For parents of Little League players, at-bats can feel particularly fraught. Maybe the kid gets a hit. Maybe not. But the third option — maybe the kid gets beaned — is hard to put out of one’s mind. Baseball is, after all, basically the only parent-sanctioned activity in which a hard ballistic is hurled toward a helmeted but largely helpless child. And serious fans know that getting hit by a fastball can and sometimes does cause serious injuries. Fortunately, grave hit-by-pitch injuries in youth baseball are rare. Unfortunately, there are parts of the game that do warrant concern that parents often overlook.
“The fear is that you’re at the mercy of the pitcher,” explains Christopher Ahmad, the team physician of the New York Yankees. “The contest between the pitcher and the hitter is a unique aspect of baseball.” Ahmad recently wrote a book on baseball injuries and how to prevent them, with coauthor John Gallucci, professional trainer and medical coordinator for Major League Soccer.
When a batter does get pegged by a pitch, the greatest concern is, predictably, the head. Recent studies have shown that concussions in football and hockey can cause long-term cognitive decline. The good news is that batting helmets works and youth leagues (legitimate ones anyway) don’t operate without them so the risk is largely mitigated. “Helmets prevent the most catastrophic injuries,” Ahmad says. “In Yankee world, I’ve seen more than one player get hit by a pitch in the head. Helmets have actually cracked without players even having concussions.”
After head injuries, the most common injury caused by getting hit by a pitch is a hand fracture. “Your hand is on the bat, and hand bones fracture easily,” Ahmad says. “Almost every baseball player who makes it to the professionals, if he’s a hitter, he’s fractured his hand at some point.” Little leaguers may not throw the ball fast enough to cause regular hand fractures, Ahmad says, but hand injuries are certainly a hallmark of the Majors. The first year Ahmad worked with the Yankees, Mets pitcher Victor Zambrano hit Derek Jeter in the hand, fracturing one of his metacarpals. It’s clear from the footage that the break hurt, but Jeter was playing again fairly quickly. It was an injury, but his longterm health was never at risk.
Those types of injuries, the truly serious ones, generally only happen when a fastball hits a batter square in the chest or the back. “I don’t want to alarm parents,” Ahmad says. “But if you get hit in the chest by a ballistic object, like a baseball or a hockey puck, it could cause your heart to go into an arrhythmia.” The condition, known as commotio cordis, can be fatal. It requires immediate treatment with an automated external defibrillator, a portable device that detects heart problems and delivers an electric shock to restore normal rhythms.
“Parents shouldn’t be fearful; it’s extremely unusual,” Ahmad says. “But it’s a great idea to have an AED at every game.” Parents can ask if there is an AED handy at the field. The answer might be yes. They are mandated in some places, including New York City and Little League encourages coaches and parents to have them on hand.
Still, getting hit by a ball is neither the most common nor the greatest risk on the baseball diamond. Because although the pitcher may seem to be the aggressor, the kid standing on the mound is at far greater risk than the batter staring him down. Whereas the batter is prepared to be thrown at, pitchers aren’t necessarily prepared to have a ball hit at them. And the numbers are a bit concerning. Though Little League pitches seldom reach velocities greater than 60 miles per hour, a ball can come off an aluminum bat at greater than 100 mph. And the distance is shorter too. If a young pitcher is doing it right, the follow through brings him or her to the foot of the mound, closer to the plate than the release point, where the pitcher is likely off-balance and leaning towards home plate.
In 2006, a New Jersey teenager was killed by a line drive while pitching in a Little League game. He was hit in the chest and suffered an arrythmia. In the years since, Little League has been proactive about updating its bat standards. This year, the league adjusted standards again, taking a bit of pop out of the metal bats being used. That said, adjustments don’t eliminate the threat. It’s not absurd to think that at some point in the future pitchers will be asked to wear more safety equipment (some wear chest protectors, but there’s little reason to think these are effective).
“The batter has a helmet designed for getting hit,” Gallucci says. “The pitcher is wearing a baseball cap.”
That said, most sports injuries are not traumas. Parents may fear for their children when they stand (confident or quaking) in the batter’s box, but the real threat lies in how many times they stand there or, more to the point, how many times they throw a pitch. It’s not intuitive to focus on repetitive stress injuries, but those are the injuries most likely to hurt children — especially children who love to play — in lasting ways.
“We’re seeing these injuries at epidemic levels, because kids are playing through the pain,” Galluci says. “Besides concussion, the biggest issue in American youth sports right now is kids injuring their elbows and re-injuring them. We can stop that injury from happening through basic awareness.”
That’s important, but it’s also important that parents understand the nature of risk in a sports context — that they not miss the forest for all the kids running around in front of it. “When it comes to risk of fatality, I’d say the number one reason would be an allergy attack,” Ahmad says. “You get stung by a bee or have a peanut allergy. Baseball is all about Cracker Jack.”
Interested in Little League? Check out Fatherly’s complete guide to all things Little League and youth baseball related. We’ve got great coaching tips, funny stories about life in the dugout, and features about the past and future of one of America’s great athletic institutions.
This article was originally published on