Softball is one of the most popular recreational and competitive sports in the United States. It also has high participation levels in over 100 other countries across the world. In the U.S. alone, it’s estimated that over 40 million children, adults, and seniors participate in at least one softball game each year. While softball isn’t typically viewed as a dangerous sport, the potential for contact and the long hours spent honing skills can produce an array of injuries.
How Do Softball Injuries Occur?
According to the National Electronic Injury Surveillance System, there were 118,354 softball-related injuries in 2001. Softball is considered a limited-contact sport, meaning that player-to-player contact is possible during play, but substantial contact is disallowed by the rules of the game. Such contact in softball can occur as a player approaches a manned base, two players are fielding a ball, or a bat swings out of a player‘s hand and strikes another player.
Generally, softball injuries can be divided into two categories - traumatic injuries and overuse injuries. Traumatic injuries occur from a single incident, such as two softball players colliding, a player being stuck by the softball, or a player twisting their ankle while fielding.
Running, hitting, throwing, catching, and sliding are just a few of the motions players repetitively perform during practice and play. Overuse injuries are the cumulative effects of repetitive motions that stress the muscles, joints, ligaments, tendons, and other soft tissue structures. Overuse injuries are common when a player suddenly changes the frequency, duration, or intensity of their softball activities.
What Are Some Common Softball Injuries?
Ankle Sprains
An ankle sprain, also called a twisted ankle, is a common occurrence in running sports, especially those that involve running on uneven surfaces, sudden changes in direction, and quick side-to-side movements. The injury occurs when the foot is turned, twisted, or rolled over past its normal range of motion. This overstretches and tears one or more of the ligaments holding the ankle joint and bones in place.
There are three types of ankle sprains:
1. Inversion sprain - the anterior talofibular ligament is injured when the ankle rolls toward the outside of the foot. This type of sprain accounts for around 90% of all ankle sprains.
2. Eversion sprain - the medial ligament is injured when the ankle rolls toward the inside of the foot.
3. High ankle sprain - the syndesmosis ligaments, which are located just above the ankle joint, are injured when the foot and lower leg are outwardly twisted.
All ankle sprains are graded based on the degree of stretching or tearing that occurs:
Grade I - a mild sprain that involves the ligament fibers being stretched or microscopically torn. The ankle joint continues to function as normal.
Grade II - a moderate amount of ligament fibers are torn. The ankle joint feels lax and weak.
Grade III - a significant amount of ligament fibers are torn. The ankle is extremely unstable.
Rotator Cuff Injuries
The rotator cuff is comprised of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. The tendons attached to these muscles are also considered part of the rotator cuff. The cuff of muscles and tendons form a cover around the head of the humerus bone. When the muscles are contracted, they pull upon the tendons and cause the arm to rotate upward, outward, or inward.
The cuff is highly involved in any type of throwing motion, thereby making it a common site of injury in slow and fast-pitch softball. Most rotator cuff injuries in softball occur from overuse, as the musculotendinous unit becomes irritated from the repetitive overhead throwing motions essential to playing softball.
The irritation may cause the rotator cuff tendons to become inflamed, a condition called rotator cuff tendinitis. The softball player may feel a dull pain along the top and front of the shoulder that’s aggravated by overhead motions and find side lying positions painful. As the irritation continues over time, the tendons may degenerate on a cellular level, a condition termed tendinosis.
A strain is another injury to the rotator cuff. This injury occurs when one or more of the rotator cuff muscles and/or tendons become stretched or torn. The supraspinatus tendon is the most commonly strained.
Strains are graded based on the degree of injury to the musculotendinous fibers as follows:
Grade I - mild stretching to microscopic tearing of the musculotendinous fibers. The shoulder joint remains stable and functioning.
Grade II - moderate tearing of the musculotendinous fibers that causes mild to moderate joint instability and range of motion limitations. Moderate localized swelling, pain, heat, and bruising may also be present.
Grade III - significant to complete tearing of the musculotendinous fibers. Joint mobility and stability is significantly compromised. Significant localized swelling, pain, heat, and bruising is usually present.
Mallet Finger
Mallet finger, also called baseball finger or dropped finger, is technically a sprain that occurs near the distal interphalangeal joint (DIP). This is the knuckle joint closest to the fingernail. It occurs when the extensor digitorum tendon is hyper-flexed and stretched or torn. The sprain commonly occurs when a softball strikes the tip of a finger and bends it past it’s normal range of motion. The finger may be swollen, red, warm, painful, stiff, and tender near the DIP joint. It may also be difficult to fully extend the affected finger. Keep in mind that such a force may also cause a finger fracture.
