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The Epidemiology of Single Season Musculoskeletal Injuries in Professional Baseball

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The Epidemiology of Single Season Musculoskeletal Injuries in Professional Baseball See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/236909694 The epidemiology of single season musculoskeletal injuries in professional baseball Article in Orthopedic Reviews · February 2013 DOI: 10.4081/or.2013.e3 · Source: PubMed CITATIONS READS 14 118 7 authors, including: Xinning Li Joseph T Nguyen Boston University Hospital for Special Surgery 104 PUBLICATIONS 867 CITATIONS 137 PUBLICATIONS 1,419 CITATIONS SEE PROFILE SEE PROFILE Marcus Jäger University Hospital Essen 193 PUBLICATIONS 2,667 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Commentary & Perspective Total Hip Arthroplasty View project Anisometry of Medial Patellofemoral Ligament Reconstruction in the Setting of Patella Alta and Increased Tibial Tubercle-Trochlear Groove (TT-TG) Distance View project All content following this page was uploaded by Xinning Li on 30 May 2014. The user has requested enhancement of the downloaded file. Orthopedic Reviews 2013; volume 5:e3 The epidemiology of single Introduction Correspondence: Xinning Li, Division of Sports season musculoskeletal injuries Medicine, Hospital for Special Surgery, 535 East in professional baseball The first game of organized baseball was 70th Street, New York, NY 10021, USA. played on 19th June 1846, at the Hoboken E-mail: [email protected] Xinning Li,1 Hanbing Zhou,2 ground, New Jersey. Since that day, it has Key words: MLB baseball, epidemiology, upper Phillip Williams,1 John J. Steele,1 become a popular sport for people of all ages in body injuries, lower body injuries, abdominal/ Joseph Nguyen,1 Marcus Jäger,3 the United States and has been appropriately groin injuries. Struan Coleman1 dubbed as the national pastime. The United Contributions: XL contributed to the conception, States Consumer Product Safety Commission 1Hospital for Special Surgery, Division of drafting, revision, data and data interpretation. (CPSC) estimates that 6 million children play HZ, JS, and PW contributed to the drafting, revi- Sports Medicine and Shoulder Surgery, in organized baseball leagues and up to 13 mil- sion, and data analysis. JN performed the statis- New York, NY, USA; 2University of lion more play non-organized baseball each tical analysis and also contributed to the drafting Massachusetts Medical Center, Worcester, year.1 McFarland et al.2 estimates that there are of the manuscript. MJ contributed to the critical MA, USA; 3University of Essen Medical editing. SC contributed to the conception, data 21,747 baseball players at college level made up interpretation, and manuscript revision. Center, Essen, Germany of 276 Division I, 194 Division II, and 283 Division III programs. By 2003-2004, the num- Conflict of interests: the authors declare no ber of NCAA university baseball teams has potential conflict of interests. increased to 867 involving 27,262 participants Funding was provided internally by the Hospital Abstract in all three divisions.3 At the professional level, for Special Surgery, Division of Sports Medicine. 4 Conte et al. reports approximately 750 major Joseph Nguyen was partially supported by The aim of this descriptive epidemiology league players and 2100 minor leaguers. Clinical Translational Science Center (CTSC) study was to evaluate the injury incidence, Baseball-related injuries are commonly seen (UL1-RR024996) across the country, from emergency rooms to pattern and type as a function of position in Received for publication: 25 September 2012. the training room tables of the professional one professional baseball organization for onlyRevision received: 13 November 2012. one complete season. The study was carried clubhouse. Although a considerable amount of Accepted for publication: 14 November 2012. out in a major academic center. Participants research has been devoted to the study of the This work is licensed under a Creative Commons were all major/minor league baseball players biomechanics and the treatment of baseball- 5-8 Attribution NonCommercial 3.0 License (CC BY- playing for one professional organization. related injuries, there are surprisingly little NC 3.0). The disabled/injury list of one single profes- data to describe the epidemiology useof Major sional baseball organization (major and League Baseball (MLB) injuries. Posner et al.9 ©Copyright X. Li et al., 2013 Licensee PAGEPress, Italy minor league players) was reviewed for all of analyzed the publically available internet MLB Orthopedic Reviews 2013; 5:e3 disabled list data from 2002 through 2008. Only the injuries and the number of total days doi:10.4081/or.2013.e3 missed secondary to each injury. All injuries major league players that were placed on the were categorized into major anatomic zones disabled list (over 15 days missed) were includ- that included: shoulder, elbow, wrist/hand, ed in their study, and injuries were categorized back, abdomen/groin, hip, knee, and by anatomic zones and divided on a monthly ankle/foot. The data was further stratified basis. The author found that upper body minor league players) for one complete sea- based on the injury type and the number of injuries were predominantly associated with son. Furthermore, a rate ratio (RR) analysis days missed due to that particular injury and pitchers while lower body injuries were more was performed on the data comparing the rate a statistical analysis was performed. In pitch- common in position players, and injuries were of days missed due to a particular injury per ers, elbow injuries (n=12) resulted in 466 more likely to occur at the beginning of the sea- season according to baseball position for each days missed. In catchers, wrist injuries son. Conte et al.1 studied a MLB disability list injury anatomic zone. Our hypothesis is that (n=4) resulted in 89 days missed. In position of 11 years from 1989-1999 and raised appropri- certain injury patterns/zones, i.e. elbow players, abdominal/groin injuries (n=16) ate concerns that injury rates on the field have injuries in pitchers or hip/groin injuries in the resulted in 318 days missed and shoulder not decreased despite vast improvements in position players, will result in a significantly injuries (n=9) resulted in 527 Non-commercialdays missed. training and conditioning, diagnostic methods, higher rate of days missed. Overall, 134 players were injured and a total and surgical treatment over the study period. of 3209 days were missed. Pitchers had 27 Although there are two studies describing times and 34 times the rate of days missed baseball injury patterns for major league play- due to elbow injuries compared to position ers who were placed on the disabled list, we Materials and Methods players and all players, respectively. have not been able to find any report describ- Abdominal and groin injuries caused the ing the injury patterns of both major and minor We analyzed the disabled and injury list of pitchers to have 5.6 times and 6.4 times the league players of one professional organiza- one single professional baseball organization rate of days missed than the position and all tion and the associated days missed due to the for the entire season of 2010 to 2011. This players, respectively. Both elbow and abdom- particular injury from both the injury (<15 included players of both the major and all asso- inal/groin injuries are the most disabling days missed) and disabled list (>15 days ciated minor league organizations. The minor injury pattern seen in pitchers. Among the missed) for one single complete season. Given league organizations were composed of players position players, shoulder injuries resulted the paucity of epidemiology data on MLB from the rookie ball, A, AA, and AAA leagues in the most days missed and knee injuries injuries in the literature, the purpose of this (total of 7 different teams). We reviewed all of resulted in the highest rate of days missed in study was to prospectively evaluate the injury the injuries and the number of total days missed both pitchers and catchers. incidence, pattern and type as a function of secondary to each injury. The data consisted of position with associated days missed in one the player’s name, team, position, type of injury, professional baseball organization (major and numbers of games played, and total number of [Orthopedic Reviews 2013; 5:e3] [page 11] Article days missed due to the particular injury. All significance was set to alpha equal to 0.05 organization. This included 127 pitchers, 31 musculoskeletal injuries were included within with SPSS version 19.0 (SAS) used as the catchers, and 133 position players (infield and this report; however, we did not include any statistical software package for this study. outfield players). A total number of 134 players injury days missed due to lacerations or med- were injured during this time period due to a ically-related issues. Some players may have number of injury zones including: shoulder, had the same injury that occurred on multiple elbow, wrist/hand, abdomen/groin, hip, knee, occasions during the season that resulted in Results and ankle/foot (Table 1). These 134 players days missed. Although the injuries are the missed a total of 3209 days during the season. same, we recorded each incidence separately; During the 2010-2011 season, we followed a Pitchers most commonly sustained shoulder we also calculated the number of days missed total of 291 professional baseball players in one and elbow injuries. A total of 885 days of the sea- separately. All of the players who had recurring injuries to the same anatomic zone of the body were reported according to positions. All of the injuries were categorized into major anatomic zones that included: shoulder, elbow, wrist (hand), back, abdomen/groin, hip, knee, and ankle (foot). The data were further stratified based on the injury type and the num- ber of days missed due to that particular injury. All musculoskeletal injuries reported on the official team injury documents and the disabled list were included in this study whether the player missed days or not.
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