Background
Baseball and softball are popular sports that have been studied with the goal of limiting injuries, especially among pitchers. Despite injuries occurring in both baseball and softball pitchers, parity between the two sports is lacking as baseball has received greater attention than softball. The purpose of this study was to describe the discrepancy that exists in peer-reviewed literature between baseball and softball in terms of quantity and quality of research.
Methods
A systematic review using PRISMA protocol was performed to identify original research articles related to baseball and softball from 1990 to 2020 using PubMed, PEDro, CINAHL, and Cochrane databases. Two independent reviewers categorized articles. Articles pertaining to pitching were identified. A comparison between pitching related baseball and softball articles was performed to include quantity, age group studied, article journal impact factor, study design, and modified MINORS criteria. Statistical significance was set at p=0.05.
Results
Between 1990-2020, there were 813 baseball publications and 158 softball publications in the peer-reviewed literature. More baseball articles were published per year than softball (p<0.001). Baseball had 368 articles related to pitching while softball had significantly fewer at 49. Pitching related baseball pitching articles were published in journals with higher mean impact factor than softball pitching articles (3.1 vs 2.0, p=0.049). Baseball had more clinical articles than softball (63% vs 43%, p<0.05). There was no difference in age groups studied between sports. There was no difference in MINORS criteria for rigorous reporting (p = 0.678).
Conclusion
Softball is under-represented in the literature when compared to baseball with over 5 times fewer peer-reviewed research articles. Pitching related softball articles are nearly 8 times less frequent compared to baseball articles and published in journals with lower impact factor. Despite pitching related injuries occurring in both softball and baseball, pitch count guidelines have primarily been designed for and implemented in baseball. Moreover, although there are differences in the biomechanics of an overhand baseball pitch and windmill softball pitch, high loads can occur at the shoulder and elbow in both throwing motions. Efforts are needed to decrease the disparity gap that exists between baseball and softball research, with an emphasis on understanding sport-specific injury patterns.