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INTRODUCTION
This chapter is focused on competitive fast-pitch softball injuries in women. Fast-pitch softball is a sport played predominantly by women, but there are many men’s or coed leagues as well. Slow-pitch softball is also frequently played across the world. However, the majority of the literature surrounding softball-related injuries is in regard to competitive women’s fast-pitch softball, which provides the rationale for this chapter’s focus.
Fast-pitch softball has grown tremendously in popularity over the past several decades. During a 15-year period between the 1988-1989 and 2003-2004 seasons, National Collegiate Athletic Association (NCAA) softball added 362 schools, causing participation to increase by over 70% (9,389 participants in 1988-1989 to 16,079 participants in 2003-2004) (15).
Softball has been an NCAA sport since 1982 and was an Olympic sport from 1996 to 2012.
During the 2009-2010 academic year, high school fast-pitch softball was the fourth most popular sport, with 378,211 participants (17).
RULES AND REGULATIONS
Comparisons between softball and baseball are constantly made due to the similar general nature of the games. Where appropriate, references to the rules and regulations of baseball are provided.
Similar to baseball, softball plays with nine field positions: pitcher, catcher, first base, second base, shortstop, third base, right field, center field, and left field.
Regulation games consist of seven innings. (Baseball: nine innings)
Distance between bases: 18.29 meters (60 ft). (Baseball: 60 ft [Little League] to 90 ft)
Distance between the pitcher’s mound and home plate: 13.11 meters (43 ft) (14 and under: 12.19 m [40 ft]; 12 and under: 10.66 m [35 ft]). (Baseball: 46 ft [Little League] to 60.5 ft)
In contrast to baseball, the pitching mound in softball is not elevated.
The ball size is 30.5 cm (12 in). (Baseball: 23 cm [9 in])
INJURY EPIDEMIOLOGY
Softball has a relatively low rate of injuries compared to other sports. However, costs for medical care of baseball and softball injuries still exceeded $1 billion in 2009 (<A onclick="if (window.scroll_to_id) { scroll_to_id(event,'R8-103'); return false; }" onmouseover="window.status=this.title; return true;" onmouseout="window.status=''; return true;5d2de4f912d430b4083397}/ID(T1-103)" title=8 class=LK href="#R1-103" name=to-R1-103 xpath="/CT{06b9ee1beed59419fa2bedb37ace85f4ef50397bb3c2ea48f132154d6696ac7a5956c24d775d2de4f912d430b4083397}/ID(R8-103)" (Table 103.1 shows game and practice injury rates per 1,000 athlete exposures (AE) for both intercollegiate and high school softball with comparisons to baseball and women’s soccer, which usually has the highest injury rate for a female sport.
The intercollegiate injury data come from studies using the NCAA Injury Surveillance System (ISS) over a 16-year period (1988-1989 to 2003-2004) (5,12).
The high school injury data come from studies using High School RIO (Reporting Information Online; The Research Institute at Nationwide Children’s Hospital, Columbus, OH) during the 2005-2006 academic year (21).
NCAA Softball Epidemiology
Softball has the lowest game injury rate of NCAA female sports (8,15) and the fourth lowest practice injury rate (8).
A softball athlete is 1.6 times more likely to sustain an injury during a game than during a practindow.status=this.title; return true;” onmouseout=”window.status=”; return true;”>21).
Table 103.1 Practice/Game Injury Rate Comparisons
Sport
Game Injury Rate (per 1,000 AE)
15).
Only 22% of softball game and practice injuries result in more than 10 days lost from activity (15).
High School Softball Epidemiology
Softball has one of the lowest injury rates among high school sports, second to volleyball (12,18,21).
Softball injuries do not tend to be severe. In a study using injury data from North Carolina high schools, 77% of injuries resulted in less than 8 days lost from activity, whereas
only 7% resulted in more than 21 days lost (12). The High School RIO data revealed a similar trend, with almost 60% of all softball injuries resulting in less than 1 week lost from activity (21).
Table 103.1 Practice/Game Injury Rate Comparisons
Sport
Game Injury Rate (per 1,000 AE)
Practice Injury Rate (per 1,000 AE)
NCAA
Softball
4.3
2.7
Baseball
5.8
1.9
Women’s soccer
16.4
5.2
High school
Softball
1.78
0.79
Baseball
1.77
0.87
Women’s soccer
5.21
1.1
AE, athlete exposures.
High school softball injuries have one of the lowest rates of injuries that require surgery (0.57/10,000 AE) (20).
Practice
40.7
33.0
Game
32.3
33.1
Head/face/neck
Practice
22.4
9.6
Game
17.1
13.4
Trunk
Practice
1.9
1.9
Game
1.5
1.1
NCAA, NAtional Collegiate Athletic Association.
Knee internal derangement (games: 0.37 injuries/1,000 AE; practices: 0.14 injuries/1,000 AE) (15)
The NCAA ISS data revealed that head or neck injuries are more likely to occur during a game, but trunk or back injuries are more common during practice (<A onclick="if
Practice
35.0
40.8
Game
49.1
43.3
Upper extremity
Head/face/neck
Practice
22.4
9.6
Game
17.1
13.4
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