Baseball

01 Overview

Baseball is a non-contact team sport played on an outdoor field using a bat and ball. The sport will make a comeback at the 2020 Summer Olympics in Tokyo. Baseball is governed locally by BC Baseball, and has a relatively low injury rate compared to other sports; common injuries include strains and sprains to the leg, knee, ankle, and shoulder, as well as concussion.

(see Section 04 - Prevention)
Athlete silhouette
View Common Injuries by clicking the blue dots on the silhouette

Hamstring and other upper leg strains are the most common injuries in baseball. Warm-up exercises can reduce the risk for these types of injury.

Although rare, facial injuries and concussions can occur in baseball.

Baseball is a leading cause of sports eye injuries and vision loss in North America.

Shoulder injuries, including strains, tears, and tendonitis, are common among baseball players—especially pitchers. Reduce your chances of sustaining a shoulder injury by tracking your pitches and participating in strength training.

Elbow injuries, including strains, tears, and tendonitis, are common in baseball players, especially pitchers.

Knee injuries are common among baseball players. These injuries can occur while running, sliding, or from an impact with the ground or another player.

Ankle are the second most injured body part among baseball players. The risk of ankle sprains can be reduced by using breakaway bases and doing regular warm-up exercises.

02 Injury Statistics

About half of all game injuries are caused by contact with something other than another player, such as the ground, a base, the ball, or a fence or wall. Sliding is responsible for 25% game injuries and approximately 40% of game injuries are caused by non-contact methods such as throwing or running. During games, the most common injuries are upper leg strains followed by ankle sprains, shoulder strains, knee injuries, and concussions. During practice, the most common injuries are shoulder strains followed by ankle sprains, upper leg strains, shoulder tendonitis, and lower back strains.

Youth
It is estimated that one-third of youth pitchers will have elbow or shoulder pain during a season due to pitching and throwing. This can be a sign of an overuse injury that may lead to long-term issues. Facial and head injuries are not common, but can be severe. One in 20 youth athletes will sustain a facial injury during a season, usually while at bat. Injuries to the lower extremities are relatively uncommon among youth baseball players.

University/College
At the university/college level, the batter, base runner, and pitcher sustain approximately 60% of all game injuries. Throwing and pitching injuries are common, accounting for 20% of all game injuries, followed by running injuries (19%), and sliding injuries (13%). Approximately 10% of all game injuries involve being hit by a batted ball, with the highest proportion of these injuries occurring to third basemen (24.7%), middle infielders (17.9%), and pitchers (13.9%). Over one-quarter of all severe injuries result from the pitcher being struck with a batted ball, involving the upper or lower extremities. A sliding injury occurs in 1 out of 50 games and is a main cause of injury resulting in more than 10 days of lost time from sport. Sliding usually results in ankle sprains but can cause partial or incomplete shoulder dislocations (subluxations) and fractures.

Curious about the research on injuries?

It is estimated that...

View Summary of Incidence Rates

03 Risk Factors

There is limited research on baseball injuries among females; the information presented is specific to males.

  • Age

    Younger baseball players are at a higher risk of suffering an injury from pitched or batted balls than older athletes. Older baseball players more commonly suffer injuries to the upper legs, hamstrings, knees, and ankles than younger athletes.

  • Shoulder Fitness

    Poor shoulder strength and flexibility increases the risk of shoulder injury, especially among pitchers.

  • Sliding

    Sliding-related injuries are common in college/university level baseball. There is a higher prevalence of injury from headfirst sliding as compared to feet first. Ankle and knee injuries caused by sliding are more frequent among older players.

  • Pitching

    Throwing too many pitches without adequate rest can dramatically increase the risk of shoulder or elbow injury. While the exact number of “safe pitches” is unknown, Baseball Canada has published age-based maximum pitch counts to address the risk of overuse injuries.

  • Ball Hardness

    The use of hard baseballs increases the risk of ball-related face and body injuries as compared to low-impact safety baseballs.

04 How can I prevent injury?

Some muscle soreness or joint pain is expected when increasing your level of physical activity. It is important to listen to your body for persistent or worsening pain, and to know when to rest. Learn more about how to prevent injuries in baseball.

  • Participant & Parent

    Talk to your coach or organization about the prevention strategies below and how they might be incorporated into training and policies.

    Equipment – Safety Balls

    Safety baseballs are about 15 to 20% the hardness of balls used by Major League Baseball. The use of safety baseballs is ideal for younger athletes in order to reduce the risk of injury.

    Note: Using safety baseballs with older age groups is less effective as these balls change shape easier at higher speeds. The change in shape may allow the ball to enter the eye socket deeper, which may cause serious injury. These balls are not recommended at the high school or university/college level.

    Equipment – Breakaway Bases

    It is recommended that high school and college/university aged athletes use breakaway bases.

    Throwing and Pitching

    Throwing with pain or when fatigued is the main cause of overuse shoulder injury in baseball. This can happen if throwing too many pitches in a game or season, or not taking time to rest in the off-season. Many young athletes play in multiple leagues and train year-round, increasing the occurrence of throwing-related injury to the elbow and shoulder.

    Reduce the risk of throwing-related injury:

    • Monitor fatigue and pain levels.
    • Never pitch or throw with pain.
    • Have no competitive baseball pitching for at least 3-4 months per year.
    • Avoid pitching on multiple teams with overlapping seasons.
    • Be aware of age-appropriate pitch counts.

    Strength Training and Neuromuscular Training Program

    Baseball is a throwing sport with a high risk of shoulder injury. Incorporating a shoulder injury prevention program into warm-up routines can increase control, flexibility, and coordination. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in injury. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    Learn more about exercises to help prevent ankle injuries.

    For more exercises, visit http://fittoplay.org/.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in injury.

    Click here to view video and poster.

    Managing Concussion

    While concussions are not the most common injury in baseball, it is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for players and parents to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Other Considerations (about this section)

    Equipment – Player Equipment
    All athletes should wear rubber spiked soles; male players should also wear a hard plastic cup.

    Catchers are recommended to use helmets, masks with throat guards, chest protectors, and shin guards.

    Batters should wear approved batting helmets with face guards to reduce the risk of head and face injury. Both metal or plastic face guards are equally effective.

    Pitchers and infielders are the top positions for being struck by a batted ball; the use of helmets with facial protection is recommended.

    Note: Chest protectors have not shown to be effective at preventing the rare occurrence of sudden death in baseball players.

    Equipment – Safety Balls
    The American Academy of Pediatrics recommends that:

    Throwing and Pitching
    The American Orthopaedic Society for Sports Medicine has recommendations on types of pitches by age.

    Know the rules governing pitch count provided by Baseball Canada.

    Pitching count apps are available, making it easy to track how many pitches (balls vs. strikes) a pitcher has thrown.

    Sport-related Physicals
    Baseball can be a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce the risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

    More Resources
    Learn more from Pitch Smart USA; SportMedBC’s article on Baseball Injuries; and the 2012 American Academy of Pediatrics Policy Statement on Baseball and Softball with 14 key recommendations.

  • Coach & Teacher

    Talk to your organization or school about the prevention strategies below and how they might be incorporated into training and policies.

    Equipment – Safety Balls

    Safety baseballs are about 15 to 20% the hardness of balls used by Major League Baseball. The use of safety baseballs is ideal for younger athletes in order to reduce the risk of injury.

    Note: Using safety baseballs with older age groups are less effective as these balls change shape easier at higher speeds. The change in shape may allow the ball to enter the eye socket deeper, which may cause serious injury. These balls are not recommended at the high school or university/college level.

    Equipment – Breakaway Bases

    It is recommended that high school and college/university aged athletes use breakaway bases. This simple change is inexpensive and does not alter game play.

    Throwing and Pitching

    Throwing with pain or fatigue is the main cause of overuse shoulder injury in baseball. This can happen if throwing too many pitches in a game or season, or not taking time to rest in the off-season. Many young athletes play in multiple leagues and train year-round, increasing the occurrence of throwing-related injury to the elbow and shoulder.

    Reduce the risk of throwing-related injury:

    • Monitor fatigue and pain levels. Never allow pitching or throwing with pain.
    • Ensure pitchers are adhering to pitch guidelines.
    • Have no competitive baseball pitching for at least 3-4 months per year.
    • Be aware of age-appropriate pitch counts.

    Strength Training and Neuromuscular Training Program

    Baseball is a throwing sport with a high risk of shoulder injury. Incorporating a shoulder injury prevention program into your warm-up routines can increase control, flexibility, and coordination. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder, knee, and ankle strong and reduce the risk of injury. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    Learn more about exercises to help prevent ankle injuries.

    For more exercises, visit http://fittoplay.org/.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Managing Concussion

    While concussions are not the most common injury in baseball, it is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for coaches and teachers to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Other Considerations (about this section)

    Coach Certification
    Courses are available to increase your development and expertise as a baseball coach/instructor. It is important to understand age appropriate skills for development among children and youth. For example, among youth, throwing curveballs increases the risk of shoulder pain by 52% and throwing sliders increases the risk by 86%. Staying informed and educated will help you and your athletes/students perform optimally.

    Baseball Canada and Baseball BC both provide information about the National Coaching Certification Program (NCCP).

    Facilities
    Make sure that the playing surface and surrounding area are clear of any obstacles, and that the diamond is level and groomed. The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing baseball in elementary schools.

    Learn more about implementing baseball in schools.

    Equipment – Player Equipment
    All athletes should wear rubber spiked soles; male players should also wear a hard plastic cup.

    Catchers are recommended to use helmets, masks with throat guards, chest protectors, and shin guards.

    Batters should wear approved batting helmets with face guards to reduce the risk of head and face injury. Both metal or plastic face guards are equally effective.

    Pitchers and infielders are the top positions for being struck by a batted ball; the use of helmets with facial protection is recommended.

    Note: Chest protectors have not shown to be effective at preventing the rare occurrence of sudden death in baseball players.

    Equipment – Safety Balls
    The American Academy of Pediatrics recommends that:

    Throwing and Pitching
    The American Orthopaedic Society for Sports Medicine has recommendations on types of pitches by age.

    Know the rules governing pitch count provided by Baseball Canada.

    Pitching count apps are available, making it easy to track how many pitches (balls vs. strikes) a pitcher has thrown.

    Sport-related Physicals
    Baseball can be a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce the risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

    More Resources
    Learn more from Pitch Smart USA; SportMedBC’s article on Baseball Injuries; and the 2012 American Academy of Pediatrics Policy Statement on Baseball and Softball with 14 key recommendations.

  • Official & Administrator

    Talk to your coaches, teachers, organization, or school about the prevention strategies below and how they might be incorporated into training and policies.

    Equipment – Safety Balls

    Safety baseballs are about 15 to 20% the hardness of balls used by Major League Baseball. The use of safety baseballs is ideal for younger athletes in order to reduce the risk of injury.

    Note: Using safety baseballs with older age groups is less effective as these balls change shape easier at higher speeds. The change in shape may allow the ball to enter the eye socket deeper, which may cause serious injury. These balls are not recommended at the high school or university/college level.

    Equipment – Breakaway Bases

    It is recommended that high school and college/university aged athletes use breakaway bases.

    Throwing and Pitching

    Throwing with pain or fatigue is the main cause of overuse shoulder injury in baseball. This can happen if throwing too many pitches in a game or season, or not taking time to rest in the off-season. Many young athletes play in multiple leagues and train year-round, increasing the occurrence of throwing-related injury to the elbow and shoulder.

    Reduce the risk of throwing-related injury:

    • Ensure that coaches adhere to the rules of baseball.
    • Ensure coaches are monitoring fatigue and pain levels.
    • Discourage pitching or throwing with pain.
    • Have no competitive baseball pitching for at least 3-4 months per year.
    • Be aware of age-appropriate pitch counts.
    • Share tools to simplify pitch counting

    Strength Training and Neuromuscular Training Program

    Baseball is a throwing sport with a high risk of shoulder injury. Encouraging your coaches and teachers to incorporate a shoulder injury prevention program into warm-up routines can increase control, flexibility, and coordination. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder, knee, and ankle strong and reduce the risk of injury. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    Learn more about exercises to help prevent ankle injuries.

    For more exercises, visit http://fittoplay.org/.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Managing Concussion

    While concussions are not the most common injury in baseball, it is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Other Considerations (about this section)

    Coach Certification
    Courses are available to increase your development and expertise as a baseball coach/instructor. It is important to understand age appropriate skills for development among children and youth. For example, among youth, throwing curveballs increases the risk of shoulder pain by 52% and throwing sliders increases the risk by 86%. Staying informed and educated will help you and your athletes/students perform optimally.

    Baseball Canada and Baseball BC both provide information about the National Coaching Certification Program (NCCP).

    Facilities
    Make sure that the playing surface and surrounding area are clear of any obstacles, and that the diamond is level and groomed. The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing baseball in elementary schools.

    Learn more about implementing baseball in schools.

    Equipment – Player Equipment
    All athletes should wear rubber spiked soles; male players should also wear a hard plastic cup.

    Catchers are recommended to use helmets, masks with throat guards, chest protectors, and shin guards.

    Batters should wear approved batting helmets with face guards to reduce the risk of head and face injury. Both metal or plastic face guards are equally effective.

    Pitchers and infielders are the top positions for being struck by a batted ball; the use of helmets with facial protection is recommended.

    Note: Chest protectors have not shown to be effective at preventing the rare occurrence of sudden death in baseball players.

    Equipment – Safety Balls
    The American Academy of Pediatrics recommends that:

    Throwing and Pitching
    The American Orthopaedic Society for Sports Medicine has recommendations on types of pitches by age.

    Know the rules governing pitch count provided by Baseball Canada.

    Pitching count apps are available, making it easy to track how many pitches (balls vs. strikes) a pitcher has thrown.

    Sport-related Physicals
    Baseball can be a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce the risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

    More Resources
    Learn more from Pitch Smart USA; SportMedBC’s article on Baseball Injuries; and the 2012 American Academy of Pediatrics Policy Statement on Baseball and Softball with 14 key recommendations.

  • Health Professional

    The role of health professionals in preventing baseball injuries has two main components:

    1. Providing ongoing education to players, parents, and coaches on effective injury prevention programs such as balance and resistance training; and
    2. Ensuring that injured players are completely healed and fit-to-perform before returning to baseball to prevent re-injury or chronic injury.

    Equipment – Safety Balls

    Safety baseballs are about 15 to 20% the hardness of balls used by Major League Baseball. The use of safety baseballs is ideal for younger athletes in order to reduce the risk of injury.

    Equipment – Breakaway Bases

    It is recommended that high school and college/university aged athletes use breakaway bases. This simple change is inexpensive and does not alter game play.

    Throwing and Pitching

    Throwing with pain or fatigue is the main cause of overuse shoulder injury in baseball. This can happen if throwing too many pitches in a game or season, or not taking time to rest in the off-season. Many young athletes play in multiple leagues and train year-round, increasing the occurrence of throwing-related injury to the elbow and shoulder.

    Reduce the risk of throwing-related injury:

    • Encourage adherence to the rules of baseball.
    • Encourage monitoring fatigue and pain levels.
    • Discourage pitching or throwing with pain.
    • Encourage players to have no competitive baseball pitching for at least 3-4 months per year.

    Strength Training and Neuromuscular Training Program

    Baseball is a throwing sport with a high risk of shoulder injury. Incorporating a shoulder injury prevention program into warm-up routines can increase control, flexibility, and coordination. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder, knee, and ankle strong and reduce the risk of injury. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent knee injuries.

    Learn more about exercises to help prevent ankle injuries.

    For more exercises, visit http://fittoplay.org/.

    Sport Injury Prevention Research Centre Neuromuscular Training
    The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.

    Click here to view video and poster.

    Managing Concussion

    While concussions are not the most common injury in baseball, it is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Other Considerations (about this section)

    Sport-related Physicals
    Baseball can be a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce the risk of injury. The American Academy of Pediatrics provides information about preparticipation physical evaluation.

    Learn more about Preparticipation Physical Evaluation.

    Equipment – Player Equipment
    All athletes should wear rubber spiked soles; male players should also wear a hard plastic cup.

    Catchers are recommended to use helmets, masks with throat guards, chest protectors, and shin guards.

    Batters should wear approved batting helmets with face guards to reduce the risk of head and face injury. Both metal or plastic face guards are equally effective.

    Pitchers and infielders are the top positions for being struck by a batted ball; the use of helmets with facial protection is recommended.

    Note: Chest protectors have not shown to be effective at preventing the rare occurrence of sudden death in baseball players.

    Equipment – Safety Balls
    The American Academy of Pediatrics recommends that:

    Throwing and Pitching
    The American Orthopaedic Society for Sports Medicine has recommendations on types of pitches by age.

    Know the rules governing pitch count provided by Baseball Canada.

    Pitching count apps are available, making it easy to track how many pitches (balls vs. strikes) a pitcher has thrown.