by Herb McReynolds, M.D. and Bob Smetanka, P.T., A.T.C.
(This article appeared in the Fall 1991 issue of HardBall Magazine)
In our Spring 1991 issue we discussed stretching and exercise programs and injury prevention. Those of you who didn't read or follow the programs outlined there will need to read this article, because it will tell you what you should have in your first aid kit. You'll need it sooner or later.
Even for those of you who take care of your bodies, the stop-and-go action of baseball can lead to some kind of sprain, strain, abrasion, contusion, laceration, sting or humiliation. Excepting the last, there should be something in your kit to treat them all.
The Cost of Poor Conditioning
What are the most common injuries to baseball players in the 30-and-over age bracket? In our league, injuries to the throwing arm seem to be most common, although they are not often acute. However, our readers have brought to our attention an alarming number of stress fractures to poorly conditioned pitchers in the MSBL.
In the "acute” column, once we descend beyond the strawberries from sliding and falling, we see a lot of hamstring (posterior upper leg) and quadriceps (anterior upper leg) strains. Somewhat less common are sprains to ankles and other joints. A strain is an injury caused by overexertion or overstretching a muscle, while a sprain is an injury to the muscles and ligaments surrounding a joint without a dislocation of the joint. Then there are contusions (bruises) from occasional collisions between runners and fielders, and/or between fast-moving baseballs and flesh and bone.
Our first aid kit must include something to stabilize the inevitable spike laceration, and the rare fractures and joint dislocations. The key word is "stabilize” because fortunately, most of us play in areas where pre-hospital care is quickly available, so simply stabilizing and immobilizing is usually sufficient until professional help can be summoned.
Know Where to Go for Help
It should be emphasized here that first aid is just that: the first assistance you render an injured player. Common sense will tell you when an injury is serious enough to warrant urgent medical attention. It is essential that several team members know the location of the nearest phone, the correct number to dial for emergency medical care, and the location of the nearest hospital to the playing field. It is just as important to be able to give the exact location of the field to the 911 operator. In real emergency, precious time can be lost due to poor communication.
The best first aid kit is of little use if no team members have been trained to use it. Everyone can benefit from a few hours of instruction from the Red Cross or local paramedics. Without wishing to sound unduly precautionary, we know of at least one MSBL player who suffered a coronary after a game. We recommend that at least one team member know CPR, as well as the basic principles of emergency management.
Bring Lots of Ice
Getting back to our more common injuries, the initial treatment for most of these is something not found in the first aid kit—ICE. Keep either chemical ice packs or ice in a cooler. Since you are likely to use ice a lot, buying the chemical packs can become expensive. But it must be noted that the chemical packs require far less storage space than real ice. Besides being essential to help reduce pain and swelling of injuries, multiple ice packs are also useful in managing heat exhaustion. Our first aid kit should contain several zip-lock bags to hold the ice and you should have a large bag of ice and/or chemical ice packs in a nearby cooler.
Make Your Own Ice Pack
Here's a great ice pack you can prepare at home. Fill a hot water bottle two-thirds full with crushed ice and one-third with isopropyl rubbing alcohol. Chill in freezer. Since the freezing point of alcohol is lower than water, you have now prepared a pack of frozen mush that can be placed in a pillowcase (to avoid cold burns, never apply ice directly to uncovered skin for longer than five minutes) and molded to the affected part. Make a couple of these, stick them in your freezer, and they'll last until you reach the championship bracket.
Next, your kit should include an ace bandage to help compress the ice pack to the affected part and also to immobilize it. This is part of the Ice, Compression, Elevation treatment we discussed in our last article (Spring 1991). We like 4- and 6-inch Ace bandages. These can be rewound and reused. Don't use the little fang clips that come with them since they tend to tear the bandage. Instead, use a couple of strips of 2-inch nylon tape (also in your kit) to secure your dressing.
The remaining contents are mostly easily obtained common-sense items. The kit can be housed in an inexpensive fishing tackle box or tool box. You don't need to buy an overpriced medical kit (and please don't buy one of the prepacked first aid kits from a catalog or sports store—most of those contain training kit items, not first aid items, and there is a difference).
At the bottom of this article, we have listed what we think should be in a first aid kit to be used at a baseball game. Use this checklist as a guide and remember to restock your kit regularly.
Injuries to players occur in all athletic events. Serious injuries are less common in baseball than in contact sports like football or basketball, but they do happen. Especially in the MSBL it is important that players be aware of procedures to correctly manage care of the injured. We wish all of you a successful and injury-free season. However, in the event of injury, proper preparation and the right equipment will take care of most onfield medical problems.
ASK THE DOC
Q: One of my players got some dirt in his eye during the game last week. It hurt enough that we couldn't get him to open his eye and get it out. What's the best way to remove debris from an eye?
A: Even a small speck of dirt can hurt a lot and the pain often causes the eye to close tightly to protect itself. First, move the player to a cool shaded area. Then, dry the sweat from around the affected eye. Moisten a cotton-tipped applicator with water. Help your player relax and encourage him to open the unaffected eye. Most of us reflexively close the good eye when we try to open the painful one. But once the good eye is open, the affected eye will probably be easier to open. Now, ask him to keep both eyes open and gently pull down on the lower eyelid while the player looks up, down, left and right. If you see the debris, remove it with the cotton-tipped applicator. The pain will usually subside quickly. If you can't see it, gently lift the upper lid and repeat the eye's range of motion. If you still cannot see it, try flipping the upper lid by holding the upper lid at the edge and using your thumb and index finger to evert it. Alternatively, place the wooden end of the applicator across the upper part of the lid, hold the lid again, and flip it up over the applicator. The eyelid must be dry, and this does take practice, though our kids seem to be able to flip their own lids at will in nice restaurants. Often you'll find a foreign body lodged under the everted lid.
If all else fails, rinse the eye with water or irrigating solution. If this also is unsuccessful, the player may need to be evaluated in an emergency room or urgent care facility.
MSBL First Aid Kit
- Zip lock bags for ice packs
- Bandaids, multiple sizes
- 4 x 4 inch gauze bandages
- Bandage scissors
- Nylon tape – 2 inch
- Hydrogen peroxide to cleanse wounds
- Bacitracin antibiotic ointment
- Tweezers (for splinters)
- Safety pins
- Triangular bandage for slings
- Tongue blades or aluminum foam-padded finger splints
- Cotton-tipped applicators (Q-tips) for applying ointment and removing foreign bodies from eyes
- 4” x 6” Ace bandages
- Eye wash (boric acid)
- Analgesic ointment
ABOUT Herb McReynolds
Dr. Herb McReynolds founded the Tucson MSBL and served as its president from 1989 to 1991. He is a former member of the MSBL National Board of Directors and was inducted into the MSBL World Series Hall of Fame in 2009.
ABOUT Bob Smetanka
Bob Smetanka is a physical therapist and athletic trainer at The Therapy Source in Boise, Idaho. He was president of the Boise MSBL in 1991 and played on the Boise MSBL Red Sox.