How You Hold Your Bat, Determines Your Risk of Injury

The use of the palmar hamate grip may increase the risk of hook of the hamate fracture in National Collegiate Athletic Association Division I baseball players, according to new research.

“Variations in batting technique may put baseball players at increased risk of hook of the hamate fractures. A better comprehension of the mechanism of such fractures is needed,” the researchers of “Pressures Exerted on the Hook of the Hamate in Collegiate Baseball Players: A Comparison of Grips, With Emphasis on Fracture Prevention” wrote.

The study, which was published online on October 5, 2021, compared 2 different grip types to quantify the pressures exerted on the hook of the hamate during batting. The researchers hypothesized that those players who hold the knob of the bat in the palm of their hand referred to as the palmar hamate grip would have higher pressures exerted on the hook of the hamate.

All the baseball players involved in the study were members of two National Collegiate Athletic Association Division I baseball teams. They were divided into 2 groups based on their usual grip type while batting.

The researchers used a force sensor system that was applied to the nondominant hand of each player with the central portion of the sensing mechanism placed on the batting glove directly over the hook of the hamate to measure pressure exerted. All the players used the same batting glove. The measurements were collected during hits using a ball machine at 70 mph.

Nine baseball players were included in the study. Five of them used the conventional grip, 3 the palmar hamate grip and 1 player naturally alternated between the two types.

Overall, the palmar hamate grip demonstrated a 366% increase in pressure exerted on the sensor overlying the hook of the hamate compared with the conventional batting grip (536.42 kPA [95% CI, 419.39-653.44 kPA] vs. 115.84 kPA [95% CI, 96.97-135.10 kPA]).

The player who used both grips demonstrated significantly higher pressure when using the palmar hamate versus the conventional grip (482.90 vs. 142.40 kPA; t = 6.95; p < .0001).

“Educating players on the risks associated with the palmar hamate grip may prevent injury and minimize time out of competition,” the researchers wrote.

The authors involved in the study included Mikhail Alexeev, M.D. and Steven M. Kane, M.D., of the Wellstar-Atlanta Medical Center in Atlanta, Georgia and Gary M. Lourie, M.D, of the Hand and Upper Extremity Center of Georgia in Atlanta, Georgia.