UF Health study: Many caregivers unaware of fastpitch softball safety guidelines

Most fastpitch softball injuries occur in the shoulder. (Getty Images)

Press release from UF Health

BY BILL LEVESQUE

GAINESVILLE, Fla. — Most parents or caregivers of fastpitch softball players are unaware of recommendations to avoid pitcher overuse in a youth sport growing in popularity — and arm injuries, a study by University of Florida College of Medicine researchers shows.

In fact, a survey of caregivers in North Central Florida indicated that 85% did not know safety recommendations existed at all, the study said.

Yet, on an encouraging note, most caregivers surveyed said they would adhere to recommendations if guidelines were made available to them, the study said. Unfortunately, researchers said, no universal regulations exist in leagues and tournaments.

The findings, published in the Orthopaedics Journal of Sports Medicine, echo what the same researchers previously found in overhand youth baseball, where pitch counts have revolutionized player usage at virtually every level of the game.

“The overuse pitching injuries are different in fastpitch softball than in overhand baseball, with less stress on the elbow and more shoulder injuries,” said Kevin W. Farmer, M.D., a UF Health orthopaedic surgeon specializing in sports medicine and a team physician for the UF Athletic Association.

Pitchers use an underhand, 360-degree windmill-style arm motion in fastpitch softball to throw the ball, with the arm moving at high speed upon release.

Common injuries include tendinitis, torn rotator cuffs, and shoulder labrum tears.

“It takes studies like this one to reveal an issue,” he added. “But it’s something we can address.”

Between 2005 and 2010, emergency rooms saw a nearly 12% increase in softball-related injuries in those ages 7 and older, with half of those injuries directly influenced by pitching, the study said.

Fastpitch softball pitchers are particularly susceptible to overuse injuries. They tend to play a great deal, Farmer said, often in back-to-back games. In some cases, softball players can throw up to 1,500 pitches in a three-day tournament, far beyond recommended usage.

“We have pretty strict criteria for overhand baseball pitchers because of research involving their injuries,” Farmer said. “With softball players, a team might use one pitcher, and that’s all they have. And the team uses the player every game, day in and day out.”

A total of 115 caregivers of youth softball pitchers in North Central Florida completed a survey for the study. Their estimates on pitch-count recommendations varied widely, which Farmer said is disheartening given the outsized role caregivers play in their athlete’s development and health.

About 93% of caregivers said they would adhere to guidelines if they knew what they were, with half the respondents saying their athlete suffered arm pain from pitching.

The American Orthopaedic Society for Sports Medicine recommends, depending on the age group, between 50 and 100 pitches per game, with two or three days of rest between outings.

Study lead author Sravya Kamarajugadda, a UF medical student, said no universal pitch count or rest standards exist in softball. Often, parents track pitch counts themselves, she said.

“When allowed to select more than one option, about half of the caregivers said either a caregiver and/or the coach did track the pitch counts,” Kamarajugadda said. “But a quarter of them didn’t know if anyone tracked the pitches at all.”

UF Health physical therapist Giorgio Zeppieri, a study co-author and a team physical therapist for the UF Athletic Association, said there hasn’t been as strong a push to limit pitcher overuse injuries in softball compared with baseball.

“Softball injuries don’t get the sort of press that baseball injuries do because injuries in softball are not as catastrophic, with less playing time lost,” he said.

Farmer said he hopes the study will raise awareness of the problem.

“We want these athletes to enjoy the sport they love while reducing their injury risk,” he said.

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