Pitcher head injuries to trigger cry for protection

Summoning a blend of courage and lunacy only he can fully grasp, Matt Hiserman of the University of San Francisco will take the mound Sunday, his eyes locking in on a batter wielding the weapon that twice resulted in a baseball striking his head. Five years ago, a line drive damaged his sinus cavities, three months ago another fractured his skull and caused his brain to bleed.

There is a touch of "The Hurt Locker" in Hiserman, a man on a mission inexorably drawn to danger. And plenty of scared college kid in him, too. A month earlier, before throwing a pitch for the first time since the second injury, Hiserman retreated behind the mound for a moment and went into a crouch. He breathed deeply and wordlessly recited the "Serenity Prayer."

What a pitcher can and cannot control regarding his personal safety is being examined more closely than ever before. No pitcher can predict whether a line drive will make a beeline for his noggin. But experts say anyone who takes the mound can minimize the chance of injury by wearing a protective helmet. Doing so is unthinkable in the pro ranks but is slowly gaining acceptance at the grass-roots level.

Hiserman has moved in the direction of protection, working with a sports equipment company to create an unobtrusive shield that fits under his cap and cover his temples and forehead. And helmets that shield a pitcher's skull are gaining momentum in a handful of youth and high school leagues, primarily in communities traumatized by a severe head injury to a local pitcher.

Novato High School in Marin County, Calif., requires its pitchers to wear batting helmets since Gunnar Sandberg, a pitcher at a nearby school, was struck above the right ear by a line drive on March 11. Sandberg underwent emergency surgery to relieve pressure from bleeding around his brain and was placed in a medically induced coma. His recovery has been slow but promising, and last week he was able to throw out the first pitch at a game between the San Francisco Giants and Oakland Athletics.

Gunnar Sandberg

Earlier this month, Brady Lee Frazier, an eighth-grader pitching against a varsity high school lineup in Burlington, Vt., died after being struck in the head by a line drive, prompting officials in Vermont and New York to inquire about pitchers wearing headgear. And a year ago, the parents and friends of Cole Schlesner, a 14-year-old from Loveland, Ohio, struck in the top of the head by a line drive, started a nonprofit organization that recently donated 1,000 batting helmets for pitchers to wear in youth leagues across four states.

The elite club organization Schlesner played for, the Cincinnati Stix, now strongly encourages pitchers to wear the protective helmets from ages 9 and up. Almost all pitchers wear them, and on some teams, all infielders wear them.

"Having every player at every position wear them at the youngest age creates an acceptance," said Scott Schlesner, Cole's father and a club coach. "As they get older, they won't feel strange wearing them."

Only padded helmets provide true protection

Frederick Mueller, a University of North Carolina professor and chairman of USA Baseball medical/safety advisory committee, said an average of one serious injury or death from high school and college pitchers being struck in the head by line drives has occurred since 1982, and he cautions that the list is probably not complete and does not include youth league players.

Just two weeks ago, San Diego State pitcher Bryan Crabb was drilled in the head in a game against Brigham Young and suffered a cracked skull and minor bruising of the brain. Little League Baseball, utilizing data from its insurance carrier, found that over a 10-year period the rate of significant head or face injuries from a batted ball was an average of one per 50,000 players.

Cole Schlesner, 15, goes though therapy to learn to walk again.

"The point isn't that head injuries to pitchers are widespread, it's that they are so often catastrophic," Mueller said.

Experts in sports safety equipment envision the day when all pitchers – at least at any level aluminum bats are used – wear headgear to minimize injury. A helmet must have at least 5/8-inch of polystyrene or a similar cushioning substance between the shell and the cranium to be effective, according to Dave Halstead, technical director of the Southern Impact Research Center and a leading expert in the area of head and neck injuries. In other words, anything worn by a pitcher ought to be equivalent to a batting helmet certified by the National Operating Committee on Standards for Athletic Equipment (NOCSAE).

"We know a helmet will prevent serious injuries, but most pitchers don't want to wear what is available so far," said Dave Halstead, "They say that it's got to look less dorky than that."

Even though Hiserman is thought to be the only pitcher ever struck in the head twice by line drives, to catch such infinitesimal odds so horrifically, he isn't willing to wear a helmet. He has, however, developed a keen interest in this evolving area of safety equipment and patched together headgear that offers a measure of protection while fitting under his cap. He took small pieces from a rigid, lightweight rib protector manufactured by a Georgia company called EvoShield and connected them with a strap. The protective shields protrude from his cap, covering his temples, looking vaguely like Elvis Presley's sideburns.

"We've tossed around some product names if this ever becomes something we can market," EvoShield president David Hudson said. "And we like, 'Chops.' "

Necessity was the mother of this particular invention. Hiserman inspired his teammates, alarmed his parents and astonished his doctors by coming back to pitch April 10, less than two months after being struck an inch above his right ear during an intrasquad game. Hours after the injury he was lying in the intensive care unit wondering if he'd ever be able to think straight, let alone throw another pitch.

Hiserman connected two pieces from a catcher’s rib protector made by EvoShield with a leather strap that fits under his cap.

"The first day I told myself I wasn't going to play anymore," he said. "Each day that went by I felt like I wanted to play a little bit more."

First he had to convince doctors he could return to school. Homework that normally took one hour to complete took four. Then he started going to practice.

"You could see it in his face, you could see he wanted to make a comeback," University of San Francisco coach Nino Giarratano said. "He started fighting to go to class. He started fighting to condition. He started fighting to get back to normal. I told him we'd better start preparing for his comeback. We'd better start finding something protective for him to wear."

Returning was equal parts mental and physical

Five years earlier at Capistrano Valley (Calif.) High, Hiserman was back pitching six days after being struck in the face by a line drive, even though he looked like a chipmunk with a mouthful of nuts.

"It was a get-him-back-on-the-horse type of thing," his father Mike said. "Looking back, that was a really stupid idea."

The psychological hurdle was difficult for Hiserman. He had difficulty throwing fastballs on the outside part of the plate, the location of the pitch that was hit back at him.

"I didn't know how to handle the fear," he said.

With help from college pitching coach Greg Moore, Hiserman gradually was able to pitch as if the injury never occurred.

Maybe that experience enabled him to come back a second time. "It's the acceptance of it," he said. "I am scared. Like before a big game, you are nervous. You have to accept the emotions and go about your business. Instead of wasting effort trying not to be scared, I accept being scared and do what I have to do, making the pitch and getting outs."

He tossed four scoreless innings against Gonzaga in his return and has pitched 34 innings in nine appearances.

"It's a miracle he's pitching," USF second baseman Rob Abel said. "Matt is a very determined person."

Coming up with a way to protect his head without resorting to a helmet was the next challenge. Hiserman recalled meeting an EvoShield representative the previous summer at the Cape Cod League. The USF trainer contacted the company, which develops and manufactures protective guards for athletes' ribs, elbows, knees, shins and backs, and asked them if they had anything to protect a pitcher's head.

"It was like a piece of light foam when it arrived, very soft," Hiserman said. "The trainer wrapped it on my head in ace bandages to hold it in place and we waited 40 minutes. We were all skeptical. But when we took off the wrap, the shield had formed and was hard enough to keep the form. I left it in my locker and next day it was real hard. If I got hit again, I think it'd be the difference between being punched and being slapped."

Companies race to develop the best headgear

EvoShield has since built a prototype based on Hiserman's invention and consulted with the Southern Impact Research Center about its effectiveness. Halstead, while acknowledging that it is better than nothing, said it would not prevent injury should another line drive hit the pitcher square in the head. Hiserman devoted a research project in his entrepreneurial business class this spring to improving the EvoShield device.

"My goal is to have kids who haven't been hit wear something to prevent head injuries," he said. "I want it to be appealing enough so kids will wear it. I know for me, I won't wear something that looks incredibly goofy, but I'm willing to look a little bit goofy."

Halstead has heard that refrain before. Some girls' softball players are willing to wear helmets and faceguards while pitching and playing in the infield, but baseball players resist.

EvoShield took Matt Hiserman’s idea and constructed a prototype. However, safety experts say the guard would not prevent catastrophic injury because it does not have sufficient padding.

"It doesn't pass the mirror test," he said. "So people come along and say, 'Put this in your cap.' Wrong. Absolutely wrong. We have tested dozens of inserts ranging from 1/8-inch to 1/4-inch of padding between the shell and the head. They might help with a glancing blow, but in the case of a direct hit, they have no function."

The aesthetics might be evolving. At Novato High, all the pitchers wear helmets during practice and about half use them during games.

"Some say they are too wobbly and uncomfortable," coach Bob Scheppler said, "but I haven't heard complaints about the look. They all wear skateboard and snowboard helmets, and they grew up wearing bicycle helmets. It's no big deal."

The acceptance of pitchers wearing helmets and even facemasks might just be a matter of time, as it was in hockey decades ago. Major league base coaches begrudgingly agreed to wear helmets after minor league first base coach Mike Coolbaugh was killed by line drive in 2007. There was a time wearing seat belts in automobiles wasn't considered cool. Hopefully it won't take a catastrophic head injury at a televised event such as the Little League World Series or College World Series to trigger widespread acceptance.

The tipping point in Marin County and Loveland, Ohio, was that a serious incident hit close to home. Schlesner was struck so hard the ball careened to the first-base dugout. A helicopter took him to the hospital for emergency brain surgery, where a chunk of his skull was removed to allow for his brain to swell – the same procedure Sandberg went through. Schlesner was in the hospital for two months; meanwhile his parents wrestled with whether to allow their other three sons, 8, 11 and 15, to continue pitching.

Helmets are gaining acceptance in Ohio

"Last summer they played and didn't have protection because we were too caught up with Cole's situation to think it through," Scott Schlesner said. "All three boys wanted to keep pitching, and my wife and I considered this moral dilemma: What does it say if I wouldn't let my kids pitch because of the danger, but as a coach would put other children on the mound?"

Cole's brothers are all pitching – with helmets. Cole is back in school but still has difficulty walking. The helmets the Play for 4 foundation purchased from the All-Star sports equipment company are old-style catcher's helmets that are padded but don't have earflaps. The come in several colors and team logos can be added so they conform to the look of a regular cap except for the bulk and hard shell.

Drew Plitt, 12, pitches while wearing a protective helmet. Plitt plays in the same Loveland, Ohio, youth league as Cole Schlesner.

The helmets provide protection for the skull but wouldn't help in the case of a line drive to the face like Hiserman suffered in high school and San Diego Padres pitcher Chris Young suffered two years ago when a shot off the bat of Albert Pujols(notes) fractured his nose and face. Pujols, of course, used a wood bat. The use of aluminum bats is raised almost every time an amateur pitcher suffers head injuries as the result of a line drive, and the issue is deeply polarizing.

The high school league in Marin County where Gunnar Sandberg played has gone from aluminum to wood bats, and the Schlesners are strong advocates of banning aluminum. North Dakota was the first state to prohibit aluminum after American Legion pitcher Brandon Patch was killed in Montana by a line drive in 2003. Patch's family sued bat-maker Hillerich and Bradsby and was awarded $850,000 when the jury ruled that the company "failed to adequately warn of the dangers of the bat." New York City banned aluminum bats in its high school leagues in 2007.

However, aluminum bat manufacturers agreed to make their products conform more closely to wood bats several years ago for use at the high school and college levels, and recent studies by USA Baseball and the American Legion concluded that the prevalence of head injuries to pitchers is the same regardless of the type of bats hitters use.

The metal vs. wood bat controversy will continue. Scott Schlesner said the bat used by the player who hit the line drive that injured Cole was six ounces lighter than an equivalent bat in a high school league, meaning it could be swung with greater speed. Also, metal bats have a larger sweet spot and often have larger barrels than wood bats. Furthermore, a study at last year's College World Series revealed that 20 of 25 composite-barrel bats randomly tested were not in compliance with NCAA regulations.

"When a (metal) bat includes all of these technological advantages, I can guarantee you there are significant differences in performance over wood," Scott Schlesner said.

Rather than banning aluminum bats – which the NCAA is considering for its Division II schools – some experts believe headgear would be more effective and easier to implement.

"It's nonsense that the non-wood bat is the reason for these injuries," Halstead said. "The exit speed from the bat is the same. The difference is that the sweet spot is bigger on an aluminum bat, meaning that a screaming line drive might occur two or three times a game rather than once with wood bats.

"The only way to ensure protection is for a pitcher to wear a batting helmet with a faceguard. If he doesn't like the way it looks, he ought to pick up Big Bertha."

Hiserman, for one, doesn't plan to give up baseball for golf quite yet. Although he graduated from San Francisco last week, he has one more season of eligibility and plans to use it while working toward a master's degree. Between now and next season, though, he wants to devote more time to developing headgear that provides safety while also passing the goofiness test. Working toward a solution also keeps him from asking the obvious question: Of all the pitchers in baseball history, why was he the one to be struck twice in the head by line drives?

"I wonder it all the time, but if I can't get the answer, why ask?" he said. "I'm sure something good will come out of it, maybe something to keep other pitchers safe. You have to create awareness. I was incredibly lucky to come back. I got hit in a very dangerous spot. But really, I'm back to normal now and I'd like to do something to prevent this from happening to somebody else."

Or to himself a third time. He won't acknowledge it yet, but if he and EvoShield cannot come up with unobtrusive headgear that meets accepted safety standards, maybe, just maybe, Hiserman would take the mound next spring wearing a helmet.