared with the percentage of game-related season-ending injuries (8.4%) ( P < .0001). Pitchers had significantly more non–game-related injuries than game-related injuries ( P < .0001). Conclusion: A large number of injuries occur in professional baseball outside of actual games. MiLB players, specifically pitchers, are particularly at risk for these types of injuries. It is feasible that the overall injury rate in professional baseball players could be reduced by analyzing these injuries in more detail to develop prevention strategies.


2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984563 ◽  
Author(s):  
David P. Trofa ◽  
Kyle K. Obana ◽  
Hasani W. Swindell ◽  
Brian Shiu ◽  
Manish S. Noticewala ◽  
...  

Background: Youth athletes are starting sports earlier and training harder. Intense, year-round demands are encouraging early sports specialization under the perception that it will improve the odds of future elite performance. Unfortunately, there is growing evidence that early specialization is associated with increased risk of injury and burnout. This is especially true of pediatric and adolescent baseball players. Purpose/Hypothesis: The purpose of this investigation was to analyze national injury trends of youth baseball players. We hypothesized that while the total number of baseball injuries diagnosed over the past decade would decrease, there would be an increase in adolescent elbow injuries seen nationally. A further hypothesis was that this trend would be significantly greater than other injuries to the upper extremity and major joints. Study Design: Descriptive epidemiology study. Methods: Injury data from the National Electronic Injury Surveillance System, a United States Consumer Product Safety Commission database, were analyzed between January 1, 2006, and December 31, 2016, for baseball players aged ≤18 years. Data were collected on the location of injury, diagnosis, and mechanism of injury. Results: Between 2006 and 2016, an estimated 665,133 baseball injuries occurred nationally. The mean age of the injured players was 11.5 years. The most common injuries diagnosed included contusions (26.8%), fractures (23.6%), and strains and sprains (18.7%). Among major joints, the ankle (25.6%) was most commonly injured, followed by the knee (21.3%), wrist (19.2%), elbow (17.7%), and shoulder (16.2%). The incidence of the ankle, knee, wrist, and shoulder injuries decreased over time, while only the incidence of elbow injuries increased. A linear regression analysis demonstrated that the increasing incidence of elbow injuries was statistically significant against the decreasing trend for all baseball injury diagnoses, as well as ankle, knee, wrist, hand, and finger injuries ( P < .05). Additionally, the only elbow injury mechanism that increased substantially over time was throwing. Conclusion: The current investigation found that while the incidence of baseball injuries sustained by youth players is decreasing, elbow pathology is becoming more prevalent and is more commonly being caused by throwing. Given that the majority of elbow injuries among adolescent baseball players are overuse injuries, these findings underscore the importance of developing strategies to continue to ensure the safety of these youth athletes.


2006 ◽  
Vol 2006 (0) ◽  
pp. _1A1-E37_1-_1A1-E37_4
Author(s):  
Yasunori SHIBATA ◽  
Yoichi MOTOMURA ◽  
Yoshifumi NISHIDA ◽  
Tatsuhiro YAMANAKA ◽  
Hiroshi MIZOGUCHI

Hand ◽  
2019 ◽  
pp. 155894471986445 ◽  
Author(s):  
Peter Charles Rhee ◽  
Christopher L. Camp ◽  
John D’Angelo ◽  
Vishal S. Desai ◽  
Steven S. Shin ◽  
...  

Background: Professional baseball players are at risk of acute and chronic injuries to their upper extremities. Methods: Major League Baseball’s Health and Injury Tracking System, a prospective injury surveillance system, was used to identify and characterize all hand and wrist injuries sustained by all Major League Baseball (MLB) and Minor League Baseball (MiLB) players during the pre-, regular, and postseason throughout 2011-2016. Injuries were included if they resulted in at least 1 day out of play and were sustained during standard baseball activities. Days missed were defined as the time between injury and the first time in which a player was cleared to return to play. Results: During the study period, there were 4478 hand and 1748 wrist injuries throughout MLB and MiLB, which resulted in a total of 105 246 days out of play. This was equivalent to the length of 575 individual MLB player seasons, and the mean days missed per injury was 17 days. Most injuries were traumatic in nature, with 43% (n = 2672) of players injured after being hit by a baseball that mainly occurred during batting (n = 2521; 40%). Injuries that most frequently required surgical intervention were hook of hamate fractures (72%) and scaphoid fractures (60%). Conclusions: Understanding the epidemiology and impact of hand and wrist injuries in MLB and MiLB players may lead to improved management of these injuries and reduce time away from play. Most importantly, preventive measures and/or enhanced protective gear may be developed to minimize these types of injuries in MLB and MiLB.


2019 ◽  
Vol 7 (7) ◽  
pp. 232596711986106
Author(s):  
Kelechi R. Okoroha ◽  
Stan Conte ◽  
Eric C. Makhni ◽  
Vincent A. Lizzio ◽  
Christopher L. Camp ◽  
...  

Background: Hamstring strains are the most common injury for professional baseball players and can result in significant time on the disabled list. To date, no study has reported the current trends in hamstring strains in professional baseball. Hypothesis: Professional baseball players would have an increased incidence of hamstring strains from 2011 through 2016. Study Design: Descriptive epidemiology study. Methods: Injury data were prospectively collected from 2011 through 2016 for every Major League Baseball (MLB) and Minor League Baseball (MiLB) team and was recorded in the MLB Health and Injury Tracking System. Data collected for this study included date of injury, activity during injury, time lost, primary injury or reinjury status, and imaging findings as well as player demographic information related to level of play, age, and position for all hamstring injury events. Injury rates were reported as hamstring injuries per number of games. Results: From 2011 to 2016, there were 2633 hamstring strains in professional baseball players. The rate of hamstring strains increased in MLB from a low of 1 injury every 39 games in 2011 to a high of 1 injury every 30 games in 2016. In MiLB, there were 2192 hamstring strains, with 1 injury every 35 games in 2011 compared with 1 injury every 30 games in 2016. The majority of injuries occurred in the infielder positions (37.5%) and resulted from base running (>50%), most commonly from home to first base. The most common hamstring injury was a grade 2 injury to the distal biceps femoris. The mean time missed after a hamstring injury was 14.5 days. Grade 3 and grade 2 hamstring strains resulted in significantly more days missed compared with grade 1 injuries ( P = .005 and P = .002, respectively). The rate of recurrent hamstring injuries was 16.3% for MLB and 14.2% for MiLB. Recurrent hamstring injuries resulted in more time lost than primary injuries (mean, 16.4 vs 14.5 days, respectively; P = .02). A total of 42 injuries were treated with platelet-rich plasma, and 19 were treated with surgery. The number of injuries treated with platelet-rich plasma increased in successive years. Conclusion: The rate of hamstring strains in professional baseball players has increased over the past 6 years and has resulted in a significant loss of playing time. Study results indicated that these injuries are affected by injury characteristics, position played, running to first base, seasonal timing, and history of hamstring injuries.


2019 ◽  
Vol 47 (5) ◽  
pp. 1068-1073 ◽  
Author(s):  
Peter N. Chalmers ◽  
Brandon J. Erickson ◽  
John D’Angelo ◽  
Kevin Ma ◽  
Anthony A. Romeo

Background: Injuries remain a significant problem for professional baseball players. There is little information regarding the incidence and outcomes of shoulder surgical procedures among these athletes. Purpose/Hypothesis: To report the incidence, pathology, procedure type, demographics, and return-to-sport (RTS) rate of shoulder surgery among Major League Baseball (MLB) players. Most shoulder procedures would be performed on pitchers with a history of injury; the labrum would be the most commonly involved; and that the RTS rate would be >50%. Study Design: Descriptive epidemiology study. Methods: All MLB players who underwent surgery between 2012 and 2016 were identified from a database prospectively maintained by MLB. Demographic information and details regarding the procedure were recorded and RTS rates determined. Only those players with a minimum 2-year follow-up were included. Results: There were 581 shoulder procedures performed (542 players; pitchers, 60%; incidence, 1.48%). Overall, 19% of surgical procedures were performed on major league players and 81% on minor league players. Most players were between 20 and 25 years old. The majority of procedures were performed on the posterior and anterior labrum. Of these, 67% involved labral repair. Within rotator cuff surgery, 84% involved debridement; most tears were articular sided (87%); and 75% involved the supraspinatus. Overall, 11% of players had prior shoulder surgery, and 76% spent time on the disabled list before surgery. The overall rate of RTS was 63%. Of those who returned, 86% returned to at least the same level of play or higher as before surgery. Of those who returned to their prior level of play, 73% later ascended to a higher level of play or could not ascend to a higher level because they were already in the majors. Conclusion: Shoulder surgery is uncommon among professional baseball players. Of those players who require surgery, the majority are pitchers and minor league players. Most procedures involve the labrum. Rotator cuff tears are mostly articular-sided supraspinatus tears. The overall RTS rate is 63%. Of those who return, 86% are able to return to the same or higher level of play as before surgery.


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