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Batting Practice Knee Injury!
by Dave
Monday, May 15, 2006
Steph wrote in to us about a season-ending injury received while taking batting practice:
She is a freshmen in high school and just made the varsity team. While taking BP, she dislocated her right knee cap. Her doctor told her it is a very common injury in softball. Her physical therapist concurred noting that there are important differences in leg anatomy between boys and girls. She says, "for girls this is extremely common because of the way our quadriceps muscles are built compared to guys. [The physical therapist] said that the quadriceps is divided into 4 small muscles, 3 long ones on the outer part and one small one on the inner part of the leg. For girls the longer outer muscles are so much stronger than that small interior muscle that they pull the knee cap outwards constantly grinding against the little cup the knee cap stays in, or the knee cap it self grinds away til one day even with the smallest aggravation pops it out of place. I was lucky because of how quickly it went back into place, I didn't need to have surgery. To prevent this in the future, I have to strengthen the small interior muscle without making the bigger, outer ones stronger. I need to exercise both legs so it doesn't happen to the other leg."
I wasn't able to locate a useful web site which discusses knee injuries specific to women or softball, or which discusses dislocated knee caps in softball. Nonetheless, I think it is at least worthy of mentioning. I don't know if what the doctors and therapists tell Steph is true but everything I have found suggests women do have less-developed thigh muscles (quadriceps) than men do and this could be an attributing factor to their overall higher frequency of knee injuries in sports. Women also tend to have greater flexibility of joints although I'm not sure if this could be a factor in Steph's injury.
Softball is a sport involving explosive strength. Softball players don't run 100 yard dashes, they run 20 yard ones. The act of throwing a ball, whether pitching or not, involves an explosive force. The same can be said of hitting. No matter what the softball skill is, frequent emphasis on building explosive force controls how we practice. Less attention is paid to overall conditioning.
In some sports, the lack of a good strength and conditioning program can actually hinder one's ability to compete. Soccer, lacrosse, and basketball obviously require a lot of running. As a result, athletes who play these sports condition themselves appropriately in terms of long-distance running. In softball, it is, I believe, a little easier to get by on the strength of one's hand-eye coordination or innate quick-twitch strength. Practice of certain skills is all important but strength and conditioning can be overlooked without significant deleterious effect. We throw every day. We take as much BP as we can find time and facility for. We shag countless flyballs, field countless grounders, and do other skill-based exercises, but perhaps we don't spend as much time strengthening isolated muscle groups as some other athletes do. The result can be a shortened game season due to injury or even a career-ending event which might have been avoided had certain exercises become part of our routine.
Please do not think for even a moment that I am saying softball players are soft, lazy or don't do enough working out. I doubt that most baseball players work half as hard as the typical softball player does. But I believe it is perhaps a little easier to succeed at softball without "being in shape" than it is basketball or soccer. I don't think enough time, money and effort is put into conditioning which does not have an immediate and direct impact on one's softball game.
I am of the opinion that if you are serious about this game, it is advisable to seek out professional guidance in crafting an off-season and in-season conditioning program. Your typical high school "trainer" is nothing more than a glorified gym teacher unless he or she has really studied anatomy and exercise, not just taken one three-credit course in it for a "C." I know it was a different day when I went to high school but I still have burned into my memory the day our football team's "trainer" told me to get dressed in full pads, ready for practice, before he would deign to even examine me. When he saw that my broken elbow had swollen to larger than the size of my leg, he decided I could get undressed and be excused from practice but even then he did nothing to help me get the pads or practice uniform off. High school trainers may have improved since my glory days but they haven't improved that much. My trainer is now athletic director at the school and I would like to have been a fly on the wall when he hired the school's new trainer! But I digress. My point is, if you or your daughter has become serious about softball, maybe it would be worth your while to spend a few bucks and a couple hours to consult with someone qualified to discuss training and conditioning.
In closing, we wish Steph a very healthy and successful rebound from her injury. It is tough to be a freshman who makes it all the way to varsity and then ends her season with an injury. On the other hand, at least she has 3 more years of competing. Good luck to Steph for a softball career free of serious injury. And good luck to all of you for the same!
Followup posting:
Randy E. writes in regarding this post:
In addition to being a Collegiate Coach and Softball Instructor, I am a Certified Strength & Conditioning Specialist who works with both Baseball and Softball Players on their conditioning. Although I know female athletes are 2.5 to 8 times more likely to incur a knee injury, I have never heard of the type of knee injury occurring to a player as had happened to Steph, therefore, I would presume that it isn't that common an injury. It's not accurate to conclude that Athletic Trainers don't know what they're doing when it comes to conditioning. In fact, they have similar academic backgrounds as I do -- BS in Kinesiology. In some respects it would be accurate to presume that some, though not all, Physical Educators lack the requisite knowledge. As I also have a Health & Physical Education teaching certificate, I know that athletic conditioning, though covered, is not nearly as complete as it could be. But then again we have a lot of other areas to cover within the program majors that we must well versed at to teach on a daily basis. It would be extremely appropriate in this day and age for athletes to seek out sport conditioning professionals, not simply Personal Trainers, who have proper credentials (i.e. Certified Strength & Conditioning Specialist with the National Strength & Conditioning Association or Performance Enhancement Specialist with the National Association of Sports Medicine; though there are others these are two of the best), and experience.
And the description of the Quadriceps muscles is partly correct. It does have 4 muscle (bellies); but there's one on the outside, one on the inside and two on the front of the thigh with one on top of the other.
 
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