The Tommy John Epidemic


#1

This last week has been freighting to me. 3 pitchers I have studied have landed on the DL for the year; Yu Darvish and Zach Wheeler with torn UCL’s, and Cliff Lee with his ongoing forearm issues. Yu Darvish is known for having extremely efficent lower half mechanics, Zach Wheeler is often used as the example of efficent “late trunk rotation” and Cliff Lee might have the best deceleration pattern in all of baseball. So, it’s simply not mechanics, there are so many variables.

What do you think are the main causes of the recent outbreak of torn UCL’s in major league baseball?

And, what are ways to keep kids safe from these injuries?


#2

My question is whether there is such a spike in injuries or whether TJ surgery is an option not so readily available in recent years.


#3

Tommy John surgeries by year (MLB players only)
2014 - 16
2013 - 19
2012 - 36
2011 - 18
2010 - 16
2009 - 19
2008 - 18
2007 - 20
2006 - 18
2005 - 16
2004 - 12
2003 - 15
2002 - 13
2001 - 12
2000 - 13
*per ESPN article
I would not call this an epidemic. It is an issue within MLB of course.
As far as pros who have been throwing very hard for a very long time, usually logging a lot of innings I think it is just the cost of doing business as much as anything. If you take someone who is doing a very physically stressful activity, repeating it many, many times year after year injuries are going to happen. If there was one simple fix or one mechanical cue that would do away with it or reduce it in a meaningful way there would be one model and one model only. Better surgery results has probably led to guys getting surgery sooner than in the past as well.
The real problem is in youth baseball in my opinion.
As for kids it is a mix of things (again, just my opinion of course). Too many games (too much pitching), asking physically weak and unprepared bodies to perform complex movements at a high level and non existent recovery protocols in many schools/teams/leagues.
The greedy, evil travel ball team owner is cast as the devil (and guys like this do exist) but uninformed parents, lazy and or uninformed coaches and lazy and uninformed players all share a piece of the blame.


#4

The quality of coaching is shockingly bad at the youth level and focused more on how friendly a coach is as opposed to how qualified. Finding good coaches who have the time to invest is the hardest thing. Also, what is the hiring system in place?


#5

It is interesting. You have daddy ball in most of the traditional youth leagues. Travel ball is its own weird little world. My son has played youth ball (starting at 12 or so),travel ball, high school, one year of college.
The coaches I would count as being good I would total at 4. Guess what? None of the screamers, cursers and jerks were worth a damn. I am sure others have had a different experience. If you really need to communicate that way you are not a teacher and probably are not very confident in what you are doing. I loath those guys.


#6

There are loads of posts concerning how to find a good pitching coach, but I don’t think too many people are reading them. It seems they’re just looking for such coaches to drop down out of the sky or something; they seem reluctant to take the time and the effort to investigate, to find out what makes a good pitching coach and what he or she can offer. This is one area where one can’t afford to lollygag. Right, Fearsome?


#7

There’s some new show on now. Not sure of the name or network but something like “Bad Coaching” & may be on Spike Network. Its a reality show about trying to reform the screamers & other negative coaches; think show is about youth coaches. Only seen bits & pieces so can’t say whether its good or bad.


#8

Sorry, its “Coaching Bad” & is on Spike. I looked it up.


#9

Agree Zita.
My son is paying price for my ignorance the first several years of his playing.


#10

Is that like Breaking Bad with Hiesenberg? They all start meaning well, but soon get in over their head and get corrupted by events going on around them?


#11

Wish I knew. Been meaning to watch an episode. The commercials are interesting, screaming coach they’re gonna reform. Only seen the promos because it comes on after Bar Rescue.


#12

The conclusion here looks to blame “bad coaching” for the amount of major league UCL tears. I’m not just talking about pro players. One of my good friends plays at Michigan State and he blew his UCL this winter and is rehabbing the rest of the year. Every D1 team has at least one. High school kids and kids that haven’t even hit their teens yet are being instructed to have this surgery.

“Bad coaching” at the youth level can mean so many things…
-teaching inefficient mechanics
-overuse when the pitcher has been undertrained
-pitches/inning,game,week,year
-long toss? (a different discussion)
-the implementation of overload/underload balls

Obviously, not just one thing is causing the amount of UCL tears around baseball.

They’re finding a majority of UCL injuries in older high school kids through college seniors (17-24 years old). A kid that’s still playing at 20 years old probably was doing something right when he was 12. He has a solid base of mechanics, but was he overused as a youth while being undertrained? Was he throwing 220 foot long toss and overload/underload balls too young?

The amount of things that can go wrong with bad coaching and young players is the problem. The stress that velocity means everything is absolutely correct but I feel it’s being stressed too young and incomplete. If you want your 13 year old to throw 80 mph, you better be covering all bases for him to stay healthy. If he’s throwing every day, he better have been trained to do so. His mechanics must be sound, he must recover well, he must train well, and he musttake care of his body away from the field well.

Just my thoughts.


#13

It’s not great.
A bunch of jerk coaches, different sports, getting anger counciling. Of course, it’s a tv show, so, they are given plenty of opportunity to look like idiots. The Ray Lewis can preach at them in all his strange glory. Ray should be thankful he not is prison and get his insane mug off the tv.
It’s just another “reality” show n


#14

Agree for the most part.
Pros and kids are very different animals however. There are injuries that are going to happen matter what. A pro who is throwing 200 inning of high stress high velocity ball a season should be at higher risk than a soft tossin kid who is throwing 40 innings. No way to know a % for kids that are playing. Millions of kids play. Little League, Pony, Babe Ruth, Cal Ripkin, travel ball teams…impossible to track that.
Like all things with mulitple causes there is not one answer. But more than anything I believe lack of preparation in youth pitchers (12+) is a major issue.


#15

I wanted to add a few outstanding external articles and resources that can help add context to the TJ issue. I wrote the first article for my youth pitching site, but here are some others that I came across while doing research for that article:

http://www.youthpitching.com/guidelines.html

  1. http://m.mlb.com/pitchsmart/tommy-john-faq/

  2. https://public.tableausoftware.com/profile/matt.chambers#!/vizhome/UndertheKnife/TheeffectsofTommyJohnsurgery

  3. http://www.brewcrewball.com/2015/3/16/8224841/brewers-tommy-john-surgery-zack-wheeler

  4. https://docs.google.com/spreadsheets/d/1gQujXQQGOVNaiuwSN680Hq-FDVsCwvN-3AazykOBON0/edit#gid=0

  5. http://www.logan.edu/mm/files/lrc/senior-research/2012-dec-41.pdf

  6. http://grantland.com/the-triangle/tommy-john-epidemic-elbow-surgery-glenn-fleisig-yu-darvish/


#16

Steven—I was reading through your article on ways to prevent injuries to young (and older) pitchers, and the first thing I noticed was something I’ve been talking about for years! What to look for in mechanics—“failure to utilize legs, hips and trunk”, which is why so many pitchers throw with all arm and nothing else and thus lay themselves wide open to all sorts of problems: they just don’t know about “The Secret”, and this is something I’ve been talking about for the longest time. They throw with all arm and don’t use the whole body. I’ve known about this for decades; I learned “The Secret” from watching how the Yankees’ Big Three rotation did it, and I picked up on it and practiced what I consider to be an essential element of good mechanics, and I found myself doing just what those three pitchers did. And no problems. In my honest opinion, this is one of the first things young pitchers have to learn—and master—and when they do this, they can avoid a lot of the major problems they would otherwise encounter on the mound.