The Tommy John Surgery Epidemic
Something needs to be done to stop the rash of serious arm injuries among youth baseball pitchers.
OK, I admit it: I’m addicted to baseball. Whether it’s major league, minor league, college or Little League… I’ll watch it, even if I don’t have a connection with either team.
But that doesn’t mean I’m oblivious to the state of today’s game. Baseball has taken its share of hits over the years (sorry, couldn’t resist the pun), and rightfully so. Games take longer, free agency has minimized the loyalty between players and teams, and umpires take liberties with the strike zone. Then there’s the latest scandal: pitchers using some sticky thing called Spider Tack to get more spin on the ball.
But there’s another issue I’ve had my eye on for a long time: arm injuries, particularly among pitchers. It’s not just a problem in the big leagues, either. Many youth pitchers experience arm trouble before they reach college. It’s especially heartbreaking to see the number of Tommy John surgeries rise among young pitchers. Many doctors across the U.S. are calling this trend an epidemic, especially at the high school level.
How Did We Get Here?
According to a 2015 study in the American Journal of Sports Medicine, 56.8 percent of Tommy John procedures occur among athletes between 15 and 19 years of age. It’s an alarming number, but not all that surprising to me. In today’s world of travel tournaments, showcases, and high school games, kids are throwing several days or games in a row. That’s a lot to put on an arm, particularly at an age when it’s still developing.
The surgery was named after former major league pitcher Tommy John, who was the first to undergo the procedure in 1974. It involves the replacement of a partial or fully torn ulnar collateral ligament on the medial side of the elbow with a tendon from another part of a patient's body or a cadaver.
Dr. Jeffrey Dugas, an orthopedic surgeon with the Andrews Sports Medicine & Orthopedic Center in Birmingham, Alabama, says even though the curve has flattened a little in terms of overall cases, the biggest concern is among younger athletes.
“In a study that we did recently on the UCL repair, the average age was 18, and that means that ranged from 12 to 30,” Dugas explained on the ABC News Perspective Podcast.
Finding a Better Way
The former major leaguer’s son, Tommy John III, has been quite outspoken about the problem over the past few years. In an interview with the Pittsburgh Post-Gazette in 2018, he said there’s only one way to change the current culture that puts young kids at risk.
“No organization, no single specialist, no league, nobody’s going to figure this out,” said John, author of the book “Minimize Injury, Maximize Performance”. “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.”
A couple of years ago, I discussed this issue with Jonathan Armold, minor league pitching coordinator for the Texas Rangers. Armold played over 40 games in the Milwaukee Brewers organization before turning to coaching. He agrees in part with Tommy John III’s assessment.
“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 me. “But you also have to do so without sucking the fun out of it.”
Armold also gives private pitching lessons to kids during the offseason. He’s lost count of how many pitchers have told him they regularly throw up to three innings over a period of several games in two days, one inning at a time.
No wonder so many young arms are being blown out.
“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.”
No Easy Solution
So how do we stem the tide of unnecessary arm injuries to young pitchers? The opinions are as varied as the number of kids who have dreams of playing in the big leagues. In his book, the younger Tommy John subscribes to 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.
Armold believes a pre- and post-throwing plan is critical. Too often, kids just want to pick up a ball and start throwing.
“You wouldn’t go to the gym and immediately start squatting whatever weight you’re going to be doing that day,” Armold told me. “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).”
Look, I’ll be the first to admit getting caught up in the moment of a game or tournament, wanting a pitcher to get that last out or go one more inning to nail down a win. But is that one moment worth ruining a kid’s arm for life? I certainly don’t think so, and I know lots of coaches who wouldn’t either.
Most kids will forget the wins and losses after they leave sports. But they’ll always remember the experience, so why risk one inning or one game for a moment of glory? Even a baseball fanatic like me knows the answer to that question.
Hot Takes and Great Reads
Speaking of the above reference to the sticky substance controversy, I can’t help but wonder what youth ballplayers think as they watch this unfold. Major League Baseball’s handling of steroids, sign-stealing and other controversies has been questionable at best. If you coach youth baseball or softball, simply reply to this post and give me your thoughts on what kids are saying about this.
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I love reading stories about people helping kids. Two women in Key Largo are organizing an adaptive swimming summer camp in July for children with disabilities.
The idea is to promote water safety and swim skills in a fun environment. A number of sponsors are on board, including a grant from the Ocean Reef Community Foundation and Shell World.
Click here to read this inspiring story.
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Not everyone is jumping up and down with excitement about the possibility of college athletes being able to financially benefit from their name and likeness. The issue is causing concern among high school and youth coaches, parents and administrators. Some are afraid this will cause adults to exploit the talent of elite athletes even more than they already do. Others believe it could create an environment where kids are pressured to spend more time marketing themselves and less on team-building values.
I don’t know if there is an easy answer to this dilemma, but I think it’s a more realistic approach than paying student-athletes directly. No matter what position you take, you might find this Washington Post article enlightening.
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Board members of the East Chambers Youth Football League in Winnie, Tx got an unpleasant surprise when they arrived at the football field. They discovered the concession stand had been vandalized, with over $2,000 worth of items stolen.
The league has organized a GoFundMe Page to replace the stolen and damaged items. As a native Texan, I’ve passed through that area on a number of occasions. If you can help these folks out, I’m sure they would appreciate it.
On Deck
Here’s a sneak peek at what’s coming up in the next issue.
The coronavirus pandemic postponed the 2020 Tokyo Olympics to this summer. That posed quite a challenge for athletes trying to stay in shape. Find out some of the creative ways they trained during the shutdown to keep their dream alive.
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