July 2, 2005
Baseball Catchers Face Irreversible Hand Trauma
Study finds force of pitches can damage nerves, blood vessels
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.
In their study, published in the July issue of the Journal of Bone & Joint Surgery, Koman and his colleagues examined the hands of 36 pro baseball players currently active with A-level minor league teams in the Greensboro, N.C.- based Carolina League. The study included nine catchers, seven infielders, five outfielders and 15 pitchers.
In the past, Koman said, the real threat for catchers was "clots in the big artery in the palm." But this study showed that newer, better-padded gloves "appear to be protecting that relatively well," he said.
Signs of hand trauma were still common, however. Overall, 11 of the players (36 percent) reported hand symptoms such as pain, numbness, weakness or tingling, the researchers said. Catchers were by far the most likely to suffer symptoms, with 44 percent reporting weakness in the gloved hand vs. in the throwing hand. In contrast, just 7 percent of pitchers and 17 percent of infielders/outfielders reported hand weakness.
Then the study threw the researchers a real curve ball.
"What we found were changes in the index finger, which [in catchers] was larger, and showed symptoms consistent with repetitive trauma," Koman said. The finding came as a surprise, he said, since the researchers had expected trauma would be focused in the palm, not the fingers.
Many of the catchers complained of weakness, tingling or pain in the index finger, especially during games, although some "resting" symptoms were reported as well. Index fingers were also often found to be significantly enlarged, another sign of chronic damage to circulation and nerves.
"What's interesting -- and what we don't really have an answer to -- is that many baseball players will place their index finger outside the glove," Koman noted. "There's this strap where they put it -- is that causing the damage?" No one is sure why catchers adopt this 'index-outside' style, he said. "It may have evolved to protect the index finger, but it might actually put it at risk," he speculated.
Koman stressed that none of these injuries seemed to hamper young ball players in terms of their ability to play the game. "They have symptoms, but it's not career-limiting," he said. "This type of injury will more likely show up as stiffness and cold sensitivity, arthritis in middle-age."
Most pro players take these types of chronic injuries in stride, he said, seeing it as the price they pay for doing what they love. "The cost-benefit of this compared to what they want to do with their lives is pretty reasonable," Koman said.
Dr. Terry Light, professor of orthopedic surgery at Loyola University Health System in Maywood, Ill., agreed. "Anyone who's doing this professionally will tell you they'll keep on playing till their finger practically falls off," he said.
But Light also stressed that most of the pro athletes he has worked with are smart when it comes to protecting themselves.
"I took care of the White Sox team here in Chicago -- specifically, their hand injuries -- for almost 20 years," he said. "Professional ball players are pretty good at avoiding the kinds of hand injuries that regular folk might get from just playing at a company picnic."
That doesn't mean catchers couldn't use a little extra protection behind the plate, however.
"I would hope that this study will help provide some impetus to look at what's involved with the index finger and find ways to help catchers protect themselves -- while still letting them play baseball," Koman said.
For more info on baseball-related finger injuries, head to the American Academy of Orthopaedic Surgeons.