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Breaking The Cycle of Tommy John Surgeries

For any pitcher at any level, the words “Tommy John Surgery” send waves of fear and dread. It’s just one of the injuries that plague pitchers from a young age all the way up to the big leagues.

Injuries among youth pitchers, and youth athletes in general, continue to rise each year. Dr. Jeffrey Dugas, an orthopedic surgeon at the Andrews Sports Medicine and Orthopaedic Center in Birmingham, Alabama, told ABC News that high school athletes now make up more than 55 percent of his Tommy John surgery patients. While that statistic is striking, there is work being done to prevent these sorts of injuries.

This procedure, also known as Ulnar collateral ligament reconstruction surgery, happens when the ligament is torn in a person’s elbow. A healthy tendon is taken from the arm or leg and threaded above and below the elbow. It takes most pitchers a full year to begin pitching again.

Tommy John III, whose father was a professional pitcher and made the elbow procedure famous, is one person that wants to do something about the problem.

In an interview with the Pittsburgh Post-Gazette, John, who runs the Tommy John Performance and Healing Center in San Diego, says there’s only one way to change the culture that wants pitchers to follow strict pitch count limits but encourages young players to play year-round along with other concepts that put kids at risk for injuries. John recently wrote about this topic in his book, Minimize Injury, Maximize Performance.

“No organization, no single specialist, no league, nobody’s going to figure this out,” John said. “If we want to change the big leagues, if we want to change the NFL, if we want to change the NBA, we have to start young.”

Jonathan Armold, who currently works as a minor league pitching coach for the Texas Rangers, agrees.

“I think it starts with education, in terms of allowing coaches and parents to understand how much is too much, what is ultimately going to be detrimental to the pitcher and the athlete in general,” Armold told The Season. “But you also have to do so without sucking the fun out of it.”

During the offseason, Armold gives private pitching lessons to kids. When he asks his students how the season is going, the typical response is, “we played a tournament this weekend, and I threw three innings.” After further questioning, Armold realized players are not pitching these innings on the same day in the same game. Oftentimes, these pitchers are asked to pitch on consecutive days.

“I’ve got professional athletes in better shape … and we don’t allow anybody to pitch back to back days until you get to AA (ball),” Armold said. “Kids are going out in tournaments and throwing not just back to back days but twice in the same day.”

For coaches, parents and players who are committed to creating a healthier pitching routine, Armold believes developing a pre- and post-throwing plan is critical. Many kids don’t understand the process of preparing the body for intense physical activity; they just want to pick up a ball and throw as hard as they can.

“You wouldn’t go to the gym and immediately start squatting whatever weight you’re going to be doing that day,” Armold explained. “You want to do some sort of warm-up, or you’re going to be at risk of hurting yourself. It’s the same concept (in baseball).”

The key, Armold says, is to do body warm-ups that will get the blood flowing. From that, warm up your arm with simple arm circles and other stretching techniques. It’s also important to establish regular arm care after throwing with light stretching and other exercises that allow for proper recovery. During the offseason, coaches and parents should allow kids to try other sports, which can help in transferring athleticism to baseball.

In his book, John recommends a holistic approach to better health and wellness for young athletes, including less long-distance running, no static stretching and staying away from milk products. While Armold doesn’t subscribe entirely to this method, he does point out professional baseball is embracing better overall health: proper sleep, strength and conditioning, physical and mental peak performance.

Even the best care won’t completely eliminate Tommy John surgeries or other injuries. It’s also unrealistic to expect a complete return to baseball of the past, where pitch counts and radar guns were not the norm. But understanding how to take care of an athlete’s body, better monitoring of pitch workloads, and keeping the game fun can open the door to change, one player at a time.

 From GameChanger and Stephen Kerr
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