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Is Sports Medicine Striking Out? The Rise of Injuries in Major League Baseball

Posted on: 10/30/2001
From a spectator standpoint, baseball may have lost some of its luster. But it still has more participants than any other sport in the United States. Given the wide popularity of the sport, these authors wanted to examine trends in baseball injuries. They looked to Major League Baseball, where sports medicine is most advanced.

In Major League Baseball, statistics are as much a part of the game as bats and gloves. One statistic kept by every team is the "disabled list." This is a list of athletes who are unable to play due to an injury that's been certified by the team physician. Once a player is on the list, he cannot play for at least 15 days. His injury may keep him on the list--and out of the game--a lot longer. In the meantime, the coach can temporarily replace the injured player to keep 25 active players on the team roster.

The authors looked at disabled lists from 1989 to 1999. They expected that improvements in sports medicine and training would result in fewer baseball injuries over time.

The opposite was true. The number of players on the disabled list actually grew over the 11-year period. When the authors compared the first three years to the last three years, they found that the number of injuries had shot up 40 percent. This increase could only be partially explained by the fact that more teams (and thus more players) had joined the league.

In addition, the number of days players spent on the disabled list went up 53 percent. This increase could not be accounted for by new medical tools that allow doctors to find previously undetected injuries. The new injuries in pitchers tended to be major, resulting in about 55 missed days per injury.

Of all the positions, pitchers were injured the most, accounting for about half of the reported injuries. They also accounted for over half of the total time lost to injuries. Over the 11-year period, both the number of pitchers injured and the number of days their injuries kept them from the game went up. This was true for both starting and relief pitchers. Third basemen also saw a rise in injuries.

Shoulder injuries most often kept players out of the game, followed by elbow injuries. Only elbow injuries showed a consistent increase over the study period.

The authors could not explain why injuries have increased in Major League Baseball. It's possible that sports medicine is not serving athletes as well as expected. It's also possible that sports medicine has managed to control certain kinds of injuries while other types of injuries are still on the rise. Whatever the reason, this is a trend that deserves further attention.

References:
Stan Conte, PT, ATC, et al. Disability Days in Major League Baseball. In The American Journal of Sports Medicine. July/August 2001. Vol. 29. No. 4. Pp. 431-436.

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