Key result
Collegiate female softball is linked to ~112% higher severe injury rates than high school play.
Why the study?
Research on catastrophic injuries and medical conditions among majority girls' and women's sports is underrepresented.
Observational
Yes
Absolute Event Rate: 2.5% vs 0.1%
Collegiate and older adolescent female softball players have a higher incidence of severe injuries and medical events, including sudden cardiac arrest, highlighting the need for targeted prevention and response measures.
May warrant age-specific prevention in collegiate female softball athletes; leaves open causal factors and intervention efficacy in observational data.
Background: Research on catastrophic injuries and medical conditions among majority girls’ and women’s sports are underrepresented. In this study, we describe the incidence, characteristics, and mechanisms of severe softball injuries/medical conditions between 2014 and 2021. Hypothesis: Catastrophic injury and illness patterns will be observed with a higher incidence rate at the collegiate level. Study Design: Descriptive epidemiologic study. Level of Evidence: Level 3. Methods: Events from the National Center for Catastrophic Sport Injury Research (NCCSIR) and National Electronic Injury Surveillance System (NEISS) were included. NCCSIR included catastrophic injuries during participation in high school (HS) or college sponsored girls’/women’s softball resulting in death, temporary or permanent disability, or life-threatening injury. NEISS included severe girls’/women’s softball injuries (product code 5034) among 13- to 17- and 18- to 24-year-olds among severe dispositions. National estimates were derived using a weighted sample for NEISS. Counts (%) and incidence rates (IR) per 100,000 participants overall and by age level, injury/medical event, and outcome were reported. Results: NCCSIR captured 0.3 events per 100,000 participants (95% confidence interval, 0.1-0.5), and incidence was higher in college (IR, 2.5; 0.9-6.6) compared with HS (IR, 0.1; 0.1-0.4). Sudden cardiac arrest was the most common event (5, 63%), and 2 (25%) fatalities were reported. NEISS captured 10.2 events per 100,000 participants (9.7-10.8). Incidence was higher in 18- to 24-year-olds (IR, 8.9; 8.3-9.6) compared with 13- to 17-year-olds (IR, 4.2; 3.8-4.6), and no fatalities were captured. Conclusion: Collegiate and 18- to 24-year-old athletes demonstrated a higher incidence of severe injuries than HS and 13- to 17-year-old athletes across both surveillance systems. NEISS captured a higher incidence of catastrophic events than NCCSIR. NCCSIR observed more cardiac events, whereas NEISS observed more head/face injuries. Clinical Relevance: Continued monitoring of severe injuries and medical events in softball is necessary to support response and prevention measures.
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Martin et al. (2025) conducted an observational in Severe injuries and medical conditions in softball. Collegiate level / 18- to 24-year-olds vs. High school level / 13- to 17-year-olds was evaluated on Incidence of catastrophic events per 100,000 participants (NCCSIR). Collegiate and 18- to 24-year-old female softball athletes demonstrated a higher incidence of severe injuries than high school and 13- to 17-year-old athletes (NEISS IR 8.9 vs 4.2 per 100,000).
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