David H. Janda, M.D., Fred M. Hankin, M.D. and Edward M. Woitys,
Section of Orthopedic Surgery, University of Michigan Medical School,
Ann Arbor, Michigan
An estimated 40 million Americans, from children to senior citizens,
participate in organized softball leagues. Unfortunately, many who play the
sport are out of shape and prone to injury. Although data on softball-related
injuries have not been collected nationwide, it is obvious that injuries are
Causes of Injuries
Base running and sliding probably account for the majority of significant
injuries that occur in softball players. We conducted a retrospective review of
community and hospital records to identify the causes and types of injury
occurring among the thousands of league participants in Ann Arbor, Mich. The
data revealed that sliding was by far the most common cause of injury (Table 1).
Base sliding injuries result from several mechanisms. The shearing force of
the infield surface against the skin can result in full- or partial-thickness
burns of the skin. The upper and lower extremities, the chest and the buttocks
are most vulnerable to this type of injury. The rapid deceleration that occurs
with sliding into a base can result in contusions, fractures, sprains or
ligamentous injuries of the foot or hand. Twisting of the flexed knee while
sliding can produce meniscal and ligament derangements, patellar subluxations
and osteochondral fractures.
Softball Injuries Reported in 1983
Mechanism Type of injury 1983 1984
Sliding Ankle fracture 2 3
Sliding Ankle dislocation 1 1
Sliding Ankle sprain 3 7
Sliding Knee sprain 4 3
Sliding Finger dislocation 3 4
Sliding Shoulder dislocation 0 1
Sliding Lacerations/abrasions 6 4
Sliding Closed head injury 1 4
Sliding Wrist sprain 3 2
Collision Finger dislocation 6 2
Collision Lacerations/abrasions 3 1
Fall Knee sprain 4 3
Fall Ankle sprain 2 0
Total 38 35
*-Figures are based on a review of hospital records in Ann Arbor, Mich.
Costs of Injuries
Although severe injuries from base sliding, such as ankle fractures or
scapholunate ligament dissociations, occur in frequently, the costs of medical
treatment can be staggering. Even a minor injury such as an ankle sprain can add
up to substantial costs. If a fracture is sustained and surgery is required, the
cost can escalate 20-fold. The estimated average cost of an ankle sprain is
$250, but if hospitalization and operative intervention are required for a
fracture dislocation, the cost can easily exceed $5,000. The average time lost
from work following internal fixation of an ankle fracture is 10 days, but for
certain jobs, it may be necessary for the employee to take sick leave for two to
three months. Thus, even if company-paid insurance premiums are excluded, the
costs to the employer can be significant.
Suggested ways to reduce the number of injuries occurring in softball players
include the abolition of sliding, better instruction on sliding techniques and
the use of quick-release bases. Another, more viable option would be to have
recessed bases for all bases rather than only for home plate.
The rule book of the Amateur Softball Association of America states that
bases may be up to five inches in height, although the bags used in organized
softball leagues are usually two to four inches above the surface. Bases such as
these, secured to the ground, serve as an unyielding barrier for the impact of
the player's foot or hand.
The use of bases that are flush with the infield surface would eliminate this
potential source of injuries (Figure 1). If the base is
of a high-contrast color, such as red or orange, a single umpire could still
call a game with relative ease. These low profile rubber bases cost between $7
and $18, compared with $12 to $15 for a standard cloth bag.
Traditionalists, whose efforts have been directed against the use of aluminum
bats, may also oppose a change to recessed bases. However, safety factors must
be considered, and the use of low-profile bases as standard equipment on
softball diamonds would undoubtedly reduce the number of injuries occurring
among soft ball players.
FIGURE 1. Low profile base as compared to a standard
- Amateur Softball Association of America official rule book. Oklahoma City,
Okla.: ASA, 1982.
- Conatt RD, Groppel JL, Pfautsch E, Bosclrdin J. The biomechanics of
head-first versus feet-first sliding. Am J Sports Med 1984;12(3):229-32.
- Wheeler BR. Slow-pitch softball injuries. Am J Sports Med
This article was published as:
Injuries: Cost, Cause and Prevention"
Vol. 33, No. 6, 1986; pp. 143-144
Janda DH, Hankin FM,
It is possible to order a copy of this article.