November 9, 2016

Tommy John Surgery False Hope for an Overworked Elbow


No longer is it a malady, it is an epidemic believe medical experts.

The Arm: Inside the Billion-Dollar Mystery of the Most Valuable Commodity in Sports, author Jeff Passan finds a frightening trend in young arms getting hurt and a youth baseball culture too ignorant to stop it.  Nearly 30% of all Major league pitchers have undergone this procedure, yet Passam reveals that their is great concern in the medical community that an increasing number of 15-19 year olds arms are being over worked and that a disproportionate of kids elbows are requiring the surgery.

Doctors consider Tommy John surgery one of the most successful medical procedures ever because it solved a problem. When an elbow ligament tore, it could be fixed. Baseball rejoiced. “We thought elbows were solved,” former Red Sox general manager Ben Cherington said. “So we stopped thinking about them.”

Because an answer for elbow issues existed, the sport never bothered to concern itself with the root cause of such injuries. Maybe it was mechanics, the way a player throws the ball and its effect on his body. Perhaps it was usage, the volume of pitches or innings in a single game, over a whole season, or even longer. Certainly a player’s genetic makeup could factor in, too, or how hard he threw, or what pitches he preferred, or his diet, or any other sort of measurable factor.

The arm after Tommy John Surgery

Tommy John surgery, it turned out, was a paradox, the procedure that worked too well. It lulled baseball into a false sense of security, and by the time the sport realized what had happened, an epidemic was on its hands. Elbows are breaking more than ever and younger than ever. And while the rash of Tommy John surgeries that spread across Major League Baseball over the last five years took out some of the game’s finest pitchers, and baseball is thus left scrambling to figure out how to keep its million-­dollar arms healthy while fixing a feeder system that keeps sending damaged goods to major league teams.

The American Sports Medicine Institute (ASMI), the baseball industry’s foremost think tank, followed nearly 500 youth-­league pitchers for a decade starting in 1999 and found that kids who pitched more than 100 innings in a calendar year were three and a half times likelier to get injured than those who didn’t. In 1997, Dr. James Andrews, the famous orthopedic surgeon who had founded ASMI in Birmingham, Alabama, was performing Tommy John surgery on one or two high school kids per year. Today, he estimates he does 80 or 90 a year.

Todd Coffey's arm after Tommy John surgery

The future generation of baseball pitchers lives in a system that takes undeveloped and underdeveloped arms and pressures them to show off for the radar guns they’re taught will determine their future. The easiest way to build velocity is through year-round throwing—and year-­round throwing, according to the ASMI study, is the single highest predictor of future injuries among kids. 

I encourage everyone from players, coaches, parents, administrators, and young kids to read the full article on the new Republic site or purchase the book.  It's frightening the toll around the year pitching has on teenagers arms.