Baseball Catchers Face Irreversible Hand Trauma

In a typical pro baseball game, a minor or major league catcher stops about 150 pitches, many slamming into his glove at speeds well over 90 mph. Add in pre-game practice throws, and the total number of catches climbs as high as 300 a day, experts say.

Now, a new study finds that despite recent improvements in glove design, that kind of repetitive pounding is causing long-term, irreversible damage to many catchers’ hands — especially their index fingers.

“We think that the repetitive impact over time causes scarring around the digital nerves and arteries, and some of the microvessels,” said study co-author Dr. Andrew Koman, a professor of orthopedic surgery at Wake Forest University School of Medicine.

While these injuries may not be career-limiting, they will have an impact on hand function and sensation as the catcher ages, Koman said.

Gloves currently used by professional catchers do not adequately protect the hand from repetitive trauma says a study published in The Journal of Bone and Joint Surgery (American). 2005;87:1464-1469.

Background: Repetitive trauma to the hand is a concern for baseball players. The present study investigated the effects of repetitive trauma and the prevalence of microvascular pathological changes in the hands of minor league professional baseball players. In contrast to previous investigators, we documented the presence of abnormalities in younger, asymptomatic individuals.

Methods: Thirty-six baseball players on active minor league rosters underwent a history and physical examination of both hands as well as additional specialized tests, including Doppler ultrasound, a timed Allen test, determination of digital brachial pressure indices, and ring sizing of fingers. Data were compared between gloved hands and throwing hands, hitters and nonhitters, and players at four different positions (catcher [nine subjects], outfielder [seven subjects], infielder [five subjects], and pitcher [fifteen subjects]).

Results: Digital brachial indices in the ring fingers of the gloved (p < 0.05) and throwing hands (p < 0.02) of catchers were significantly diminished compared with those in all other players. Doppler testing showed a significantly greater prevalence of abnormal flow in the ulnar artery at Guyon's canal when catchers were compared with other position players (p < 0.01). Doppler abnormalities were significantly more common in the gloved hand compared with the throwing hand (p < 0.05). Seven of nine catchers (and only catchers) were found to have index finger hypertrophy (average change, two ring sizes; p < 0.01); the hypertrophy occurred at the proximal phalanx and the proximal interphalangeal joint of the gloved hand. Catchers had a significantly higher prevalence of subjective hand symptoms (specifically, weakness in the gloved hand) compared with pitchers and infielders/outfielders (44% compared with 7% and 17%, respectively; p < 0.05). Conclusions: Microvascular changes are present in the hands of otherwise healthy professional baseball players in all positions, with a significantly higher prevalence in catchers, prior to the development of clinically important ischemia. Repetitive trauma resulting from the impact of the baseball also leads to digital hypertrophy in the index finger of the gloved hand of catchers.

Flap’s son is a baseball catcher and although not a professional has caught a good number of innings (over multiple seasons), since the age of 8 (he is 19 now and plays American Legion ball). His gloved hand is often bruised and his index finger is usually exposed outside his glove.

Technology needs to develop padding or glove material that is flexible enough to be used in a one handed catching environment.

Hat Tip: Medgadget