With all the talk about overuse injuries due to early specialization of late, my wife picked up a book at the Library that is one I am reading now called “That’s Gotta Hurt”, written by Dr. David Geier regarding the various sports injuries and their remedies that have impacted sports.
One chapter is dedicated to Tommy John Surgery and I thought would be a great to share some of the nuggets.
I believe everyone knows the reason the repair of the Ulnar Collateral Ligament (UCL) in the pitcher’s arm is called Tommy John as the first ever one done was on MLB pitcher Tommy John after he suffered the tear to his UCL pitching for the LA Dodgers against my former favorite team, the Montreal Expos (who were on track to win the World Series in the lock-out year then only to be moved to Washington a decade later but that is another story in itself).
The date of that game was July 17, 1974 and it revolutionized how the UCL tear was repaired, when Dr. Jobe conducted the first ever “Tommy John” surgery by taking a tendon from the forearm of the non-throwing side to replace the torn UCL.
It is a major reconstruction, takes over a year of rehab to get back to the mound, but the upside is statistically the % is quite high that pitchers will be able to return back to competitive level they were prior but the big unknown is for how long and if they have one as early as Roberto Osuna did @ 18 years old (pitcher for the Toronto Blue Jays), if they will require a subsequent Tommy John Surgery down the road.
Thus far, the only pitcher to enter the MLB Hall of Fame ever to have had Tommy John Surgery is John Smoltz, and this was his classic “rant” when he was being inducted in the hall of fame in 2015 as the number of Tommy John Surgeries being done on teenage boys was continue to escalate when it previously was only MLB pitchers to prolong their careers in their 30’s (Tommy John was 31 when he had the surgery, John Smoltz was 32).
Fast forward to current times, now over 60% of the Tommy John Surgeries being done are on 15-18 year old boys. Over 60%!!!
Compare that to the last 2 decades
In 2010 – 33%, In 2000 – 18% so the number has increased over 300% !!
Part of the reason is due to overuse, but the other reason is due to poor mechanics that should be corrected by minor baseball coaches. As the current winning at all costs environment makes them focus more on the outcome of winning games vs. prolonging the pitching careers of their young pitchers, providing technical expertise for the correct mechanics and discouraging specialty pitches until their teen years (curve ball, sliders, knuckle ball) it is leading to the ever escalating increase of Tommy John Surgeries with no signs of it reversing any time in the immediate future.
One of the experts that contributed to the chapter, Dr. Glenn Fleisig, research director at the American Sports Medicine Institute (ASMI) as well as others shared the insight that the UCL injury is PREVENTABLE if pitchers focused on the right mechanics as well as limited their number of pitches in youth baseball year over year.
Why then has the number of surgeries tripled on teenage boys the last 2 decades?
- Specialization – overuse where pitchers are throwing in Spring, summer, fall and even winter ball.
and
2. Lack of proper instruction in terms of the proper mechanics for various pitches
There was even a head coach of a team that has a very successful record who had pitchers throw over 200 in games (when the MLB pulls pitchers when they get over 100) and used the analogy that kids from the Dominican Republic do so all the time so did not think it was big deal.
The other sad statistic that has evolved is a study done by Christopher Ahmed found that …..
- 30% of coaches
- 37% of parents
- 51% of high school athletes
- 26% of college athletes
…..believed that Tommy John Surgery should be performed on players with NO INJURY to improve pitching performance.
Say again? Performing a major reconstructive surgery on someone that is NOT INJURED?
Would be different if we used medical advances to repair serious injuries but another altogther aspiring for that robotic arm no?
Surely everyone knows that the TV series Six Million Dollar Man in the 70’s and the upcoming movie 6 Billion Dollar Man based on the same series is fictional?
Talking to some parents as I have travelled the country, they have heard that the surgery will increase their son’s pitching velocity by up to 5 MPH and with multi-million contracts for pitchers they “claim” their son is willing to undergo the surgery to chase the dream.
Reality Check – there is no anecdotal evidence that the surgery done on an uninjured UCL will increase pitching speed, nor is there any longitudinal studies showing how long their professional careers may be if they have the surgery in their teen years as is the majority now.
When the son of a mother reached out to me regarding her sad story that her 15 year old son was quitting competitive baseball and the reasons he was doing so was so he could also play other sports (basketball) so would play (recreational baseball in Spring only).
In a subsequent follow-up email she shared with me her 15 year old son made the decision to quite due to the intense pressure playing competitively, sports evolving to year-round work, more and more kids are quitting the game than ever.
He also told his Mom “he doesn’t want to injure his arm (pitching) too young so, he can play longer etc…I think sometimes our children are OUR biggest teachers and sometimes we need to sit back and be taught!”
If a 15 year old GETS it, why don’t the adults?
The youth baseball coaches when kids start to pitch at 9 years old should have best interests of the child in mind, not the outcomes of games to ensure that they teach them the proper mechanics, avoid competitive pitches until later (breaking balls, curve balls, sliders) as John Smoltz touched on in his Hall of Fame Induction Speech.0
It is even more critical now as baseball is the sport that has been affected most by attrition, in Canadian study done by Statistics Canada from 1998 to 2005 baseball saw overall participation rates drop by over 50% (youth and adult). Like many other sports baseball is in jeopardy also in terms of fans, the Toronto Blue Jays lost over 7,000 season ticket holders this year.
Many MLB stadiums are having the worst attendance they have had to start their spring seasons in decades including image below from recent Chicago White Sox game.
The seats are empty because less are playing to begin with or those that do, are quitting because they are burnt out or are suffering career ending injuries in their teens from overuse coaches not keeping track of pitch counts.
Simple Math – You play the game, then you watch the game because your LOVE IT.
If less play the game, less will watch the game later in life as fans.
Now, more than ever, we must work together to bring the game back to the kids … where it belongs.
