If you follow professional baseball, I am sure you have observed an alarming rate of pitchers who underwent ulnar collateral ligament reconstruction (“Tommy John surgery”) already this year. Miami Marlin’s rising star, Jose Fernandez, became the 18th professional pitcher in 2014 to undergo this surgery, equaling the total number of pitchers to have Tommy John surgery all of last year.1
Why does this trend continue to rise?
According to the American Sports Medicine Institute’s (ASMI) Position Statement for Tommy John Injuries in Baseball Pitchers, many of these injuries actually began when these pitchers were young.2 Mike Reinold, a nationally known physical therapist in the baseball community, states, “we are starting to see the results of what these kids did 10 years ago. The excessive pitching from youth and high school baseball is catching up. There is a lifespan on your ligament.”3
In addition, more and more young athletes undergo this surgery. In 2008, 32% of individuals undergoing Tommy John surgery at, the Andrews Sports Medicine & Orthopaedic Center were youth and high school pitchers.4
Risk Factors for Adolescent Pitchers:
Recommendations for Adolescent Pitchers:
Maximum Pitch Count
Age |
Pitches Per Game |
7 to 8 |
50 |
9 to 10 |
75 |
11 to 12 |
85 |
13 to 16 |
95 |
17 to 18 |
105 |
Required Rest Days (Based on Pitches Thrown)
Ages 14 and Under |
Ages 15 to 18 |
Required Number of Days Rest |
1 to 20 |
1 to 30 |
None |
21 to 35 |
31 to 45 |
1 Calendar Day |
36 to 50 |
46 to 60 |
2 Calendar Days |
51 to 65 |
61 to 75 |
3 Calendar Days |
66+ |
76+ |
4 Calendar Days |
Source from the STOP Sports Injuries Website and the work of Dr. James Andrews and Glenn Fleisig, PhD. 5
Sources:
1. “Notable MLB Pitchers Had Tommy John Surgery This Year.” ESPN. 16 May 2014. Web. 04 June 2014. http://espn.go.com/blog/statsinfo/post/_/id/89542/jose-fernandez-surgery-confirmed-as-tommy-john-epidemic-continues .
2. “Position Statement for Tommy John Injuries in Baseball Pitchers. American Sports Medicine Institute. May 2014. Web. 04 June 2014. http://www.asmi.org/research.php?page=research§ion=TJpositionstatement .
3. Reinold, Mike. “5 Reasons Why There Are So Many MLB Tommy John Injuries.” MikeReinold.com. 21 April 2014. Web. 04 June 2014. http://www.mikereinold.com/2014/04/mlb-tommy-john-injuries.html .
4. “Youth UCL Surgery (“Tommy John Surgery”).” American Sports Medicine Institute. Web. 04 June 2014. http://www.asmi.org/research.php?page=research§ion=UCL .
5. “How Can Overuse Baseball Injuries Be Prevented?” STOP Sports Injuries. Web. 04 June 2014. http://www.stopsportsinjuries.org/baseball-injury-prevention.aspx .
6. “Position Statement for Youth Baseball Pitchers.” American Sports Medicine Institute. April 2013. Web 04 June 2014. http://www.asmi.org/research.php?page=research§ion=positionStatement .
7. Andrews, James R. “Baseball.” Any Given Monday: Sports Injuries and How to Prevent Them, for Athletes, Parents, and Coaches – Based on My Life in Sports Medicine. Scribner, 2013. 73-87.
1 Comment
Shane Hayes - Sports Physiotherapist
Exactly, rising epidemic. Is it just occurring because of surgeons able to make money from it? The same occurred with FAI’s, where were they before? no athletes seemed to need surgery for it before, now they all do. But they seemed fine before, and most are non-symptomatic. Looking for something wrong that wasn’t there is my opinion!