Despite a significant risk of head injuries in baseball and softball, helmet use in those sports is low, a new review says.
“Our review demonstrates that traumatic brain injury in baseball and softball affects players of all levels and all positions,” said study lead author Dr. Michael Cusimano, a neurosurgeon at St. Michael’s Hospital in Toronto.
“Although the risk for traumatic brain injury is lower in baseball than other, high-contact sports like hockey and football, because the injuries can lead to very serious injuries like skull fractures and bleeding in the brain caused by balls or bats, it should be considered equally as serious and addressed in a way that reflects that,” he said in a hospital news release.
Cusimano and his colleagues reviewed 29 studies that included nearly 243,000 traumatic brain injuries sustained by baseball and softball players between 1982 and 2015. Playing levels extended from youth leagues all the way to Major League Baseball players.
While baseball and softball had the lowest rate of traumatic head injuries compared with 15 other sports, serious brain injuries occurred once in about every 2,000 games.
All formal baseball and softball leagues included in the studies required players to wear helmets. Five of the studies examined the use of protective equipment and found that only 7 percent of players who suffered traumatic brain injuries that required emergency department care were wearing helmets.
The study also found that traumatic brain injuries accounted for 6 percent of all injuries among youth baseball players and that concussions were among the top 10 injuries that caused players to miss games and the most common cause of catastrophic injury among professional baseball players.
Among younger children (ages 5 to 9), the most common cause of traumatic brain injury was being struck by the bat — 54 percent in boys and 61 percent in girls.
Among both older males and females (ages 10 and up), the most common cause of traumatic brain injury was being hit by a baseball.
In all age groups for both males and females, rates of traumatic brain injury were four times higher in games than in practices, according to the study.
The findings show the need for mandatory helmet use at all positions at all levels of youth baseball and softball, the researchers said.
“There is enough evidence to lead me to believe that if all players in all positions wore helmets, these severe injuries could be largely eliminated,” Cusimano said.
The study was published online Oct. 30 in the journal Frontiers in Neurology.
The American Academy of Family Physicians has more on traumatic brain injury.