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The Increase in Tommy John Surgeries on High School Pitchers

By Shivan Amin | October 26th, 2018

High school baseball today is more competitive than ever. Every aspect of the game is faster, and this includes the pitchers, many of whom can throw at more than eighty miles per hour. This short time success on the mound, however, can come with devastating consequences. When pitchers throw at high speeds consistently, their UCL tendon stretches and can eventually snap. More high school pitchers throwing at high speeds will, consequently, lead to more Tommy John surgeries.

A Tommy John Surgery is a procedure in which the UCL is reconstructed by taking a tendon from another part of the body, usually the hamstring, and using it to obtain a new UCL. Rehab takes two to four months, but it can take as many as six to nine months for athletes to regain the elbow strength that they once possessed.

Dr. James Andrews is the head of Andrews Sports Medicine, a premier orthopedic center in the United States. Dr. Andrews led a research project where he charted the rise in Tommy John surgeries on adolescents. He discovered a forty-five percent increase in total patients under the age of 18. Indeed, in a 2015 interview, Dr. Andrews stated that he performed only one or two Tommy John surgeries on high school pitchers in 1997; now he performs eighty to ninety each year.

There are two interconnected reasons to explain this increase. The primary reason is the specialization in a single sport at a young age. Dr. Randolph Cohen, an orthopedic surgeon in Hollywood, Florida, led a research project studying U18 pitchers undergoing Tommy John surgery. Dr. Cohen says, “The biggest issue is that there’s an overall kind of irrational push by parents on children who are playing sports for such long hours and such long durations and such great repetition.” Parents want their kids to achieve—as they should. But specializing in a sport at a young age has risks, and parents should know as much.

Many states are aware of this issue and are working towards a solution. Some are making teams keep a pitch count, as seen in the image below. Players will be able to pitch for only a certain number of days before resting. In addition, many doctors recommend that coaches put their pitchers through less rigorous training and advise icing and rest. For younger pitchers, doctors recommend only practicing pitching two to three days a week and not throwing curveballs and change-ups until pitcher’s bones have fully matured.

These are small steps in solving the problem of Tommy John surgeries, but they are steps in the right direction. Implementing them will allow pitchers to have successful careers later on in life, whether they choose to pursue a future in baseball or in another career altogether.

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