The Tommy John Surgery Epidemic
If you thought there seemed to be an especially high number of pitchers blowing out their elbow tendons this spring, you were right. In a USA Today article, Dr. James Andrews, currently the foremost Tommy John surgery specialist, says that it’s an epidemic at least insofar as his own practice is concerned. There is also a recent survey which suggests the problem is getting worse.
Between 2000 and 2011, there were roughly 16 Tommy John surgeries a year among pitchers who had pitched in the majors. That number jumped to 36 in 2012, slid back down to 19 in 2013, and is at 12 this spring, with Matt Moore deciding whether to become the 13th and most of the season still ahead of us.
The USA Today article suggests that the biggest reason for the increase is that major league pitchers are throwing harder than they ever have because of increasingly sophisticated training techniques that are building up their pitching muscles. Unfortunately, there’s really no way to build up an athlete’s ligaments and tendons, so as the pitcher throws and torques harder, his ligaments and tendons take increasing strain.
Another proposed reason for the increase in elbow tendon injuries, aside from increased use of the slider, is that young pitchers (those still in grade school) are pitching more than they ever have in the past. In Florida, Texas, Southern California and elsewhere the weather permits, the best young players are often playing baseball year ’round, instead of getting the off-season rest they once got. Playing more games through more of the year means that young pitchers are getting a lot of stress on their arms at early ages.
Another cause of the increase in Tommy John surgeries is the fact that the procedure has generally been so successful (83% of the pitchers who receive the surgery return to the majors and 97.2% return to professional pitching) that young pitchers now typically elect to have the surgery rather than trying to rehabilitate the tendon through rest even when the tendon tear is only partial.
The bigger-stronger-muscles-but-no-stronger-ligaments/tendons theory makes a lot of sense to me. Teams and pitchers are much more aware of proper pitching mechanics than they were 20 years ago, but the number of blow elbow tendons only seems to be increasing over time.