In what should not be a terribly big surprise, Tommy John Surgery (TJS), also known as Ulnar Collateral Ligament (UCL) replacement surgeryhas spiked in the last decade or so.
Thanks to Buster Olney for pointing this one out.
I'm a bit slow, I guess, but some things I find confusing:
- Generations ago, kids played ball all the time (fewer other distractions)
- Generations ago, pro pitchers pitched every fourth day, not every fifth like today
- Generations ago, pitchers routinely went the distance in games, or at least approached each start as if they planned on finishing the game.
- Generations ago, medicine, training, education about arm health were rudimentary, at best.
- Today, fewer kids play baseball (more options)
- Today, fewer kids play baseball all the time (again more choices)
- Today, kids as young as 8 are on pitch counts (I know this first hand)
- Today, pro pitchers take the hill every 5th day, at best.
- Today, pitchers rarely go the distance, expecting to last six, maybe seven, innings before handing the ball off to a middle reliever or two, for an inning or so each, before handing the ball off to a closer.
- Today, medical knowledges and advancements are saving arms and careers.
- Today, we're doing more career-saving elbow surgeries than just 10 years ago despite everything we now know.
The conventional wisdom, which I am willing to admit might be flat-out wrong, is that use built up arm strength. The Japanese are legendary with regards to this (see also: Dice-K's history). And now, the prevailing wisdom is not to pitch your way to arm strength, but to limit your arm to protect it.
Dr. James Andrews, one of the nation's most respected orthopedic surgeons, has also seen a spike in the number ofhigh school pitchers he has performed the procedure on.
In a three-year span from 1996-99, Andrews performed Tommy John surgery on 164 pitchers, 19 of whom were high school aged or younger. From 2004-07, that number had jumped to 588 pitchers, 146 of whom were high school or youth league players — a seven-fold increase.
"Without a doubt, it's an issue," said Glenn Fleisig, the Smith and Nephew Chair of Research at the American Sports Medicine Institute, which was founded by Andrews. "The numbers are staggering in adolescents. More and more high-school-aged kids are having the surgery."
"Without a doubt, the No. 1 statistical cause (of UCL injuries) is overuse," Fleisig said. "In our studies, when a pitcher regularly threw with arm fatigue, he was 36 times more likely to be in the surgery group as opposed to the non-surgery group. That's the strongest statistical correlation in any study we've ever done."
High school coaches agree pitchers are throwing too much these days — and it starts before their high school careers. With the warm weather in Houston, the high school season is just one part of an elite pitcher's year. Such pitchers often play with select or travel teams in the summer and sometimes in the fall, leaving little time for rest.
The final paragraph in the article sums it up quite nicely, too:
But parents and coaches at all levels also have to take responsibility.
"Dads thinking (their sons) have to win at all costs at 9, 10, 11 and 12 years old to win those championship games (at tournaments) — all that means nothing in the big picture. They are fun years, but they all mean nothing compared to (the high school) level. It's not worth risking your son's arm to win a tournament at all costs."