The event is more common in projectile sports such as baseball, softball and lacrosse. Because the balls used are consistent shapes and sizes within the sport, it’s easier to track than football, in which people may get hit by a ball, helmet, elbow, knee, or other areas.
“Of all the sports where you might see a commotio cordis event, football is one of the least likely sports where it could happen,” Oliver said.
The velocity of the impact also plays a role, but it’s not necessarily based on the hardest or fastest hits. Once the speed of a ball reaches about 40-50 miles per hour, Oliver said, the chance of getting commotio cordis actually goes down.
He said the reason is not clear, but there are a couple theories. One is that the energy of the impact peaks too early to affect the cardiac cycle. The other relates to how the body absorbs the impact of the hit.
“Once you get up above about 45-50 miles per hour, if you don’t have protection, an impact with a baseball will do some measurable damage to the tissue – it’s going to bruise it, it could even maybe break a rib or cause a lot of trauma to the tissue. In doing so, the body’s sort of acting like a protective pad,” Oliver said. “It’s absorbing a lot of that stuff, so not as much gets through to the heart.”
