Softball-related head and facial injuries in the United States

Red Spot Highlighted on Brain Scan

Softball is a popular pastime in the United States, where 10 to 12 million people partake in the sport each year. However, due to the fast-paced, high-energy nature of the activity, athletes who play softball are at risk of sustaining traumatic brain injury (TBI) and other injuries to the head and face, which can result in disability or even death. Although protective headgear can reduce the frequency and severity of TBI, rules mandating headgear use are inconsistent, leaving some players vulnerable to head injury. Moreover, research on TBI among athletes has historically focused on more widely played sports such as football and baseball, creating significant gaps in knowledge about mechanisms and outcomes of TBI among softball players.

A recent study in Florida sought to address this gap by conducting a review of head and facial injuries sustained by softball players between 2013 and 2017. Researchers used the National Electronic Injury Surveillance System (NEISS) to collect data from individuals who visited the emergency department for softball-related head or facial injuries. They identified 3,324 such injuries that occurred in this five-year timespan, and the NEISS algorithm used this figure to calculate that the annual incidence of softball-related injuries is about 121,802 per year. The researchers also found that:

  • Most players who sustained head and face injuries were female (72.1%).
  • TBI and other head injuries, including lacerations and internal brain bleeding, were the most common diagnoses. About one-fifth of these injuries were considered severe.
  • Three-quarters of the injuries were caused when a ball struck the head. The second most common cause was collision with another player, which accounted for 8.3% of injuries. The majority of players who were struck by a ball were playing defensive positions.
  • Female players were more likely to wear helmets than male players.

Head and facial injuries are prevalent among softball players, some of whom may experience long-term physical, neurological, and cognitive deficits as a result of TBI. The results of this study suggest that defensive players are at particular risk of sustaining strikes from a softball, which can reach speeds up to 99 miles per hour. Because direct ball strikes are the most common mechanism of TBI among softball players, there is a need for tighter and more consistent regulation of headgear for players, particularly those who play defensive positions.

Strickland JS, Crandall M, & Bevill GR. A retrospective analysis of softball-related head and facial injuries treated in United States emergency departments, 2013-2017. The Orthopaedic Journal of Sports Medicine. (2019).