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Tommy John surgery becoming commonplace in high school baseball pitchers

If an investor saw the stock price of the stock he or she bought increase 700% over a four year span, do you think he or she would be happy?

What can be done to stop the Tommy John epidemic
Darren Tracy Photo

On the flip side, if incidences of drunk driving, or any other crime went up 700% in a four year period, would society call it an epidemic?

There IS an epidemic going on with high school baseball pitchers across the country. Matter of fact, we have seen this epidemic throughout all of amateur and professional baseball. Twenty major league pitchers have already gone under the knife this season, their 2014 seasons lost. More and more high school pitchers are suffering the same fate.

Tommy John surgery is becoming the new LASIK, and not in a good way

What is Tommy John surgery?.... The surgery repairs damage to the ulnar collateral ligament in the elbow. The ligament tears, and needs to be replaced. It is called Tommy John surgery because former Major League pitcher Tommy John was the first player to have this type of surgery done, in 1974. It involves removing the damaged ligament, drilling two small holes in the ulnar bone of the elbow, and using a harvested tendon from the forearm and weaving it in a figure eight through the holes. Rehab takes up to a year, and it can be argued that a pitcher will never throw any harder, or get any better than what he was before the surgery.

What causes these kids to need this surgery?.... Overuse, overuse, and overuse. It's the "win at all cost" mentality that is starting at a younger and younger age, leading to arm problem later on. In an article to the Houston Chronicle, Glenn Flesig, Chair of Research at the American Sports Medicine Institute, confirms that belief:

Without a doubt, the No. 1 statistical cause (of UCL injuries) is overuse. In our studies, when a pitcher regularly threw with arm fatigue, he was 36 times more likely to be in the surgery group as opposed to the non-surgery group. That's the strongest statistical correlation in any study we've ever done.

Obviously, the more stress one put on an area of his or her body, the more likely it is to breakdown. Damage to the UCL is a progressive type of injury, meaning that one pitch at any given moment isn't going to cause the UCL to tear. It's the accumulation of innings, pitches, and lack of rest. Outside of coaches not looking out for their pitchers, what are the other causes of stress and overuse on a high school pitcher's elbow?

  • Year round play... Baseball, like many other sports, has become specialized. Kids that used to play basketball and football are now playing in fall and winter baseball leagues instead, which just leads to overuse. In the same article to the Houston Chronicle, Flesig talks about the switch to year round play:

Kids get more specialized, playing all year round, but that's what got them here. With so many pitches thrown, their total pitch count is now what a 25-year-old man used to have.

  • Too many curveballs.... When curveballs are thrown incorrectly, without the proper mechanics, it puts an incredible amount of strain on the elbow. Throw in the fact that curveballs are now being thrown by kids at a younger and younger age only adds to the stress. Saving a kids arm should be the priority. Curveballs should only be thrown with the proper mechanics, and only after the child in question has hit puberty.
  • Lighting up the radar gun.... What is the number one thing college and pro scouts look at? Velocity. How hard a kid throws. The problem with this is that kids now are throwing as hard as they can, putting great stress on their shoulders and elbows. In most cases, the ligaments in their elbows have got gained the strength that the rest of their body may have gained.

So, how bad has to overuse of young pitchers gotten? In an article to ESPN, Dr. James Andrews, arguably the most famous orthopedic surgeon in the world, who has done the Tommy John surgery on numerous Major League pitchers, talks about the epidemic of this surgery on high school pitchers:

Three years ago, I was doing three to four of these a year on high school kids. Now I am doing three to four a week

Dr. Andrews is a big proponent of overuse being the cause of such injuries, and it being the cause of doing the surgery at a younger and younger age:

Why do we have red lights and stop signs? Because we have to have them. Nobody likes them. I hate red lights. But they make you safe. Someone has to police these young kids to get them out of the operating room.

One of the ways that has been adopted to maintain the health of young pitchers is pitch counts. Pitch counts seem to be a hot topic on all levels of baseball these days One may argue that pitch counts have nothing to do with the amount of Tommy John surgeries that have happened in Major League baseball. Major League teams have had their pitchers on pitch counts for a number of years now, and the amount of Tommy John surgeries has actually gone up in the last few years.

That logic is flawed. Since the number one cause of the surgery is overuse, and damage to the UCL is a progressive process, wouldn't it make sense to limit ones pitches as they are younger?

That is exactly what Dr. Andrews has done. He was THE driving force it getting pitch counts and mandatory days rest as a regulation in all Little League baseball. Those rules are still it place today.

He hasn't stopped there. Dr. Andrews, through his research at the ASMI, will be releasing an App called Throw Like a Pro. On this App there will be places to enter a child age, a pitch counter, and the recommended days of rest. It will also have pregame and post game stretches and exercises to keep these young kids in good health.

One thing is for sure. This epidemic of Tommy John surgery on high school pitchers has to stop. Hopefully, with common sense from coaches and players, this alarming trend can come to an end.

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