Injuries in baseball


The origin of the American game of baseball is uncertain. There are those who insist that it is of purely American origin, but some historians contend that it had its roots in the old English game of rounders. Regardless of its origin, the game has been very popular for at least 150 years and it continues to be one of the most popular sports in America and in the Far East, particularly Japan.

Originally, baseball was a warm, fair weather game played outdoors on natural grass and dirt under daylight conditions. For the most part this is still true, although, thanks to technological developments, some changes have taken place. Since 1930, many fields have been artificially lit, thus allowing games to be played outdoors after dark. In recent years several large arenas have been built which allow for play indoors under any weather conditions and at any time of the day or night. Because of the failure of grass to grow inside the arenas, synthetic surfaces have been developed and even some outdoor stadia now have synthetic surfaces, particularly those that also stage football.

Playing area

Baseball is played on a large field consisting of an infield and an outfield. The infield is laid out to exact measurements and in such a manner that the batters will not have the sun in their eyes when they face the pitcher. The infield is a 90-foot (27.4m) square (60-foot (18.3cm) for younger players). The corners are known as home plate and in a counterclockwise direction first, second, and third bases. The pitching mound (where the pitcher stands to throw the ball) is equidistant from third to first bases on the fine from home plate (where the batter stands to hit the ball) to second base but slightly closer to home plate.

The outfield is the area beyond the infield between the foul lines formed by extending the two sides of the square from home plate past first and third bases to the end of the field. Everywhere within the boundaries formed by these two lines is known as fair territory. It is recommended that the outfield should be enclosed by a fence. Except for a minimum requirement of 250 feet (76.2m) from home plate to the nearest obstruction in fair territory, there are no specific requirements for placement of the fence, even though greater distances are recommended. The required distance for younger players is less than 250 feet (Figs. 12/la and lb).


There are numerous specifications for equipment, but only the specifications for the ball and the bat are covered here. Specifications for the baseball were determined in 1872 and still apply. The ball is a sphere weighing not less than 5 nor more than 5£oz (142-149g), and measures not less than 9 nor more than 9iin (22.9-23.5cm) in circumference. It is formed by yarn wound around a small core of rubber, cork, or combination of both, and covered by two pieces of white horsehide or cowhide tightly stitched together (until several years ago only horsehide was allowed). Specifications for the bat were determined in 1876 and still apply. The bat must not exceed 42in (107cm) in length nor be over 2$in (7cm) in diameter at its thickest part. Until recently all bats were constructed of solid wood; for games, other than professional, laminated wood or aluminium bats are now allowed.


Baseball competition requires two teams of nine players each. However, teams carry additional players for substitution purposes. Unlike some other games, a player cannot return to play, after he has been removed from the line up.

The team at bat is known as the offensive team and its objective is to have its batters score runs. The batter stands along either side of the home plate in a designated marked-out area 6 x4ft (1.83 x 1,22m) called the batter’s box. It is the aim of the batter to hit the ball thrown by the pitcher and drive it into fair territory. The batter then becomes a baserunner, and his objective is to reach each base safely, and to proceed on a tour of the bases: from home to first, from first to second, from second to third, and from third to home in that order. If he does this legally before the third man is put out, he scores a run.

Batters may start their journey around the bases in a variety of ways: (1) hitting safely; (2) being hit by a pitched ball while in the batter’s box; (3) being given first base on balls (that is, the pitcher fails to throw the ball over the plate on four pitches before the batter hits the ball or strikes out); and (4) on a defensive player’s error. They may advance by stealing bases, on hits, errors, passed balls and in other ways.

The team in the field is known as the defensive team and its objective is to prevent offensive players from becoming base runners and to prevent their advance around the bases. When three offensive players are legally put out, the teams change positions.

The pitcher and catcher form what is known as the battery. The pitcher must throw from the designated spot in the infield to the catcher whose position is back of home plate. The infield is composed of a first baseman, second baseman, third baseman, and a short stop who is stationed between second and third bases. There are three outfielders who play in left, centre, and right fields. None of the players is stationary; they all move about as the situation warrants, taking in as much territory as their abilities permit in fielding the ball and covering the bases.

A batsman or a base runner may be put out in a number of ways (only five are listed here): (1) he may strike out (swing and miss the ball three times); (2) he may hit a ball in the air that is caught by a defensive player before it touches the ground; (3) he may hit a ground ball in fair territory and be thrown out, the first baseman getting the ball and touching the base before the runner gets there; (4) a defensive player touching a base with the ball in his possession before the runner arrives at that base; or (5) by touching the runner with the ball when the runner is not touching the base.

When each team has a turn at bat (offense) that is known as an inning. The usual number of innings is nine; for the younger players a game is usually shorter than nine innings. If the game is tied at the end of the designated number of innings, the game continues with equal turns at bat until one team has scored one more run than the other.


While few deaths to either players or spectators have resulted directly from the American game of baseball, serious and minor injuries occur each year to thousands of players. Injuries curtail the sports careers of baseball players from the little league to the major professional league (Owen, 1974).

The hazards of the game can be divided into five groups: (1) running; (2) body contact; (3) risk from both the bat and the ball; (4) the barriers which enclose the field; and (5) hard throwing and swinging motions (Ryan, 1962).

In his survey of professional and college baseball injuries, Polk (1968) noted that 82.5 per cent of all injuries may be attributed to five types: (1) sprains, 27.3 percent; (2) strains, 18.7 percent; (3) contusions, 16.9 per cent; (4) pulled muscles, 11.3 per cent, and (5) fractures, 8.3 per cent. Polk found that sliding and running between bases were the primary causes of sprains. Strains were predominantly caused by throwing, followed by running between bases. Contusions were caused by the batter being hit by a pitched ball, followed closely by collisions between players. Pulled muscles occurred primarily running between bases, followed by throwing the baseball. Fractures were caused equally by sliding, and the batter being hit by a pitched ball.


The catcher is the most likely player to be injured because of his position immediately behind the batter. Hazards include the pounding of the hand by the pitched ball, the jolt of foul balls (tips), home plate collisions, and bruised throwing arms. It is the task of the catcher to catch all the throws of the pitcher not hit by the batter. When many pitchers throw the baseball with a velocity of 80 to lOOmph (BO-ieOkmh’1), the possibility of injury is obvious. This velocity is greatly accelerated when the batter barely touches the ball with the bat. The resulting foul ball or tips are a major cause of injuries. The catcher wears protective equipment for the face, chest, shins, and one hand, but it is impossible to completely protect the body. The bare hand is the most vulnerable.

A play that causes injury to the catcher occurs at home plate when the runner tries to score and the ball is thrown to the catcher who tries to tag the runner with the ball which may be in his gloved hand before the runner touches home plate. Frequently the catcher, depending upon his added protective equipment, will block the plate trying to keep the runner from scoring. The oncoming runner knocks the catcher down with possible injury to either the catcher or runner or both.


The pitcher is the key person in the game. Most of the game action is initiated when he throws the ball towards home plate. Injuries happen to pitchers while throwing the ball and attempting to catch or stop the batted ball. Arm and shoulder injuries are the most common, because the overhand motion is an unnatural motor movement. These problems can result from: (1) throwing pitches or using styles of delivery which puts a great deal of strain on the arm or shoulder; (2) a lack of conditioning; or (3) throwing too hard for a long period of time or throwing too many pitches.

Regardless of the level of the sport, the pitcher is in the most vulnerable position for being hit by the batted ball. The pitcher is only 60ift (18.4m) (45ft (13.7m) for younger players) from the batter. Contusions and even fractures may result from extremely hard hit balls.


The majority of injuries occur in the tagging or forcing out of a base runner. Infielders suffer spike wounds of varying severity on plays where an opposing runner slides, feet first and spikes high, into the base the infielder is attempting to cover.

Infielders are subject to contusions and even fractures, because the batted ground ball sometimes hops badly and hits the fielder on some part of the body other than the gloved hand. Because of errant throws from the other players, the first baseman is especially vulnerable to injury from collision when he is forced to move into the path of the player running from home plate to first base in order to catch the thrown ball.


Usually an outfielder must run a greater distance to catch the ball. As a result, the major danger of playing the outfield is that of collision with the fence, with other outfielders, or with infielders. Because of the layout of the field, on sunny days one or more of the outfielders must face into the sun. There is a possibility of being hit by the ball after losing sight of it against the sun. Because of the distance from the batter, outfielders have fewer chances of throwing the ball than infielders. When they do, they must make long hard throws to get the runner. As a result, sore arms are a common occurrence among outfielders.


The greatest risk of injury to the batter comes from being hit by the ball. The batter may be hit by a ball thrown by the pitcher, or from his fouling the ball off his shin or foot. Contusions and occasionally fractures result from being hit by the ball. Pulled or strained muscles can result if the batter does not warm up properly before attempting to take strong swings in batting practice or in the game.

Base runner

Quick starting, speed in running the bases, and the ability to slide properly are fundamental skills for the base runner. The player must be properly conditioned in order not to pull muscles through quick starts. Sliding (where the runner hooks the base with a foot or hand to avoid being tagged by the defensive player) is one of the most common causes of injury to the base runner. Many injuries occur when the runner changes his mind while in the act of sliding. Litwhiler (1967) concluded that more sprained ankles, broken legs, and other injuries are inflicted on base runners by this mental lapse than by any other playing action.


Hein (1963) listed five general underlying principles for injury prevention in sports. These principles fall under the following headings: (1) developing skills; (2) conditioning of participants; (3) supervising play; (4) providing equipment and facilities; and (5) assuring health care. Each of these principles plays an important role. McConnell (1960) stressed the importance of skills: ‘It is possible to perfect baseball skills and at the same time to avoid injury. In fact the possession of skills helps to prevent accidents. Very seldom do we hear of a player who executes a play properly being injured. The man who knows how to throw, and uses this knowledge in throwing, doesn’t pull a muscle in his arm, and the fellow who knows how to slide and uses this knowledge doesn’t sprain an ankle or strain an elbow. It is important that every player concentrate on the basic fundamentals.’

The coaches and officials who have responsibility for supervision of play must be well versed in the game. They must not only have the technical knowledge of the skills of the sport and the ability to transmit this knowledge to the players, but have an understanding of what effect the activity will have upon the players’ welfare. Stafford (1942) developed a simple set of principles of supervision, which if carefully followed, offer a maximum of safety. These principles involve: 1. An understanding of the hazards involved in each activity. 2. The removal of unnecessary hazards. 3. Compensating for those hazards which cannot be removed. 4. Creating no unnecessary hazards.

The players must be furnished with proper equipment and taught how to use it properly. Regardless of budget size the key to good management is the best use of available funds. A little extra expenditure for better products will pay off over the years, for good equipment, if properly cared for, lasts longer and is more economical in the long run. Rather than outfit a team with inferior equipment, the coach should omit nonessentials and buy well-made essential items.

Health care will not be discussed specifically in this article. A brief statement on conditioning is given in the next section. The remaining three principles will be included in the following paragraphs which focus on positional roles.



As stated earlier, the bare hand is most vulnerable to foul tips. Because of radical changes in the design of the catcher’s mitt, catching techniques are changing. The new mitt allows one-handed catching by experienced catchers. ‘The handling ease of the mitt allows the catcher to hide his arm and hand protecting them from foul tips or even wild pitches in the dirt’ (Vivian, 1976).

However, young catchers must continue to use two hands, and there are many situations where experienced catchers must use both hands. Howard (1966) recommended that the catcher hold the rim of the glove with the bare hand or keep the bare hand folded and not clinched until the ball is in the mitt. He further recommended that the catcher place the forefinger of the gloved hand outside the mitt and use sponge rubber or a golf glove inside the mitt to ease the impact of the ball . The catcher needs to wear a protecting mask, a chest protector, shin guards and a protective cup. There is a growing trend for the catcher to wear a hard hat under the mask. The protective equipment should fit snugly and securely .

Because of the undue strain on the knee of the young catcher from the squatting position that is assumed on each pitch, the number of innings in which the player is used as a catcher should be limited .


Pitching styles vary considerably, but the young pitcher should try to perfect a smooth delivery that will not put undue strain on his shoulder. Throwing the curve ball (spin is imparted on the ball by rotating the arm at the wrist and elbow when throwing the ball causing it to curve in flight) is a problem for pitchers and especially for the young pitcher because of the relatively late completion of bone development. Throwing curve balls by young growing players should be discouraged if not forbidden. The young pitcher should be encouraged to develop control and proper form instead.

Because of the vulnerability of the pitcher to line drives, it is important that in teaching a young person how to pitch, follow-through and balance should be emphasised. The pitcher should finish the pitching motion and immediately be in a position to receive a line drive, I.e. a solidly hit ball, most of whose flight approximately parallels the ground. Follow-through also helps to prevent sore arms.

First baseman

When the first baseman prepares to receive throws from other infielders, he should place one foot on the inside corner of the base, giving most of the base to the runner. This will help to avoid being stepped on by the runner and keep him clear of the baseline, thereby reducing the possibility of a collision. If he is pulled off the base and has to tag the runner coming into the base, the tagging arm should be relaxed to avoid injury.


Usually the infielder can avoid being spiked by straddling or standing directly behind the base when he is trying to tag out the runner. As the ball is caught he either sweeps (depending upon how close the runner is) or puts the glove containing the ball directly down next to the base in the line from which the runner is coming. The fielder making the tag should be sure to protect himself from getting spiked as well as run over if the runner decides not to slide. When the fielder has to tag a person running by he should tag quickly, low and then get out of the way.

In fielding ground balls the infielder should stay close to the ground and keep his eyes on the ball until he fields it. The infielder must charge towards the ball if possible. He must track the ball into the glove and remember the glove’s position. If the ball is above the waist, the heel of the hand is lower than the fingers. If the ball is below the waist, the fingers are lower than the heel of the hand. When picking up the ball the glove hand should start on top of the ground and come up if necessary rather than starting above and going down. The cardinal rule in fielding a ground ball is to keep the eyes on the ball. Turning the head increases the chances of the ball hitting the fielder in the face or some other part of the head if it bounces awkwardly.

Sometimes on plays where the infielder must go from the sure footing of the infield din to the less secure outfield grass he may turn his ankle in his haste to get to the ball or get set for the throw. There is not much the player can do to prevent this occurrence except to check out the playing surface to know which spots are wet or slippery.

The playing surface, both dirt and grass, should be constructed and then maintained as smooth as possible for practice and games. The playing field should be inspected regularly for hazards, particularly for holes or low spots.


The outfield must work together as a unit. The centre fielder is the key person in the unit and should catch any ball he can unless another outfielder is in a better position. Fly balls (balls in the air) that are hit between the infielders and outfielders should be taken by the outfielder whenever possible. It is important that the fielders call out their intentions so there is no uncertainty about who is going to catch the ball.

On sunny days all fielders should wear sunglasses -infielders as well. The glove can be used also as a shield. Care must be exercised when using the glove as a shield that sight of the ball is not obstructed.

The playing field including the outfield should be enclosed with a fence. The fence should be high enough so that the players cannot fall over it. All light poles and posts should be located outside the fenced-in playing area. In many parks a warning track is installed near the fence. This allows the player to stop short of the fence or prepare to cushion the impact. Hard unyielding surfaces should be padded to protect a player when he runs into them. If at all possible when fly balls are hit over his head, the player should hurry to the fence, then turn to re-locate the fly ball and catch it.


While there is no particular batting style recommended, each batter should be in a comfortable on-balance stance and keep his eye on the ball. This should enable him to avoid being hit by a pitch thrown at him. Since helmets are required, they should be worn at all times while batting, whether in practice or in a game.

Proper batting instruction may help prevent the batter from hitting the ball against his foot or shin. Some players wear a modified shin guard for protection.

The batter should loosen up the back, shoulder, and arm muscles early in the practice or game to avoid being hampered by pulled or strained muscles. Players should swing several bats or bats with attached weights before entering the batter’s box.

Base runners

In running out batted balls to first base when a turn is not going to be made, the runner should run straight ahead touching the front edge of the base with the toe. Most authorities recommend sliding into first base only when attempting to avoid a tag by the first baseman who has been pulled off the base by a wide throw.

Players should be taught the proper techniques of sliding very early. Most authorities advocate sliding feet first except under special circumstances because the risk of injury to the head, arms, or hands is great in sliding head first. The most important thing to remember is that once a player decides to slide he should complete his slide.


Baseball is unique in that only three individuals are actively involved in every pitch – the pitcher, catcher and batter. While it is true that all players should be alert on each pitch, and a few may be involved, the majority of players will not participate in most plays.

Since speed, agility, and coordination are key ingredients for success in baseball it is important that the body and particularly the arms and legs be kept in shape. During the off-season jogging and running, flexibility exercises, and sports such as handball are recommended. Before and during the season it is important that players continue running, particularly wind sprints, and stretching exercises. Each player should warm up properly for running, throwing, and batting before trying quick starts, throwing or swinging hard.

Writing in 1979, Soderholm advocated that ‘The best overall conditioning programme for baseball would centre around proper strength training (and flexibility training depending on the equipment used), combined with a limited amount of sprinting, and the practice of baseball skills.’


Coombs, J. (rev. Litwhiler, D.) (1967). Baseball, 4th edition. Prentice-Hall, Englewood Cliffs.

Hein, F. V. (1964). Health aspects of accident prevention. In 1963 Annual Safety Education Review. American Association for Health, Physical Education, and Recreation, Washington DC.

Howard, E. (1966). Catching. Viking, New York.

McConnell, M. (1960). How to play little league baseball. Ronald, New York.

Owen, M. (1974). Play it safe. School Safety, 2,4-6.

Polk, R. G. (1968). The frequency and causes of baseball injuries. Athletic Journal, 49, 19-20, 53.

Ryan, A. J. (1962). Medical care of the athlete. McGraw-Hill, New York.

Soderholm, E. (1979). Striking out the myths in baseball conditioning. Scholastic Coach, 48, 52-56.

Stafford,G. T. (1942).Recreationandathletics. In H. J. Stack and E. B. Siebrecht (eds). Education for safe living. Prentice-Hall, New York.

Vivian, R. W. (1976). Catching: two-handed vs. one-handed. Athletic Journal, 56, 48-50.

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