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A Pitch for Kid-Friendly Baseball

Precautions such as softer balls, face guards can reduce injuries

MONDAY, May 12, 2003 (HealthDayNews) -- As the pint-sized boys and girls of summer return to America's baseball diamonds this spring, parents and coaches need to know the national pastime isn't without risk.

More than 90,000 children 14 and under suffered baseball-related injuries requiring emergency room visits in 2001, the U.S. Consumer Product Safety Commission says. Those injuries ranged from fractures and concussions to sprains, bruises and strains. And children aged 10 to 14 suffered three-quarters of all the injuries, the agency says.

Now, a new study suggests many injuries could be prevented among the estimated 5 million kids playing organized baseball.

In what they call the largest study of its kind, researchers from the University of North Carolina reviewed injuries resulting in health insurance claims being paid during three Little League seasons, 1997 through 1999. About 2.5 million children played each season in Little League -- one of several organized leagues in the United States -- and the researchers found 4,233 compensated injury insurance claims among them.

They also found that use of softer balls decreased ball-related injuries by 23 percent, while face guards attached to helmets reduced facial injuries by 35 percent, says the study, published recently in the Journal of the American Medical Association.

To determine the effectiveness of softer "safety balls" and face guards, the UNC researchers compared injuries in leagues that did and did not use the safety equipment.

Stephen W. Marshall, principal author of the study, says he has no doubt more use of the safety balls and face guards would reduce injuries among young ballplayers.

"Anything we can do to give them the skills of the game and give them the experience of playing together as a team while minimizing the risk of injury makes a lot of sense," says Marshall, a UNC assistant professor of epidemiology and orthopedics.

Ball-related injuries -- batted or thrown by a player other than the pitcher -- totaled 1,890, or about 45 percent, of all injuries, the study says. The 183 facial injuries comprised only about 4 percent of the total.

Some parents, baseball purists perhaps, resist the safety ball, optional in Little League, because they believe it changes the nature of the game, Marshall says.

He says 63 leagues tried, then discontinued, use of one type of safety ball, the "reduced-impact" baseball, made with a polyurethane center rather than traditional cork and yarn. The switch back to traditional baseballs often came after complaints about the bounce of the reduced-impact balls, which the study says reduced injuries by 29 percent.

The UNC study, however, cites research showing that when the labels were removed, neither children nor adults could tell the difference between traditional baseballs and the softer balls.

"There's lots of feeling that the modified ball just isn't the real ball," Marshall says. "I'm surprised at how much resistance there is."

That may have something to do with big-league dreams among parents, Marshall suggests.

"It's a minority, but some people truly have a perception that their child is destined for the pros and needs to learn to play the right way," he says. "They've kind of lost sight of what it's about. They kind of think it's about winning and losing and making the big time."

Among the study's findings:

  • Safety balls proved most popular among the youngest players, in T-ball (ages 5 to 8), where 85 percent of leagues used the softer balls.
  • Use of the safety balls dropped sharply in older age groups, ranging from about 8 percent to 15 percent of leagues.
  • Face guards, made of clear plastic or wire mesh and attached to helmets, have been slow to gain acceptance. About 26 percent of T-ball leagues used them, but the proportion dropped to just under 16 percent among leagues with players 13 years old and older.
  • Risk of injury increased with the age groups of players, while use of the safety equipment decreased.

"T-ball is incredibly safe," Marshall says. "Most of the injuries occur above the T-ball leagues, and that's where the safe equipment is needed, absolutely. You know, they get off to a good start certainly with the safety balls in T-ball, but it needs to continue up into older age groups."

Little League Baseball, the governing body for many of the nation's youth programs, assisted with the research, and the group's risk-management director, Dan Kirby, co-authored the UNC study.

Little League Baseball says it plans to review the study and make it available to local league volunteers. Softer balls and face guards are optional in Little League, which accounts for about half of all players in organized youth baseball in America.

Dr. Robert Gotlin, director of orthopedic and sports rehabilitation at Beth Israel Medical Center in New York City, says he hopes the study will inspire more use of safety equipment.

"I have been an advocate pushing for these safety issues for a long time," says Gotlin, a member of the National Youth Safety Council who coaches teams in Rockland County, N.Y. "This study really hits home... and brings to the forefront something important."

The U.S. Consumer Product Safety Commission (CPSC) says the study's results are consistent with the agency's findings.

The CPSC estimates safety equipment -- softer balls and face guards as well as breakaway "safety bases" designed to reduce sliding injuries -- could decrease baseball-related emergency room visits by up to a third.

We're talking about children here," says Ken Giles, a CPSC spokesman. "We need to do what we can to reduce the risk for kids, and we know these safety devices are out there and they reduce the risk."

More information

For more on preventing baseball injuries, visit the Academy of Orthopaedic Surgeons or KidSource Online.

SOURCES: Stephen W. Marshall, assistant professor, epidemiology and orthopedics, University of North Carolina, Chapel Hill; Robert Gotlin, D.O., director, orthopedic and sports rehabilitation, Beth Israel Medical Center, New York City; Ken Giles, spokesman, U.S. Consumer Product Safety Commission, Washington, D.C.; Feb. 5, 2003, Journal of the American Medical Association
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