I recently had the pleasure of talking with Mike Oliver, the Executive Director for NOCSAE, and Dr. Gary Green, the Medical Director for Major League Baseball, for a book I am writing. I reached out to Dr. Green to discuss safety efforts in baseball and to Mr. Oliver to better understand helmets and other protective equipment in sports. After the injury I describe below, I wanted to include their thoughts in my latest newspaper column. I expect more attention will be focused on protective equipment to protect baseball pitchers in the coming months and years.

A scary event last night at Yankee Stadium will undoubtedly renew calls for baseball to find better ways to protect pitchers.

Yankees pitcher hit by line drive

A line drive rocketing off the bat of Minnesota Twins’ shortstop Eduardo Nunez struck New York Yankees rookie pitcher Bryan Mitchell in the face. The ball knocked off the right-hander’s cap, and Mitchell fell to the ground. Seconds later he rose to his knees and lifted his head as blood poured down his face.

Yankees manager Joe Girardi later told ESPN, “It was really, really scary. It seems like your heart just drops into your stomach, and you are scared for the kid. You see blood coming out. … I was really worried.”

Mitchell walked off the field with a towel on his face and with his arm around the team’s athletic trainer. Doctors at New York-Presbyterian Hospital diagnosed him with a small nasal fracture. They released the pitcher from the hospital, but the team will continue to monitor Mitchell for concussion symptoms.

The risks to batters and pitchers

Injuries to batters, like Giancarlo Stanton and Jason Heyward, hit in the face by pitches have brought attention to batter safety in recent years. Pitchers face similar risks.

I talked to Mike Oliver, the Executive Director for the National Operating Committee on Standards for Athletic Equipment (NOCSAE), about the risks to players hit by line drives.

Also read:
Should baseball pitchers wear helmets?
Should Major League Baseball adopt breakaway bases?

“Honestly, I can’t see that a player in the field has less exposure to an injury than a batter,” Oliver argued. “Arguably, it’s bigger, because the ball comes off the bat typically faster than it came in. A batter is at risk of getting hit by a pitched ball, but a baserunner or a defensive player is at risk of getting hit by a batted ball. I would think head protection ought to be at least as robust as the batter’s helmet, particularly if you’re talking about protecting the face.”

Serious, but fortunately rare, events

These events, while both frightening and potentially catastrophic, are fortunately rare. I discussed pitcher protection with Dr. Gary Green, the Medical Director for Major League Baseball. He estimates that a batted ball hits a pitcher in the head one or two times per season. With roughly 750,000 pitches thrown in Major League Baseball every year, about one ball in every 300,000 pitches or so results in head or facial injuries to a major league pitcher.

Padded caps not enough to protect baseball pitchers

In response to several high-profile injuries to pitchers in recent years, including Brandon McCarthy, J.A. Happ and Alex Cobb, MLB and helmet manufacturers have tried to create padded caps to prevent skull fractures. Few players currently wear them.

Four MLB pitchers have been struck in the head this season, according to the New York Times. The ball hit each pitcher below his cap line. A padded cap would not have helped in any of those events, including protecting Mitchell’s nose.

The problems with facial protection for pitchers

Dr. Green notes that adding facial protection could be problematic. Such a shield would probably require a chinstrap, interfering with a pitcher’s head motion and vision.

Oliver agrees that adding facial protection could be challenging because it couldn’t be added to the current baseball caps. “The face guard,” Oliver explains, “has to be worn with the head protection because it needs that rigid system to support the blow and manage the energy.”

If baseball wants to mandate helmets, or even helmets with additional face guards, it would best start at the youth level. Dr. Green thinks that if a Little League pitcher started wearing a protective cap, it would begin to feel normal as he progressed to high school, college and the minor leagues.

Technique changes might be better approach to protect baseball pitchers

He does, however, point out a potentially better way for young pitchers to avoid these injuries.

“The other way to prevent this, in addition to equipment, is proper pitcher positioning,” Dr. Green states. He points to former Atlanta Braves pitcher Greg Maddux, who always finished his follow-through with his face toward the plate and his glove raised. Maddux’s technique helped him win 18 Gold Glove awards.

Message for parents and youth coaches

That could be the important message for parents and coaches. “Teach proper pitching mechanics when they’re young so that they’re not falling off the mound, and they are in the proper fielding position to protect themselves as well,” Dr. Green says.

Also read:
Concussions in professional baseball
Discourage home plate collisions in baseball

Expect baseball to continue to research helmets and facial protection to better protect baseball pitchers and batters. It probably won’t become mandatory equipment for years, if they ever are.

Head and facial injuries to baseball pitchers are fortunately rare events, but they can result in catastrophic injuries when they do occur. Baseball coaches and parents teaching better mechanics at an early age might be a good step even without better equipment.

Note: A modified version of this article appears as my sports medicine column in the August 18, 2015 issue of The Post and Courier.

References:
Yankees Game Turns Grisly in an Instant as Bryan Mitchell Is Hit. By Tyler Kepner. The New York Times. August 17, 2015.

Yankees P Bryan Mitchell has nasal fracture after taking line drive to face. By Andrew Marchand. ESPN.com. August 18, 2015.