Steubs, John A.

Purpose To characterize the shoulder injuries experienced by baseball batters and position players (nonpitchers); to quantify the outcomes of these injuries with respect to time out of play, recurrence, and surgery rates; and to identify any injury patterns that are associated with worse outcomes. Methods Between 2011 and 2017, all Major League Baseball (MLB) and Minor League Baseball (MiLB) players who sustained shoulder injuries were identified using the MLB Health and Injury Tracking System (HITS). Injuries were included if they were sustained during baseball activity, resulted in at least 1 day missed (DM), and occurred in position players (nonpitchers). Results Over the study period, a total of 3,414 shoulder injuries occurred in batters, resulting in a sum of 68,808 DM and a mean of 22 DM per injury. Most injuries were a result of acute trauma (n = 2125; 62.2%) with throwing as the predominant activity (n = 1292; 38%). Rotator cuff strain/tears was the most common diagnosis (n = 790; 23.1%), and SLAP tears had the highest season‐ending rate (35.3%) and need for surgery (45.1%). There was a lower frequency of surgery (6.2% vs 9.2%; P = .002) and reinjury (2.03% vs 3.62%; P = .007) in the throwing shoulder vs the nonthrowing shoulder. There was an increased frequency of surgery for the front versus the back batting shoulder (8.2% vs 6.2%; P = .031) with similar DM (20.7 vs 22.2; P = .333) and return to play rates (94.0% vs 92.2%; P = .135). Conclusions During the 7‐season study period, there were a total of 3,414 shoulder injuries that resulted in nearly 70,000 days of out of play in professional baseball position players/batters (nonpitchers). Although pitchers were intentionally excluded from the analysis, throwing was still the most common mechanism of injury, and rotator cuff injuries were the most common injury. Labral tears were the most likely injury to be season ending and require surgery. Clinical Relevance This study is meant to help determine characteristics of shoulder injuries that occur in non‐pitchers by focusing on professional baseball batters and position players. This information could be helpful to sports medicine practitioners and shoulder specialists to better prognosticate injury recovery.

Background: Basic pitcher statistics have been used to assess performance in pitchers after injury or surgery without being validated. Even among healthy pitchers, the normal variability of these parameters has not yet been established. Purpose: To determine (1) the normal variability of basic and advanced pitcher statistics in healthy professional baseball pitchers and (2) the minimum pitches needed to predict these parameters. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Publicly available data from the MLB Statcast and PITCHf/x databases were used to analyze MLB pitchers during the 2015 and 2016 seasons who recorded a minimum of 100 innings without injury. Basic and advanced baseball pitcher statistics were analyzed. The variability of each parameter was assessed by computing the coefficient of variation (CV) between individual pitchers and across all pitchers. A CV <10 was indicative of a relatively constant parameter, and parameters with a CV >10 were generally considered inconsistent and unreliable. The minimum number of pitches needed to be followed for each variable was also analyzed. Results: A total of 118 pitchers, 55 baseball-specific statistical metrics (38 basic and 17 advanced), and 7.5 million pitches were included and analyzed. Of the 38 basic pitcher statistics, only fastball velocity demonstrated a CV <10 (CV = 1.5), while 6 of 17 (35%) advanced metrics demonstrated acceptable consistency (CV <10). Release position from plate and velocity from the plate were the 2 most consistent advanced parameters. When separated by pitch type, these 2 parameters were the most constant (lowest CV) across every pitch type. Conclusion: We recommend against utilizing nonvalidated statistical measures to assess performance after injury, as they demonstrated unacceptably high variability even among healthy, noninjured professional baseball pitchers. It is our hope that this study will serve as the foundation for the identification and implementation of validated pitcher-dependent statistical measures that can be used to assess return-to-play performance after injury in the future.