Youth Baseball and the Rise of Tommy John Surgery

Youth Baseball Tommy John SurgeryWe have already seen 15 pitchers sent to the Disabled List with a torn ulnar collateral ligament (UCL) THIS YEAR! Why is this such a big deal? The treatment: UCL reconstruction, better known as Tommy John surgery.

“It’s unreal,” said former major league pitcher Tommy John, the surgery’s namesake. “And it’s crazy that they would pick 2014 to be an epidemic year, it seems like guys are going down right and left.”

About Tommy John Surgery

A revolutionary procedure when it was first performed 37 years ago on John. Before that moment, a damaged UCL was a career-ending injury. As of today, more than 50 active major league pitchers have undergone the procedure, which uses a tendon graft from the wrist to replace the torn UCL.

Today, 92% of elite pitchers who undergo Tommy John Surgery return to their prior level of competition. But the problem doesn’t stem from pitching in the majors, suggests John.

“Throwing pitches in the big leagues will not hurt your arm,” said John. “It’s what you did down the road when you were younger. … In essence, the injury itself is a buildup of overuse. And not overuse as an adult, but overuse as a kid.”

Youth Baseball and the Rise of Tommy John Surgery

A study conducted by biomechanics expert Glenn Fleisig followed 500 pitchers for 10 years, starting at age 12. The findings: kids who pitched more than 100 innings in a year were more likely to have Tommy John surgery. While other factors, such as mechanics, play a major role in injuries, Fleisig found that a heavy workload in youth baseball was the strongest factor of all.

Famed orthopedic surgeon James Andrews has a slightly different ranking of the major factors leading up to Tommy John surgery, but the end result is still the same.

“The No. 1 risk factor for UCL injuries is poor mechanics,” said Andrews. “The No. 2 factor is overuse. And if you overuse with poor mechanics, you’re doomed.”

How often does your son pitch?

“What I would like to see these guys do, these surgeons and all, is ask all the guys who have had the surgery — ‘How much did you pitch as a kid and how often, and did you pitch year-round?’” said John. “And nowadays, probably 70 to 80 percent of the pitchers today have been pitching 12 months a year since they were seven, eight or nine years old. And your arm is not made for that.”

Many doctors attribute the rise in UCL injuries to overuse and the extension of the baseball season. Nowadays, it isn’t unheard of for a child to pitch 12 months out of the year.

“Kids are getting run into the ground,” said Yankees reliever Shawn Kelley, who has twice undergone Tommy John surgery.

The good news is that many of these injuries are preventable. It is up to you, as a parent or a coach, to listen.

  1. Monitor you’re the child’s innings and pitch count.
  2. Listen to the child. If he says his arm is sore, don’t push him. This could be the first warning sign of something more serious.

“When you’re young, it’s hard to think about the long term,” said Dr. Rebecca Carl. “They don’t think, ‘I don’t want to be 30 with a bad elbow.’ But we do.”

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Sources

Tommy John on surgeries: ‘Unreal’ ESPN

Tommy John surgery now routine in Major League Baseball, but is youth baseball partially to blame? New York Daily News

In baseball, overuse injuries plaguing more young athletes Chicago Tribune


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