Major League Baseball has a new epidemic on its hands. Instead of steroids, human growth hormone, and other performance enhancing drugs, players are suffering elbow injuries at an alarming rate. According to a report from SB Nation, at least 135 pitchers, or 20% have had the operation at least once.
In 2014 alone there have been more than 40 different players between the majors and minors who have gone under the knife. Most recently Yankee pitching ace Masahiro Tanaka was diagnosed with a partially torn ulnar collateral ligament in his elbow. Most likely Tanaka will require Tommy John surgery. If Tanaka has the surgery, it will take 12-18 months before he is fully recovered.
This is alarming, considering many of the pitchers getting hurt are in their first few years in the majors. Teams are trying to protect their young pitchers by placing them on innings limits. However, it has had varying levels of success. The New York Mets tried to put an innings limit on their ace Matt Harvey last season, but Harvey still wound up getting injured. A similar incident happened with Washington National’s phenom Stephen Strasburg in the 2010 season. Strasburg was scheduled to throw a total of 160 innings between both the majors and minors before being shutdown but he was hurt well before he reached his ceiling in late August.
Named after a famed Los Angeles Dodger and New York Yankee pitcher, Tommy John, who was the first player to undergo the operation in 1974. The surgery replaces the torn ligament with a ligament from a different part of the arm or knee. Dr. Frank Jobe, a renowned orthopedic surgeon who was the Dodger's team doctor, pioneered the operation.
Not just pitchers
Position players are just as susceptible to the elbow injury as pitchers. Baltimore Orioles All-Star catcher Matt Weiters tore his UCL in mid-May and underwent surgery in June to repair the tear. For some, like Oakland Athletics’ pitching ace Jarrod Parker, or Padres' pitcher and former Marlins ace Josh Johnson it’s their second time getting the operation. Other big names such as Bronson Arroyo, Patrick Corbin, Matt Moore, Kris Medlen, and Jose Fernandez have each had or will have surgery this year.
It is possible that a player can successfully rehab the injury. But the risk is always there that the ligament fully tears. Back in 2004 Cardinals pitching prospect Adam Wainwright partially tore his ligament, similar to Tanaka. But Wainwright elected not to have the surgery and successfully rehabbed the injury. That process held up until the 2011 season when Wainwright, now the Cardinals ace, tore the ligament in spring training. Wainwright had the surgery and was back in time for the 2012 season.
No one is sure what is causing all these injuries. Some have argued that it is too many innings at too young an age. Kids are playing baseball all year round, some pitching all year round and in different leagues where the regulations aren’t as strict. It is something that needs to be kept to a minimum, says Stan Conte, a researcher for the American Sports Medicine Institute and head athletic trainer for the Los Angeles Dodgers. Conte believes many parents want their children to receive the surgery due to the myth that pitchers come back throwing harder than before.
Renowned orthopedic surgeon Dr. James Andrews believes there is another factor in the spike in Tommy John surgeries. Andrews has been seeing many more high school players on his operating table. Andrews thinks that pitchers are throwing too hard too soon. They are performing professional level tasks while their bodies are still developing, thus dramatically increasing the risk for injury. Though many reports have said there is minimal risk of injury, Andrews believes that throwing a large quantity of breaking balls (curve balls, sliders, splitters) is a significant reason why younger players are going under the knife. Breaking pitches put added strain on young arms, Andrews says. Former major league pitching coach for the Oakland A's, Mets, and Milwaukee Brewers, Rick Peterson, is a big advocate of pitchers throwing more changeups as it puts less stress on the arm.
There is one new item on the market that can perhaps curb the amount of surgeries performed going forward. Motus Global is a biomechanical facility headquarted in both Long Island, and on the campus of the IMG Academy in Brandenton, Florida. Motus has developed a sleeve that can pick up the kinetic motion, arm speed, etc. The sleeve looks like a normal compression sleeve regularly worn by players in all sports, but contains sensors to study the motions of the athlete wearing it. A player enters his height and weight into a smartphone app, and sensors in the sleeve will feed the app information about its wearer. It is not readily available to the public, but a similar device would likely work wonders.
I am not sure what can be done to prevent the injury at the major league level. But it seems as though more can be done at the high school and little league levels to prevent unnecessary wear and tear on a pitcher’s arm. Sometimes building from the ground up is the best way to work.