Secrets To Preventing And Treating Baseball Injuries

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Sharing A Few Thoughts From Leading Athletic Trainers

Recently, I had a telephone conversation with Richard “Richie” Bancells, the head athletic trainer for the Baltimore Orioles and the president of the Professional Baseball Athletic Trainers Society (PBATS).

He noted there is currently no official reporting service for injuries that occur in Major League Baseball (MLB). Currently, the MLB is investigating, negotiating and finalizing plans to set up an official data reporting service. In Bancells’ experience, he feels there is no current trend or change in daily baseball-related injuries in comparison to previous years.

I also recently had a conversation with Scott Sheridan, who serves as the head athletic trainer and physical therapist for the Philadelphia Phillies. As the team podiatrist, I have worked with Sheridan for the last five seasons.

In his experience treating players in the Minor Leagues and at the MLB level, Sheridan notes that minor league players are on the field easily two to four hours more each day than the major league players. The on-the-field activities include fitness, instructional sessions and full
ball games.

The minor league player tends to have more overuse injuries as he is in spikes much longer compared to the major league player. Sheridan adds that there is more frequent iliotibial band syndrome, shin splints, fasciitis, stress fractures and patellar femoral dysfunction among minor league players.
Sheridan also points out that there seems to be less conditioning among MLB players versus minor leaguers and typically the field conditions are different. He notes that most of the injuries he sees among MLB players involve the shoulder, upper extremity, neck and lower back.
— Nicholas Romansky, DPM

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Author(s): 
Nicholas Romansky, DPM, and Bill Sayer, MS

With spring finally here, amateurs and professionals alike have returned to the baseball diamond. More than 40 million Americans participate in baseball and softball each year. According to the American Academy of Orthopedic Surgeons (AAOS), there are over 500,000 injuries per year related to baseball.
American children begin playing organized baseball at 5 or 6 and some people continue to play the sport past the age of 60 whether games are competitive or during a family picnic. As a result of this, different injury patterns present themselves. Most of us who have played can relate to some type of degree of injury associated with our baseball experience. Most of the injuries occur when sliding into the base, rounding the bases or colliding with another player or with the outfield fence. There are also a fair share of stress or overuse injuries, as well as injuries that occur from being hit by the ball.
Unfortunately, there is very little in the literature regarding baseball injuries at the present time. There are only a few selected general articles on baseball. The literature that does exist is typically all about pitchers’ shoulders and elbows as well as treatments associated with the Tommy John surgery. There are only a few citations on college baseball and softball.
Podiatrists who have a strong emphasis on sports medicine strive to make the game as safe as possible for players and protect athletes from further injury recurrence. There are four keys to injury management and these keys include: complete evaluation;
early recognition and treatment; caring for a definitive injury; and the timing of the return to play.
In preseason or spring training at any level, one needs to evaluate the players in order to assess their weaknesses, special injury risks and individual needs. At all levels, it is important to teach players body wellness and fitness. There is a distinct level of injuries that occur at different levels of play that include Little League and Babe Ruth leagues and the professional Minor Leagues and Major Leagues.

Inside Insights On Shoes And Playing Surfaces

At all levels, players should utilize running sneakers for fitness. Additional items in the player’s bag should include flat gum sole shoes for artificial surfaces, molded rubber spikes or metal cleats. Depending on the playing surface and weather conditions, players should select shoes for the majority of play. The proper selection of shoes is critical and is involved in the treatment and prevention of growth plate injuries.
Shoe selection is of great concern with all injuries. This can be a tricky issue at the Little League levels as a team may be sponsored by a local sports store or a particular parent may have a contact providing shoes and textiles for the team. (Also see “Pertinent Preventive Considerations With Adolescent Ballplayers” on page 60.) An injury may be tied to the actual shoe design or cleat placement.
The podiatrists should evaluate the shoes, including the flex point and those shoes with a very stiff plate in the arch. This has presented a unique set of circumstances with metatarsalgia, plantar fasciitis and Achilles tendonitis being secondary to inherently poor shoe design.
In regard to playing surfaces, more and more schools and leagues are going to an artificial turf or multipurpose surface type. It is not so much the “thickness of the carpet” and blade height but one has to be especially cognizant of the importance of the under surface or basement membrane that is present beneath the actual playing surface.
Depending on this type of membrane, it is very reasonable that athletes can use metal cleats without posing any extra issues with ground surface contact. If the basement membrane is too hard, then athletes may use a different type of shoe, including a flat or turf type shoe with multiple small cleats.

Pointers For Managing Common Injuries

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