Epidemiological trends of elbow and forearm injuries in high school baseball and softball players

Abstract

Background

Elbow and forearm injuries are common in high school baseball and softball players. Given the trends in overuse and early sport specialization, it may be prudent to provide an updated review of the epidemiological data to aid injury prevention efforts.

Methods

Data regarding elbow and forearm injuries in high school baseball and softball players from the 2005-2006 through 2018-2019 seasons was extracted from the National High School Sports-Related Injury Surveillance Study.

Results

There were 518 total elbow and forearm injuries reported for 5,738,470 athletic exposures (AEs) yielding an overall injury rate of 0.90/10,000 AEs. Baseball had an increase of 0.044 elbow/forearm injury increase per 10,000 AEs per year (P = .04, 95% Confidence Interval: 0.03, 0.085) while softball did not have a significant change. Baseball had a significantly higher injury rate in competition than practice (Injury rate ratio = 2.29, 95% CI: 1.86, 2.83). While there was no significant difference in overall injury rate for baseball pitchers than nonpitchers, softball nonpitchers had a significantly greater injury rate than pitchers (Injury rate ratio = 0.25, 95%; CI: 0.15, 0.42).

Conclusion

This study found that overall forearm and elbow rate of injury has increased for baseball since the 2005-2006 season. There was no significant trend in softball. Softball nonpitchers had a higher rate of injury than pitchers, while there was no difference between positions in baseball. This trend and difference between sports and positions imply the importance of injury prevention efforts tailored to each athlete.