Traumatic brain injuries in baseball and softball are down, but they were not really all that high to begin with, and that may be why there is poor compliance overall with helmet use and return-to-play guidelines following concerns about a concussion.

A Frontiers in Neurology review looked at 29 studies which collectively identified 242,731 baseball-and-softball related traumatic brain injuries sustained between 1982 and 2015. As you might expect, baseball and softball had low rates of traumatic head injuries. What may be a surprise is that they were lower than 15 other sports. Injuries occurred once in about every 2,000 games.

And the lack of risk may be why the review found that in the five studies that examined the use of protective equipment during head injuries that required a visit to an emergency department, players were wearing helmets only 7 percent the time. Concussions were also among the top 10 injuries that caused players to miss games, and the most common cause of catastrophic injury in professional baseball, according to the review. 


Other key findings, according to the authors, include: 

Among younger players, the most common mechanism of injury was being struck by a bat. For children ages 5-9, being hit by a bat accounted for 54 per cent of traumatic brain injuries in boys and 61 per cent in girls.

Among older players (ages 10-19 and beyond), the most common mechanism of injury was being struck by the baseball for both male and female players

Across all ages and for both male and female players, rates of traumatic brain injury were four times higher in games than in practices

Despite the lack of risk, the authors are calling for mandatory helmet use at all positions at all levels of youth baseball and softball.