Running Head: TOMMY JOHN EPIDEMIC

Tommy John Epidemic

Ryan Milton
University of Southern Mississippi
Dec.7, 2015

TOMMY JOHN EPIDEMIC

Tommy John Surgery Keeping Pitchers of the Mound

Abstract
This research paper studies an increasing problem the entire baseball world is
being faced with. It is starting to be known as a growing baseball epidemic. Over the
past decade, the amount of Tommy John surgeries has increase drastically. The largest
increase of this surgery has been in youth pitchers. It is terrible to see a kid destroy his
baseball career before it even has a chance to get started.
The reason for choosing this topic is because it is a growing problem in the sports
world today that I have been around all throughout my baseball career. If you turn the
television on a sports show during baseball season, there is a great chance the talk of
someone recovering or someone that was just faced with a tear of the ulnar collateral
ligament will come up. The growing dilemma could be caused from multiple reasons, so
researching this topic could fill many different gaps and change many views. It is a very
common injury in baseball pitchers, with the damaging of the ligament starting from
youth baseball. No matter the age or the size of the pitcher, the pitching motion alone can
generate enough force on the ligament to cause a tear. Unlike pitching in softball,
baseball pitchers are required to pitch using an unnatural arm motion. Therefore a pitcher
is basically forcing his arm to throw an object the wrong way. That is why it is very
important for parents and coaches to have an understanding on what can cause a UCL
tear as well as different ways to help avoid the injury in order to keep their children in the
game.

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Introduction
The sporting industry is a multi-billion dollar global industry that acts as
entertainment for millions of people on a daily basis. The majority of people grow up
playing sports at an early age hoping to one day be the superstar they follow on
television. However, most of the pitchers that do fulfill their dreams are still faced with a
roadblock along the way known as Tommy John Surgery. This type of surgery is
becoming very popular due to a drastic increase over the past decade. The number of
young pitchers forced to have Tommy John is increasing annually and several reasons are
being blamed for the cause. Tommy John surgery is common in baseball pitchers
because is it the reconstruction of the ulnar collateral ligament (UCL) of the elbow.
When a pitcher throws, the UCL is put in an extreme amount of stress. The wear and tear
of the ligament can cause a complete tear, forcing the need for surgery. Many sports
related professionals, such as coaches and managers, are also affected when this occurs.
A tear of the UCL can be caused by numerous reasons, but there are many different
beliefs and recommendations to help avoid it. To help investigate causes for Tommy
John Surgeries and ways to avoid it, interviews were conducted to show qualitative
research gathered from different sports related professionals.

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4
Literature Review

Many peoples lives across the world today are influenced or evolved around
sports. Sporting events are the most common watched television programs across the
world. However what if your favorite teams star player has to sit out because of an
injury? That specific team and many fans are affected because of that. The rate of sports
injuries is on an increase every year, causing many teams to face adversity and forcing
them to make adjustments due to a key player being out for surgery. In baseball the most
common surgery many pitchers are faced with is known as Tommy John Surgery. It is
the reconstruction of the ulnar collateral ligament in the elbow. The surgery received its
name from one of the greatest pitchers of all times named Tommy John. Tommy was an
exceptional pitcher who pitched 26 seasons in the major leagues with a total off 700
career starts. On July 17, 1974 in the middle of a pitch against the Montreal Expos, he
felt a searing pain when he tore his Ulnar Collateral Ligament. The only option for
Tommy to return to the game he loved was to allow the teams orthopedic surgeon, Dr.
Frank Jobe, to attempt a surgery that had never been attempted. Before the surgery John
asked Dr. Jobe for the odds of a successful outcome, and in return the doctor replied
saying 1%. However the surgery went well and so did the rehabilitation. Two years after
the surgery Tommy returned to baseball pitching 13 more seasons before ending his
career in 1989. (John, 1978).
Today the success rate of this surgery for elite MLB pitchers is roughly 80%. Also
the rehabilitation is also a lot more effective allowing a patient the ability to return
quicker. Following the surgery about 12 months is required before returning to the
mound. For the pitchers that are fortunate enough to return to the game, the average time

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until they return to their previous level of competition prior to the surgery is 18 months
(Ortiz, 2015). Even with a great success rate, the main problem is that an unbelievable
amount of young pitchers who will most likely never play in the big leagues are being
faced with Tommy John. Several reasons are being blamed for causing this growing
dilemma in these young athletes. Some examples include, improper mechanics, overuse,
and the lack of proper rest (Andrews & Yaeger, 2013; Burger, 2015). It is hypothesized
that overuse is the greatest cause of a tear in a young pitchers ulnar collateral ligament.
However there have not been many studies completed on Tommy John Surgery. Which
this should be researched more as the game of baseball is being played all around the
world making a lot of elbows suspects to a tear.
UCL injuries are caused from many different types of scenarios or reasons.
However, only a few different things are believed to cause a tear in the UCL. Dr.
Andrews is the leading orthopedic surgeon when it comes to pitchers needing Tommy
John surgeries (Cook, 2014). Dr. Andrews has a very high success rate, but states that
there are many misunderstandings when it comes to the surgery. Some parents will
question him about their children having the surgery even though there are no problems
in the elbow. They believe that immediately following the surgery their child will be able
to throw harder and wont be faced with elbow problems in the future. However this is
false information that many parents have heard (Makhni & Lee 2014; Stark, 2014). In an
article by Dodd (2003), it states that the procedure takes about an hour however it will be
at least a year before a pitcher can return to the mound due to the mandatory rehab that
follows. Dr. Andrews believes this is one of the main reasons for the increase of the
surgery, uneducated parents about the process and the possible causes for a tear. Parents

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as well as coaches should focus more on how to help eliminate Tommy John surgery for
their children.
Parents are encouraging and allowing children to play ball year-round causing a
lot of stress on the elbow with zero rest. The majority of children today do not grow up
playing multiple sports because they want to focus on just one in hopes to grow to be the
rich professional superstar athlete found all over the television. There are multiple
reasons for this culture in todays society. One reason for this type of baseball culture is
because a lot of parents expect too much from their children and try to relive their
childhood through their young athletes (Hyman, 2009). Another is because of all the
advertisements and endorsements persuading young minds to grow up and be a
professional athlete and to keep chasing that dream in order to grow rich and famous.
High school-aged baseball players tend to have role models in the major
leagues. They all want to grow up and become a pitcher for their favorite big league
team and will do anything for that opportunity. This is believed to cause more stress on
their developing elbows because it challenges them to throw faster and throw better
breaking balls to be like the guys on television (Glier, 2014). When they are on the field
with the coaches, many pitchers are forced to throw more pitches than their developing
elbow should, as well as throw hard to light up a radar gun (Smith, 2014). In return, a
recent study has showed that in the last few years there has been a 50 percent increase in
the number of Tommy John procedures performed on high school-aged and younger
athletes (Petty & Andrews, 2004). This is the reason it has been looked at in the last
decade as a Tommy John epidemic. In 2000 alone, famous orthopedic surgeon Dr. James
Andrews performed reconstruction surgery on 17 youth and high school elbows

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accounting for 18% of his surgeries. Ten years later, Dr. Andrews performed the
procedure on 41 kids resulting in 31% of his total procedures in 2010 (Laken, 2014).
In the research article by Lyman, Fleisig, and Andrews (2002), the specific goal
was to improve the understanding of why youth pitchers develop elbow problems and to
provide information for establishing recommendations to help eliminate the problems.
These goals are very important to keep baseball games and players running smoothly for
the world to enjoy watching. For the goals to be met, 476 pitchers between the ages of 9
and 14 volunteered to participate in the study. Each pitcher answered a questionnaire
before the start of the season to collect demographic and baseball related answers to
identify if they were faced with arm problems prior to the study. Two hundred and forty
pitchers that volunteered were videotaped and qualitatively analyzed for proper pitching
mechanics. During the season, a pitch count log was recorded and a questionnaire was
answered for every game each pitcher participated in. The questionnaires were given to
evaluate any complaints of pain and the types of pitches thrown in each outing.
The results from this study supported the hypothesis that overuse is the main
cause for an UCL tear in the young athletes future (Lyman, Fleisig, and Andrews 2002).
It was shown in the study that elbow injuries are most commonly due to the accumulation
of wear from the repetitive pitching motion. Some injuries occur in high school or levels
after because the amount of overuse from childhood days catch up to the elbow (Kocher,
2000). High pitch counts were shown to have a large impact on the number of arm
problems. When the youth pitchers started reaching around the 600 total pitch levels, the
risk of elbow pain steadily increased. Therefore a strict pitch count is highly
recommended for children and should be monitored by their parents and coaches.

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Another study was conducted to qualify the cumulative amount of throwing

injuries in young baseball pitchers who were followed for ten years. The study was
conducted because of the increasing demand of elbow surgeries over the past decade. In
the study 481 youth pitchers volunteered in the ten-year study. Each pitcher was
interviewed every year. The tests throughout the study were used to investigate risks of
injury for pitchers that threw over 100 innings in at least one calendar year, pitchers
throwing curveballs before the age of 13, and players that played catcher for at least three
years. The results of the study showed that pitchers that threw over 100 innings in a year
were 3.5 times more likely to be injured. The study was unable to demonstrate that
curveballs and playing catcher resulted in an increase of injury because the trend was not
significant with the size of the study sample. However in conclusion, the study showed
that pitching at least 100 innings annually does significantly increase the risk of an injury.
It is very important parent and coaches understand and know recommendations to
help prevent their children from experiencing a season or career-ending surgical
procedure. No matter the age of the children, coaches should evaluate the pitcher and
keep the pitch count for each outing. It will benefit the coach in the long run by
eliminating some of the arm problems to keep the team healthy and on the field winning.
Decreasing the use of the elbow at an early age playing ball will allow the athlete to play
ball longer in life. This will also help avoid the negativity and stress of the surgery and
rehabilitation process that follows. Every young pitchers goal is to grow up and become
a major league baseball player. By implementing simple rules or limitations, this dream
can stay possible because after all there is no guarantee one will return to the field
performing as well as they did prior to Tommy John.

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Methodology

Literature review:
Data will be reviewed from various information sources, a case study through the
university library, and various Internet search engines. This type of qualitative
observation will help receive a background of the information and come to a conclusion.
Also in support of my research, I conducted three interviews throughout the
summer and the fall of 2015. These interviewees represent various levels of baseball and
include a high school coach, a college medical trainer, a minor league pitching
coordinator, and a professional baseball player who has been through the complete
Tommy John process. By conducting these interviews, it has allowed me to get insight
from a coachs and medical trainers point of view, as well as the point of view of a
baseball player who has competed at every level who has been through the adversity
dealing with Tommy John.
Coach David Pittman began his baseball career at a very early age and has been
around it ever since. Coach Pittman was born August 6, 1958 and just 4 short years later
his parents had him out on the baseball field playing the game he would love for the rest
of his life. Throughout his childhood he always dreamed of making a living one-day
playing baseball, however after his college career at Southeastern Louisiana University
his years of playing baseball ended. However that was just the beginning of a very long
successful coaching career. During the interview with my former high school baseball
coach, he informed me that in 2017 he would retire with 33 years under his belt coaching
at the high school and the college level. With his extensive career Coach Pittman was

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able to give me insight on what he has noticed from Tommy John injuries and the effects
he has witnessed.
During the interview Coach Pittman told many stories about different players he
had coached that tore their UCL and has to have Tommy John Surgery. Every player that
he talked about that fell into that category would be one of his most talented players on
the team during the year of the injury. According to Coach Pittman the majority of the
players that he coached that tore their UCL had parents that were die-hard fans. He said
it was almost like the parents were trying to relive their childhood through their sons.
Coach Pittman also added that the players that had the tears were usually the most
talented kids on the little teams growing up that everyone around the town would talk
about and, say when he gets older he will be really good as long as he keeps his head on
straight. Coach Pittman stated that because the kid was usually the best growing up, his
parents and coaches pushed him to the limit and made him pitch more than the other kids
and also encouraged him to play year round the older they got. However that ended
quickly whenever they would get to the high school level and have Coach Pittman as
their coach.
Coach Pittman doesnt believe in making the pitchers pitch all year round. In the
interview he stated that he recommends for pitchers to play the spring season and take the
summer off, and then play a fall league, which isnt has lengthy as the spring with taking
the winter off after that. According to him it is very important to allow kids to take at
least half the year off from pitching to minimize the stress that is being put on the elbow.
After that comment I asked him if he believed pitching 50 miles per hour as a little kid is
really putting a lot of wear and tear on the elbow. He followed up stating that yes

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because at that age the body hasnt finished growing and whatever the kid does to their
body at that age is obviously going to effect how it grows and in return may cause
problems down the road.
To get more insight on how a pitcher can help reduce the risk of this serious injury
I asked him if what he forced us to do while I was playing for him was suppose to help
decrease the chance of a UCL tear. According to Coach Pittman it was and it is
something he calls arm care. All pitchers and catchers when I played for Albany High
School was required to do arm care at least twice a week during the legal period for high
schools to practice and play. Before actual practice starts at the high school, there is what
is called 7th hour. It is the last hour of school everyday and all the baseball players have
Coach Pittman for it. This is the time to work on whatever you feel that you need work
on fundamentally, and it is also the time to get arm care in. Coach really believes in arm
care and he said if the players actually take it serious and do all the exercises correctly it
would definitely help in a positive way. Arm care consisted of 10 different arm exercises
that helped develop and strengthen the elbow and also the shoulder muscles. Then to
follow up arm care is three basic stretches that help the arm from getting tight. Coach
Pittman stated that arm care really helps throughout a baseball players career and helps
the arm handle the long-term rigors of the season. He recently changed arm care this
season and is trying a routine with bands that his players are really enjoying because it is
a lot quicker routine. Coach Pittman still encourages his players to do the old arm
exercises as well, however it is not mandatory where the band routine is.
From the interview I concluded from a very popular and successful coach in
Louisiana that overuse of the arm has a dramatic effect on the overall durability of the

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arm overtime. It is also very important to give the arm proper rest between seasons and
games to help allow the elbow to recover from a long stressful season. There is no way
concluded to stop from tearing your UCL as a pitcher, but according to Coach David
Pittman it will only help if you put in just a little bit of time every week doing arm
exercises and stretches to help maintain and strengthen the money maker he said.
My second interviewee also believed that there are ways to help strengthen and
keep the arm in shape to help from a serious injury occurring. His name is Mark Waller
and he is the Certified Athletic Trainer for the Southern Miss baseball team. Mark has
been part of the staff at Southern Miss since 2012. He is responsible for the athletic
training needs for the baseball student athletes. Before becoming part of the Golden
Eagle Family, Mark served as a graduate assistant for two years at the University of
Memphis while he earned his Masters Degree in Health and Sports Science. Even
though Marks career as a Certified Athletic Trainer has only been for a short period of
time, he is very well educated and has worked with numerous injured athletes.
During the interview Mark mentioned that every year when school starts for the
fall semester, he meets a bunch of new guys that are lucky enough to continue after high
school to play baseball at Southern Miss. He said every year at least one of the new high
school pitchers have to sit out their first fall because of elbow pains or injury. I asked
Mark why this is common in mostly freshman newcomers and his response was because
the pitcher was the ace on his high school team which caused him to throw more than he
should have. He went on to explain how most high school coaches are only worried
about winning therefore they try to pitch their best arm the most. He said that this is one
of the main causes for Tommy John in pitchers. Mark also stated that the elbow can only

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handle so much strain before something has to give, which is usually the Ulnar Collateral
Ligament.
To finish up the interview I asked Mark what he recommends to help strengthen
the elbow, what is the proper rest needed for a pitcher, and what type of pitch count
should a pitcher be limited to? Marks answers were a little more detailed than the
answers I received from Coach David Pittman. Mark stated that it is really tough to focus
on simply just the elbow because there isnt too much to really do to the actually elbow.
He said it is more important to build the muscles in your shoulders and the positioning of
the forearm. The majority of the arm exercises he requires his pitchers to do are focused
on the shoulders and the forearm. He mentioned that if either one become weak or
excessively tight throughout the course of the season, it will in return put more stress on
the elbow. Therefore he requires his pitchers to complete a series of exercises three times
a week to help maintain the entire arm. To answer the questions I asked about the proper
amount of rest and the recommended pitch count Mark stated that every pitcher is
different. Starters at Southern Miss are on a pitch count between 100-120 pitches,
depending on how his outing is going, with a seven-day rest after each start. Relief
pitchers vary depending on different scenarios that may occur during the game or
throughout the week with other games, however relief pitchers at Southern Miss usually
do not exceed fifty pitches with a three-day rest after each outing. Where as the Golden
Eagle closer is usually limited to thirty pitches with a one or two days rest.
The final interview was with a former teammate I met over the summer playing
minor league ball for the Detroit Tigers, Kyle Dowdy. Kyle played high school baseball
at Francis Parker High School in San Diego, California. Then got the privilege to

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continue after when he signed with the University of Hawaii. Kyle completed his first
year in Hawaii before transferring to Orange Coast College in Costa Mesa, California.
With another one-year stay at Orange Coast, he transferred for his junior year to the
University of Houston. However his first year as a Houston Cougar was a nightmare to
any competitive college athlete as he suffered from a season-ending injury and did not
make an appearance. He returned the following season after a medical redshirt looking
for revenge as he posted great stats filling the role as the Saturday starter for the cougars.
As a result after the hardworking recovery year of Tommy John and the successful season
following, the Detroit Tigers in the 12th Round of the 2015 MLB First-Year Player Draft
selected Kyle. He has been through a lot throughout his spotty college career, and he was
very helpful when I questioned him about answering a few questions for me.
During the interview I simply just asked Kyle what the surgery process was like
and what has he learned post surgery that he does different now? He replied saying that it
was one of the longest years of his life, and he does not wish it upon even his worse
enemy. Kyle is a very competitive pitcher that has loved the game of baseball since the
age of five. Losing a year of competing on the mound was miserable for him and would
be for the majority of pitchers. Kyle also talked about how time consuming and dreadful
the rehabilitation was after the surgery. He stated that it was hard to believe that doing
simple exercises with no weight or resistance after the surgery could be so tiring and
challenging. He said once something got easy during rehab it was time to up the weight
or resistance and the exercises would become next to impossible again. Kyle was joking
about it during the interview but was also very serious when he said he doesnt
recommend the surgery to anyone.

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To finish the interview I questioned what he believed was the main cause for his
Tommy John Surgery. Kyle continued by saying he started playing ball when he was five
years old and has played every year since. Not to mention starting when he was 14 years
old he had played ball year round until he had the surgery. Kyle mentioned that he
believes it was a combination between playing ball excessively before the injury with
little to no rest at all and also doing zero preventative exercises to help strengthen and
keep the arm maintained.
Conclusion
The results of the interviews supported that the main cause for Tommy John
Surgery is basically the overuse of the arm at such an early age. There are several other
factors that can cause a tear in the elbow, however they all can be traced back to the
overuse of it. The interviews I conducted really supported the research I gathered. The
information I received from the sports related professionals also opened doors for other
problems to research. With this dilemma occurring frequently in baseball, is the
recommended exercises and amount of rest really helping slow the problem down or is it
just because the younger pitchers are not motivated enough to take action in doing extra
work? Also many sports fans havent even noticed the increase in UCL tears in pitchers
over the past decade and dont see it as such a negative set back. Maybe its because we
only hear about the 80% that return to the mound and not about the other 20% that was
never able to return to the game they love. However with the high success rate in the
surgery and the professionals on television competing a year later following the
reconstruction surgery, many people do not see whats so bad about this injury.

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While the baseball industry across the world increases along with the Tommy
John epidemic, the love for the competitive sport will always be there as it is considered
Americas favorite pastime. There is no way to stop this injury as long as the sport
continues, but it is very important parents and coaches do their parts to help slow it down.
A tear in the elbow is no way to end a childs dream of playing baseball in the Major
Leagues. Even though the research was not able to narrow the problem down to one
cause, it was concluded that the main causes of a tear is just overuse and not keeping the
arm maintained properly. In conclusion no matter how much your son loves baseball and
wants to play year round, sit back and think if its really worth putting that much stress on
his elbow without letting him rest throughout the year. Maybe practice does make
perfect, but too much practice and playing could also cause a major surgery to occur.
Future Implications
Repko 14.14
During all of my research I kept noticing a gap in in the information I gathered.
The United States, Dominican Republic, and Latin America all average around the same
number of pitchers that suffer from a UCL tear every year. However the average age of
American pitchers receiving Tommy John Surgery is younger than both the Dominican
and other Latin American countries. With my data future research is possible on to why
the average age of Tommy John victims is younger than in the other countries. From the
research I found, the Americans seemed to be pushed more to the limit at such an early
age and have more availabilities to pitching facilities and teams to play for.

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Annotated Bibliography
Andrews, J. R., & Yaeger, D. (2013). Any given Monday: Sports injuries and how to
prevent them, for athletes, parents, and coaches : based on my life in sports
medicine. New York: Scribner.
With the number of sport injuries increasing, there should be more awareness and
training given to young athletes to help eliminate some injuries. The most popular
orthopedic surgeon when it comes to athletes is Dr. James Andrews. In this book he
reveals his professional advice to help decrease injuries in young athletes. He wrote this
book to inform parents and coaches of young athletes the importance in injury
prevention. He covers every major sport in the book and identifies different injuries and
how they occur. He informs what and what not to allow growing children to do. Dr.
Andrews reveals how athletes can help maximize their potential and do so with a healthy
life as well.

Burger, R. (2015, March 9). Throwing elbows: Tommy John prevention starts in youth
baseball. Retrieved from http://www.newsleader.com/story/sports/2015/03/09/throwing-elbows-tommy-john-preventionstarts-youth-baseball/24662195/
Tommy John surgery is caused usually by a pitcher or athlete throwing a ball too
much or incorrectly. A former collegiate pitcher from Missouri State, Clay Murphy,
works as a baseball instructor with kids ages 8 to 18. He teaches them the correct
mechanics and fundamentals of pitching. His goal is to instruct kids at an earlier age to
help decrease the number of Tommy John surgeries. He emphasizes the need for correct

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pitching mechanics because he believes a lot of injuries comes from pitchers throwing
with a terrible form. He also teaches kids about how rest is very important as well.
Another cause for injury is over use of the arm. He teaches how to build up the number
of throws made day by day and also how to keep the totals. He suggests how many
throws are made from a day-to-day basis. He believes the correct throwing program,
correct mechanics, and the proper rest will drastically decrease the amount of UCL tears
in baseball pitchers.

Cook, E. (2014, June 24). To Prevent Tommy John Surgery, Retrieved from
http://www.latimes.com
Dr. Andrews is the most well known leading orthopedic surgeon to perform
surgeries on athletes. He is really known for his specialty called Tommy John surgery.
The article describes what exactly Tommy John surgery is and the risks of having
Tommy John. Dr. Andrews mentions that the number of surgeries is steadily increasing
and also it is becoming popular in younger athletes. He mentions in article that he wishes
he wouldnt have to perform as many surgeries as he does. Therefore he wants people to
teach ways to prevent the surgery at an earlier age. Coaches should take the proper
techniques and be more cautious of the injury to help both the players and their futures
out.

Dodd, M. (2003, July 29). A Year of Rehab for Tommy John Patients. USA Today.
Retrieved from ebscohost.com

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The actual surgery to repair a torn UCL takes about an hour, which doesnt seem
long for a serious surgery such as Tommy John. However it will be a while before
returning to the playing field. The rehabilitation takes about a year depending on the
doctor and the therapist. The basic schedule for rehabilitation of after Tommy surgery
consists of a very strict and monitored process. The week after the surgery the elbow is
immobilized at 90 degrees in a hard brace. The week following, the arm will be in an
adjustable brace that puts limitations on the movement that can be made. The range of
motion and the building of the arm with small weights will be the emphasis during weeks
three through eight. After week 12 the throwing process will begin but at a very slow
pace. With every week slowly progressing at a farther distance. Six months following
the surgery the pitcher will be able to start pitching off o the mound but only with 50%
speed or effort. Not till around the 10 month the pitcher will be able to throw will 100%
effort, and this process will last around 2 months as well depending on the pitchers
progress. The return to competition will be around the one-year mark but during the year
following the rehabilitation, the pitcher will be monitored with a close eye. This entire
process should not be looked at as a benefit to the throwing arm because there is always a
chance of not returning to the playing field.

Glier, R. (2014, July 19). How High School Pitchers Try to Avoid Tommy John Surgery.
Retrieved from http://www.usatoday.com
High School players around the world look up to major league pitchers. When a
professional pitcher tears his UCL and Tommy John surgery is needed, many young
baseball pitchers begin to worry when and if the same injury will occur with them. Most

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UCL tears occur in a pitcher that is a hard thrower. Multiple high school pitchers admit
that they get worried after hearing about another pitcher needing Tommy John. Most
high school pitchers that are taking precautions to help decrease the chance for Tommy
John are top prospects that have been informed by coaches about what increases the
chance for a tear. Pitchers are becoming more aware how trying to impress a scout by
lighting up the radar guns can cause a tear. It is very important at a young age to not
worry about the radar guns and just relax and pitch as if the scouts are not there. Many of
the showcases put on for college or professional scouts are causing wear and tear on
younger pitchers elbows. This is because the radar guns are believed to have an
influence on pressuring the pitchers to throw as hard as they can.
Hyman, M. (2009). Until it Hurts: America's Obsession With Youth Sports and How it
Harms Our Kids. Boston: Beacon Press.
The majority of parents expects too much from their children and try to relive
their lives through their young athletes. In the book a fourteen-year-old baseball pitcher,
Ben Hyman, is faced with an injury due to baseball. He approached his father with
terrible news that his shoulder was tired and he felt a small pain in his arm. The correct
way to approach the problem would be for Ben to take off some time and rest. However
his father did not agree with rest and forced Ben to pitch the next game. Stories like
these are becoming very common over the last seventy-five years. Parents now days are
pushing their children beyond their physical and emotional limits. Parents should listen
to everything their children are saying when it comes to a possible injury but also they
must take any situation seriously.

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James, C. (n.d.). Erik Davis throws off a mound, the next step in his long recovery from
Tommy John surgery. Retrieved from http://www.washingtonpost.com
Erik Davis is a major league pitcher that was faced with the adversity of a UCL
tear. He had a successful surgery and began his long road of rehabilitation. Even though
this yearlong process is pretty simple, Davis states that the hard part is the mental aspect.
He says it is important to understand what you are working towards during the rehab. It
is very common for pitchers to get lazy and not correctly do the proper rehab. He says
the hardest part to manage mentally is watching people pass you while you are sitting out
due to the surgery. It is very important to only worry or focus on what you can control.
Understanding what you are working towards and how you will most likely get back
where you was prior to the tear if you work hard doing everything the proper way.

John, T., & John, S. (1978). The Tommy John story. Old Tappan, N.J.: F.H. Revell.
The story explains how the UCL surgery received its name. His wife and Tommy
John himself tell the story of his remarkable history as a well-known major league
pitcher. He talks about his past in the major leagues and how he was faced with a great
deal of adversity. Tommy John was faced with a UCL tear in his elbow and didnt
believe he was going to have the chance to pitch again. Then a doctor allowed him the
chance to receive a brand new surgical procedure that could get him back on the game
mound. Tommy John accepted the chance to receive the surgery and was the first person
to do so. The surgery was very successful and is know known as Tommy John surgery.
It has a very successful return rate now compared to when Tommy John received the first
procedure.

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Laken, Litman. (2014). Youth Pitchers Feel Pinch of Surgery. USA Today,
Retrieved

from ebscohost,com

Dr. James Andrews performs has performed hundreds of Tommy

John surgeries during his career with a great results. He informs the
USA Today that many children are being shut down years before they
could reach the big leagues because of Tommy John. He mentions that
the success rate is lower on children than it is for adults. This is
because they are just at the age that its not important to them to work
hard and return from the surgery like they should. This is tough for Dr.
Andrews to talk about knowing that the largest group of patients he
performs the procedure on is youth. He has witnessed about a 50%
increase in the number of teenage patients he has performed the
surgery on in the last 10 years.

Lamb, R. (2009, February 11). Is Surgery Changing Baseball? Retrieved from

http://health.howstuffworks.com
An orthopedic surgeon named Dr. Drank Jobe created Tommy John surgery. The
surgery got its name because the first procedure was performed on Los Angeles Dodgers
pitcher Tommy John in 1974. He allowed this radical new surgery to be performed on
him because at the time he was suffering from a torn ulnar collateral ligament. The
surgery was a success and do now baseball pitchers need the most common surgery. The
procedure is done by removing a tendon from the patients opposite forearm or hamstring
and placing it into the elbow to become the new UCL. To keep the tendon where its

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suppose to be, the surgeon must drill a series of holes into the patients ulna and humerus
bones. Then the tendon is weaved into a figure eight pattern through the holes and that
new tendon serves as the new ulnar collateral ligament. The surgery is very risky
because the surgeon must detach major muscles from the body and replace them in anew
spot in the body. When the first surgery was performed, the odds of recovery were 1 in
100. However the odds today of recovery are around 80% but like with all surgeries they
can be very dangerous.

Makhni, E., Lee, R. (2014). Performance, Return to Competition, and

Reinjury After

Tommy John Surgery in Major League Baseball

Pitchers. American Journal of Sports Medicine. 42(6), Retrieved from

ebscohost.com.
The rate of pitchers having to receive Tommy John surgery is becoming so
common it is always ridiculous. The surgery is becoming more popular in young pitchers
that are having minimal elbow pain that just have the scare of a UCL tear. It is common
for orthopedic surgeons now days to hear parents or young ball players ask if they should
have Tommy John surgery in the absence of an injury, because they think it will increase
velocity and control. However that is a myth because there is a fact at not even returning
to pitching at all. There are numerous myths people believe in about the surgery.
Another false statement is that the UCL can be made bigger and stronger by lifting
weights. Another common myth is if you are suffering from elbow pain, Tommy John
you should worry about a UCL tear. The majority of time when a pitchers elbow is
hurting, the reason is just common soreness or irritation.

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Ortiz, J. (2015). Armed But Not Ready?. USA Today. Retrieved from
ebscohost.com.
In 2014, 31 major league pitchers were placed on the disabled
list that had the procedure known as Tommy John surgery. This
number made the 2014 baseball season the second highest of all time.
There has been a huge increase in the surgeries since 2000. With just
Tommy John surgeries alone, the famous so-called slow sport is
becoming very dangerous. The toughest part for the pitchers
recovering from it is just the mental side, not knowing if he will return
to the mound where he left off one day. However in 2014, a study by
the American Sports Medicine Institute confirmed that Tommy John
surgery has an 80% success rate. This being measure by the players
ability to return to his previous level of competition.

Position Statement for Tommy John Injuries in Baseball Pitchers. (2014,

July 1).

Retrieved from http://www.asmi.org/research

There are plenty of recommendations for professional pitchers and teams to
reduce the risk of a UCL tear. The major way to help avoid the need for surgery is know
and practice the proper mechanics through drills. It is also important not to throw as hard
as you can every pitch you make. The importance of understanding your body and when
you are becoming fatigue is also very important. To help eliminate unnecessary stress on
the UCL, it is recommended for pitchers to not always throw maximum effort in practice
or bullpens. The proper amount of rest is very crucial to allow the UCL and body time to

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recover after a season of pitching. Being in shape and eating the correct nutrition has an
effect on the UCL as well.

Roegele, J. (2015, March 23). Tommy John Surgery Success Rates in the Majors.
Retrieved from http://www.hardballtimes.com/tommy-john-surgery-success-ratesin-the-majors/
Many people have looked at Tommy John surgery differently. Some believe the
surgery is very serious while some believe it is better to not delay the surgery and have it.
The fact is approximately 80% of pitchers that undergo Tommy John return to where they
left off before the injury. It is proven that younger pitchers that undergo the surgery have
a better return rate than older pitchers. Every pitcher that has the surgery differ in the
amount of time it takes to rehabilitate their injury. This may result in some pitchers
having the sit out for multiple seasons, which will also increase the chance in not
returning to their success before having the surgery.

Smith, J. (2014, April 14). Tommy John surgery rebuilds pitchers' careers. Retrieved
from http://www.tampabay.com/sports/baseball
Tommy John has become a very successful surgery. Reasons for such great
success are because UCL tears are more easily diagnosed due to technology. According
to the most popular orthopedic surgeon when it comes to a UCL tear, Dr. James Andrews,
the increase on these surgeries is steadily increasing. Dr. Andrews believes the increase
is because of the youth baseball culture. This because pitchers are throwing harder,
playing year-round, and they are throwing more innings. It has ben very difficult to

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determine what is the main cause with the risk factors being bad mechanics, not proper
resting, throwing too hard, and genetics being a possible cause. There is no way to
completely prevent a UCL tear, however Dr. Andrews is searching for ways to slow his
business down by trying to decrease chance of a tear. With younger pitchers elbows and
bodies still developing, pitching more innings and trying to light up a scouts radar gun is
not recommended but is very common. Parents are trying to force their kids to become a
major league pitchers starting at a very early age. It is encouraged for parents to learn
about UCL tears and try to help their child from sitting out because of this major injury.

Stark, J. (2014, May 4). Tommy John surgery 'epidemic'? Retrieved from
http://espn.go.com
In a few recent years of major league baseball, the thought of Tommy John being
an epidemic has passed through the minds of many people. The fact is that it is not an
epidemic however many players get worried as if it was when someone they know is
faced with a UCL tear. The fact is it is just a chance every hard throwing pitcher is faced
with. There are also people who believe the myth that once you have Tommy John that
your new UCL cannot be torn. However this is also becoming a more popular occurrence
as well. After the surgery some returners pick up different flaws in their mechanics and it
will put more stress on the new reconstructed ligament. It is very important for coaches
to be able to teach and correct any negatives movements in a pitchers throwing motion.

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