Houston Astros Concussion Consultant says pitching head injuries are more common than thought

“I tried to get back up. To get the ball. And then I fell on the ground. And that was when the pain set in." 

"I ended up blacking out on the field, I was bleeding out of the nose, the mouth and the ears. It ruptured the temporal artery in my right temple. I was convulsing and my brain swelled to such a degree, I began to lose functions in my body,” said former El Paso Diablos pitcher Dave Whigman.

Whigman, founder and owner of Delmarva Aces Baseball Club, vividly remembers the day his life changed forever. July 2, 2009 was supposed to just be another day on the mound — but one line drive, landing directly in his right temple, changed everything for the Ocean City, MD native.

According to a personal injury medical journal, including but not limited to concussions and traumatic brain injuries (TBIs), 242,731 baseball- and softball-related injuries occurred spanning from the years 1982 until 2015. In 2009, 38,942 patients with baseball-related head injuries were treated in American emergency rooms alone. But as innovative headgear struggles to find a foothold in baseball, numbers continue to rise among a specific position group.

Director of Houston Methodist Concussion Center and Houston Astros Concussion Consultant Dr. Kenneth Podell told FanSided that he and other doctors in the field have seen a reported rise in these injuries among pitchers.

“There is an undoubted increase in the number of reported concussions and other injuries among pitchers,” Podell said.

Astros concussion specialist sheds light on danger to pitchers, both young and experienced

Medical Implications

According to the same medical journal, a 90 mph fastball can be hit back at an initial velocity of almost double that speed — with batters possessing the unintentional ability to send the ball straight back to the pitcher. 

In most cases, pitchers shorten the distance to the batter as a result of the follow-through from their pitch, often leaning forward and putting themselves in an even more unprotected position to the hitter. 

“The injuries can be severe. You can have skull fractures. You can have a bruise on the brain, that significant bleed to a hematoma, subarachnoid hemorrhages, subdural hematomas,” Podell said. “There are deaths related to those types of traumas in professional baseball.”

After being taken from the field in an ambulance, Whigman underwent one emergency surgery, one follow up surgery and was in and out of the hospital for the following two weeks as a result of fractured skull and an epidural hematoma.

Dr. Gavin W. Britz is Director of the Houston Methodist Neurological Institute, and chairman of the Department of Neurosurgery at Houston Methodist Hospital. He is also a Professor of Neurological Surgery at Weill Cornell Medical College.

Accordingly to Dr. Britz, skull fractures and hematomas — considered TBIs — are the most common diagnosis as a result of rebounding line drives.

“The problem is, people can actually die from hematomas,” Britz said. “The classic what we call the lucid interval. People have their trauma, they get this cold fracture, and then they're completely lucid. They just you know, normal, you wouldn't know they had an injury. They go to bed, and then they don't wake up from a large hematoma.”

And according to Whigman and Podell, the effects of these injuries are not just physical. 

“The doctors explained to me all of the issues that I was going to face, because it hit the part of the brain that affected emotion, it affected memory and I had issues with irritability,” Whigman said. “And, I had seizures for three and a half years."

"It was so bad after I got injured that I remember one time I was going out, and I didn't even put my pants on. I only had a t-shirt and underwear and shoes and socks on because my memory was so messed up afterwards.”

In the impact of the ball causing mental detriments, Whigman is not alone.

“There are individuals with severe traumatic brain injuries that become disinhibited now or impulsive,” Podell said. “They just become impulsive. They don't plan on killing themselves. They end up doing something impulsively and end up dying by suicide.”

Further Emotional Implications

Jeremy Giambi, brother of former New York Yankees slugger Jason Giambi, died in February of 2022 — with his official cause of death being marked a suicide. He shot himself in his chest.

Giambi won a College World Series title with Cal State Fullerton and was selected by the Kansas City Royals in the 1996 Major League Baseball Draft. He was called up to the majors in September of 1998. His span in MLB lasted from 1998 until 2003 across four total franchises, where he batted .263 with 52 home runs and 209 RBI.

Following the conclusion of his playing career, he had begun serving as a pitching coach.

In August of 2021, while performing his coaching duties, Giambi was struck in the head by a baseball, which fractured his cheekbone. This incident was sixth months before his suicide.

Giambi was found dead in his parents’ home in Southern California by his mother. The coroner’s report was written by Ricardo Lopez, which NBC News later obtained.

According to Giambi’s mother, since he was struck by the baseball he “had not been the same” and was “very negative and would let the smallest things ruin his day, emotional, and paranoid.” Lopez detailed these accounts in his reports.

“It's not uncommon for one of the initial symptoms to be emotional lability,” Podell said. “There's a lot of parts of the brain involved in emotional functioning. So it's just not one part of the brain. It's often multiple parts, but there are multiple ways that emotions can be disrupted after a head injury.”

It is worth noting that both Giambi brothers previously admitted to steroid use. In the coroner's report, Lopez also detailed that Jeremy Giambi in particular also struggled with abuse of methamphetamines and Percocet. He was also placed on a psychiatric hold eight years prior to his death.

However, according to Lopez, a post-mortem screen for drugs such as fentanyl, methamphetamines, cocaine and various opiates came back negative, coroner's records showed.

Due to his mother’s psychiatric concerns, Giambi was scanned, but a neurologist could not come to a final diagnosis.

Although doctors and others speculate steroid use potentially played a factor, doctors also said it was impossible to rule out whether Giambi’s head injury contributed to his suicide attempt or not.

Podell also said that TBIs can also cause another condition called Pseudobulbar Affect.

“It's a scenario where you have poor control over emotional reactions," Podell explained. "So imagine a commercial that you know is meant to kind of tug at your emotions a little bit, you start bawling and crying your eyes out, right? Or another example, imagine being in a restaurant and a staff person drops a glass and it breaks, and they start bursting out laughing, right? These are examples of Pseudobulbar Affect.”

Danger Posed to Youth - Little League

When it comes to head injuries at the youth level, Little League pitchers are much more susceptible to serious ramifications.

“If you're talking below the age of 13, these players’ brains are not fully formed yet, they're still developing, the skull hasn't reached full maturity,” Podell said. “So the skull bone is not as strong as that of a professional 21-plus-year-old individual. So we are very much very concerned about when a child takes an injury like that.”

Eighth-grader Calvin Ness falls in that age group. During warmups for the Charlottesville Babe Ruth League on May 10, 2023, he was struck in the head with a baseball hit by a coach. He never regained consciousness.

He was immediately transported to the hospital, where he later passed away due to his injuries. His organs were donated and he was then cremated, with his ashes being spread.

His baseball league went on to suspend all practices and games and an emergency board meeting was held to discuss how they should then move forward.

“In life, tragic and terrible things happen to wonderful people. Coach Adam and Calvin fell into this situation,” the Ness family said in a published statement. “Calvin LOVED being on Coach Adam's team. Adam reinvigorated Calvin's love for baseball, and Calvin was beaming with that love until his last moment on earth."

"Once the families and players have had space to reflect and grieve, it is time to play ball again. Calvin wouldn't have it any other way.”

According to his obituary, most of the 13 years of Ness’ life were spent on the baseball field.

It is unknown what sort of head protection, if any, Ness was wearing when the injury occurred and what the official cause of death was. 

Danger Posed to Youth - High School

“When the time is right, I, THE LORD, will make it happen,” Isaiah 60:22 reads.

Jeremy Medina, a Gainesville High School senior pitcher and catcher, posted these words on his Instagram on Nov. 20, 2023 before a batting cage session. This batting cage session would quickly become his last.

During the cage session at his high school, Medina’s head was accidentally struck by a bat during a teammate’s swing follow-through due to a complication of net positioning.

“Obviously a 35-year-old man has a thick skull, it’s going to be more resistant to fracture trauma,” Britz said. “But the younger you are, the thinner your skull, so you wouldn't necessarily need a 100 mile fastball to cause that kind of damage. If you have a reasonable shot in your head, you can fracture your skull.”

After two weeks in a coma and in critical condition, Medina was declared brain dead on Wednesday, Dec. 6, 2023, according to the Northeast Georgia Medical Center. He was removed from life support and passed six days later.

Brandon Sewell, a baseball trainer and hitting instructor with Takeoff Baseball Training, had a session booked with Medina for later that day on Nov. 20. 

“He was supposed to hit with me the day that it happened. He was supposed to be with us here in a group session. It really, really hit me hard,” Sewell said. “It hurt because it was unexpected. And I knew that he was supposed to be in that group with us that day”

Medina was not wearing head protection when the incident occurred at the batting cage. 

“This also makes you think about asking that question, ‘Should everyone start wearing a helmet while they're in a cage?’ You know, I don't want to be that guy,” Sewell said. “But at the same time, it's a very serious matter. Because I know for me, the next day after finding out what happened, I was very cautious in the cage.”

His father stated publicly that Medina had already received an offer to play college baseball prior to his accident.

A lawsuit from the Medina family was filed this year against staff members at Gainesville High School in May of 2024.

“This changed baseball. This right here will change the way I train, probably forever,” Sewell said.

Danger Posed to Collegiate Play

On March 24, 2023, then-No. 8 Virginia pitcher Nick Parker took a line drive to the head off of the bat of Florida State’s James Tibbs III.

The hit came in the first inning, following Parker having given up a walk and a single.

Acting quickly in getting the injured player medical attention after any kind of high impact taken to the head is extremely critical, said Podell.

“In injuries like this, time is of the essence,” Podell noted. “And that's why all of the athletic trainers, and even now, coaches at the Little League level go through mandatory training and education for these types of assessments.”

Parker was immediately taken for full examination and concussion protocol. Luckily, he only sustained a broken cheekbone.

“I was extremely lucky for to have only hit that part,” Parker said. “Where it hit is really only there for facial structure and nothing else. So, I got extremely lucky that it wasn't my nose, behind my temple or anything like that. I’m very grateful for that.” 

Tibbs said that the incident also left a lasting emotional impression on him, and made it a point to reach out to Parker following the conclusion of the 3-2 Virginia win.

Parker was not wearing any form of head protection during the game, but said an insert in his cap is something he’d now consider.

“The hospital actually had me fitted for a face mask but I ended up not wearing it because it was too uncomfortable and too visually impairing for me,” Parker said. “I think if something protective were to feel comfortable in your hat and then not be bothersome, I could see implementing that.” 

Danger Posed to Professionals 

At the Major League Baseball level, the average exit velocity ranges anywhere from 90 mph up to 107 mph. This puts MLB pitchers at a higher risk for more severe injuries, should a line drive rebound.

“With a ball going 100 miles per hour, if there is any sort of impact I think they should get CT scans personally,” Britz said. “Because that's such a small projectile at that speed, it’s best to be extra careful.”

For Ryan Feltner and Ryan Yarbrough, they know this risk well. The pair of major league pitchers took rebounding line drives to the head exactly seven days apart in 2023.

On May 7, 2023, Yarbrough was pitching for the Kansas City Royals against Oakland Athletics. A rebounding line drive off of Ryan Noda’s bat hit Yarbrough in the head while traveling 106.2 mph.

He suffered from multiple non-displaced fractures and was at first placed on the 15-day injured list May 8, then transferred to the 60-day IL.

The play made an impression on the MLB community, with announcers continuing to bring it up even after Yarbrough underwent a change in franchise.

“The mental gymnastics that he has probably had to get through to stand 60 feet, 6 inches from the hitter again and know that the ball could come back at him is showing some serious toughness,” said the announcers on a 2023 Dodgers-Padres broadcast.

Feltner, who pitches for the Colorado Rockies, sustained a concussion and fractured skull while playing against the Phillies on May 14, 2023. His, too, was a rebounding line drive — traveling at 92.7 mph — taken to the right side of the head.

MLB stated he dealt with hearing problems as well as dizziness following the injury.

While Feltner has since recovered and returned to the mound like Yarbrough, he said he initially considered quitting the sport as a result of the head trauma.

“Right when it did first happen, the initial thought was, ‘I don’t want to do this anymore,’” Feltner said. “I think that is a natural reaction, a healthy reaction. But I realize this is what I do, this is what I work towards and I wouldn’t want to come this entire way to put things at a halt.”

Conclusion

According to the National Library of Medicine, there is a stated poor compliance with helmet use and return-to-play post-concussion guidelines in the sport of baseball. 

The same medical journal notes an increase in TBI rates has been observed over time, and multifaceted preventive strategies must be implemented to reduce the frequency and burden of these injuries.

“Pitchers right now aren't wearing much protective gear. So depending on how they react to how fast that ball comes out, and how direct the hit is, makes all the difference in the world,” Podell said.

While a lot of fans in baseball probably predict these kinds of injuries to be more of a rarity, according to Forbes, one in roughly 105 pitchers get in the head by line drives across their careers in the MLB. 

“If we go back to the pitchers, I could see mandating head gear for our younger players,” Podell said. “And that's how change starts at the top. Major League Baseball, NCAA, even Little League could start funding some of the research to improve this technology.” 

A Possible Solution

SST Baseball is a company focused on head protection for pitchers. Their products are a range of head guards that slide into a pitcher’s cap; the design was created with the idea in mind that the only person who knows it's in use is the pitcher.

“Our product is very thin, low profile and lightweight. We wanted pitchers to feel like they were just wearing a regular baseball hat,” SST Founder Matt Meier said. “The game is meant to be played. We didn't want to draw attention to it, you can't tell if somebody is wearing it or not.”

Meier, who currently coaches his 12-year-old son, came to the idea after he was pitching an All-Star Game and was struck by a ricocheting ball. By 2008-2010, he started seeing videos of pitchers getting hit and began the early stages of development.

The main goal of the product is not simply to be all-encompassing in its total injury prevention, but to limit significant injury at high-speed impacts to the head, said Meier.

“We settled with the idea that the brain bleeds were the main thing we were looking to help with this,” Meier said. “This device will not help you with the concussion. You will not be injury free if it happens because that ball is coming so hard, but we feel really good that it's going to help deter a skull fracture.”

During the product’s initial stages of development, former MLB pitcher Brandon McCarthy sustained an epidural hemorrhage, brain contusion and skull fracture after being hit by a line drive and remained in a life-threatening condition for two days following his injury in 2012. Ultimately, he made a full recovery and pitched again, finishing his career in 2018.

Word of mouth regarding the product then spread and production increased. After going through over 50 different prototypes, which underwent testing through a digital accelerator as well as tests of up to 115 mph, their product range was settled on and the first SST product was launched in 2014.

“I applaud the companies for going after this problem. I am all for improving the safety of our athletes, at all levels,” Podell said. “People make the argument that if it happens two, three times a year throughout all of Major League Baseball, it's not frequent enough to mandate its use. Now, okay, but can we make it available to them? Can they decide if this is something they want to use? The answer is yes.”