Pain on the Diamond – Common Baseball/Softball Hand Injuries

Baseball season is in full swing! And with it comes a host of game-related injuries. Whether a player is swinging hard at a fast ball, or sliding into second base, hand and wrist injuries are common and vary in severity.

According to a recent study conducted by the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS), more 231,000 baseball injuries are treated annually with 83 percent of those injuries among males. Among those injuries, the most common are broken and/or dislocated fingers and wrist bone fractures. The average number of injuries per year in softball is 63,795, which means the sport produces the seventh most injuries out of 33 sports analyzed. The highest incidence of softball injuries occurs in female players between 13-17 years old.

With so many bones, ligaments, tendons, and joints keeping hands and wrists working, there is ample opportunity for severe injury when playing baseball or softball. The most common sports-related hand and wrist injuries can be classified into two main categories, traumatic (acute) and overuse (chronic).

Traumatic (acute) refers to any specific, sharp pain that is of rapid onset or pain that results from an incident such as an athletic injury. The most common traumatic injury in the baseball/softball population is found in the fingers and includes joint dislocations, sprains, muscle strains, broken bones, tendon inflammation, and ligament tears.

Some common traumatic injuries in baseball or softball are:

A Hamate hook fracture occurs in the hamate bone in the wrist, and is common in racket and club sports such as baseball. When a player is at bat, during the follow-through on the swing, the butt end of the bat handle can strike the hamate hook and shear it off. A prompt surgical excision may be necessary to repair the damage.

Mallet injuries, including tendon injuries and fractures, are also common. They can occur when the ball hits the tip of the finger, causing the tip of the finger to buckle down. Where the ball impacts the finger, there can be a chip fracture at the top of that joint attached to the tendon. If a player does experience a mallet injury, the majority of the time they are treated with splints — only occasionally do they require surgery.

A Scaphoid fracture in a baseball player can affect hitting, throwing, and training. This injury usually results from a fall on the outstretched hand in a game or during practice. Although the pain is often too severe to permit hitting or throwing, the pain is more subtle at times and manifests as weakness with all baseball activities. One player had pain only while swinging in the batter's box but not at the plate. These fractures may be extremely hard to find on an x-ray; and may need an MRI or CT scan to diagnose.

Distal phalanx fractures are more common than proximal and middle phalanx fractures due to their more vulnerable position at the tips of the fingers. Common occurrences, such as a ground ball hitting the tip of a finger or sliding into base, can cause distal phalanx fractures.

Additional injuries can occur when runners slide into a stationary base with their fingers extended out, or when outfielders collide with an outfield wall or fence, causing hand and wrist injuries.

Overuse (chronic) injuries are more likely to occur in baseball and softball athletes because their sport requires repeating a particular movement. Overuse injuries are likely to be stress induced and include tendon inflammation and dislocation, nerve injury, and overuse stress fractures. Chronic injuries have a higher tendency to develop long-term effects. However, long-term disability is less likely to occur from overuse injuries than from traumatic injuries. An athlete’s performance may significantly diminish, if the chronic injuries are left untreated. Surgery may be required if the overuse chronic injuries persists and continues to develop over time.

While many injuries are impact-related, there are some prevention methods a player can take to help reduce injuries. Batting gloves designed with anatomical relief zones in the finger flexion creases, lead to no extra muscle work for the forearms and hands when gripping a bat. For catchers, these gloves offer pressure relief pads in high impact zones, helping to not only prevent, but rehab injuries as well.

Athletic hand and wrist injuries can cause great pain and strain both physically and emotionally. Should you experience a hand or wrist injury while participating in any physical sport where an attending team physician is not present, seek immediate medical attention. It is important to be aware of what the immediate symptoms include, yet not limited to the following: