Spike in Tommy Johns Due to “Pitch Younger, Pitch Faster, Pitch More Often” (Orthopedics This Week)
The culprit in the recent upsurge in Tommy John surgeries just may be things that happened years ago, says new research. Neal S. ElAttrache, M.D. is a sports medicine specialist with the Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California. Dr. ElAttrache, the team physician for the LA Dodgers, tells OTW, “The number of UCL (ulnar collateral ligament) injuries—and thus Tommy John surgeries—at the professional level has been alarming. We are seeing more primary UCL tears and now also seeing re-tears in players that have undergone previous Tommy John surgery. Some players are having surgery in their teens and early twenties and then experiencing a re-tear several years later, while some re-tear within 18 months of their return to play. As it stands now, just under 1 in 3 pitchers in the professional leagues will have had a Tommy John operation, BUT almost 25% of those who have a Tommy John will not make it all the way back to their previous level of performance.”
“From the data trends we are seeing, it appears that this increase is linked to several things, including the number of innings pitched prior to entering professional baseball, year-round participation and early specialization as a pitcher, and high velocity pitching. When a teen is throwing a ball over 90 mph and doing it year-round, he has a much higher chance of ending up in our office. It may be a sudden tear that brings him in, but it’s usually due to a series of incompletely healed micro-tears that may or may not be symptomatic, but gradually compromise the elbow until it fails.”
“Kerlan-Jobe and ASMI [American Sports Medicine Institute] have conducted independent studies on this topic and are now working together with professional players on this issue. One of the benefits of doing this at the professional level is that it shines a spotlight on the problem. We can say to kids, ‘By early specialization and over-use with year-round participation, you are increasing your chances of injury and hurting your chances of progressing in the big leagues. We have studied this and these practices down-grade you.’ Some parents and coaches think it’s a good idea to play year-round and specialize as a pitcher at age 11, but in fact if they do that before 15/16, they are most likely eliminating the chance that their child will become an elite-level player.”