Tommy John surgeries have become alarmingly common in today’s baseball climate, but the most disturbing trend is the age at which the bulk of these procedures are performed. Craig Davis of the Sun Sentinel sheds some spotlight on a recent study showing that teens between the ages of 15 and 19 account for 75% of all Tommy John surgeries. Davis cites the words of Dr. Tommy John (son of the former major league pitcher and the procedure’s namesake), who bluntly says, “The success rate after Tommy John surgery is not good. You don’t want this surgery, especially if you have it in your teenage years.” One possible reason for the dramatic increase in youth Tommy John surgeries is single-sport specialization; Dr. Randolph Cohen of Joe DiMaggio Children’s Hospital in Hollywood seems to believe it’s a big issue. “There’s an overall kind of irrational push by parents on children who are playing sports for such long hours and such long durations and such great repetition that we’re seeing an increase in the injuries in children than say we saw 20 years ago, where injuries like that were much more rare,” he said.
A few injury-related notes from around major-league baseball…
- Though injured Yankees star Gary Sanchez hasn’t begun running drills yet, Bryan Hoch of MLB.com reports that his recovery is going well. The Bombers are apparently hopeful he’ll be able to return around the All-Star break. Though he’s currently batting below the Mendoza line, the young Sanchez leads all MLB catchers with 14 homers to this point in the season.
- The Red Sox are set to add a valuable reliever even before the July 31st trade deadline hits, as Chris Cotillo of masslive.com reports that Tyler Thornburg is expected to return to the club this week. The 29-year-old right-hander has yet to pitch in a game for the Red Sox since being acquired from the Brewers in exchange for Travis Shaw and a pair of minor-leaguers. There wouldn’t appear to be a great chance of salvaging the trade at this point, but if Thornburg can return to post something close to the 2.15 ERA and 12.06 K/9 he posted with Milwaukee back in 2016, he could be of great help to an already-strong bridge to Craig Kimbrel.
- The Giants got some good news today, as it appears Pablo Sandoval has avoided any serious injury. Panda’s x-rays showed no fractures (according to a tweet from Andrew Baggarly of The Athletic), so his diagnosis is simply an elbow contusion after being hit by a Zack Godley pitch during today’s matchup against the Diamondbacks.
Only Panda!!!!
I’d like to see how many converted position players in the minors (who go to pitching) have arm issues. X player was a SS/OF until A ball or double A. Brian Gordon comes to mind.
IMO these tommy John are a result of babying the pitchers and not allowing the ligaments to get strong to handle the rigors of pitching. Up until the early 2000s pitchers would throw 250 innings plus no problems and if a pitcher needed tj it was surprising. These days at 100 pitches a pitcher is taken out or they have a have innings limit and the injures are rampant. You can’t seriously say that the innings limits are preventing anything. Why not let them pitch 200 innings plus and see what happens. it’s just insane how weak these pitchers are these days. For almost 100 years pitchers had no limits and were never injured now that we baby them they are hurt yearly….
What was the speed of the average fastball? I’m wondering if there’s an increase in speed if that could contribute to the issues?
There’s a huge increase in speed average.
aanders515…..Your post starts out with a fallacy…”not allowing the ligaments to get strong”. Ligament don’t strengthen, muscles do. When pitcher throw at max effort the stress is transferred to the ligament and after years of stretching, starting in childhood it finally tears.
Pitcher today fall prey because, unlike years ago, they play baseball almost year round with very little off time. They play on multiple teams, tournaments, travel teams etc. Young arms can’t handle that and if they do, by the time they are drafted most of the damage is done.
Max effort all of the time, trying to light up the gun by throwing in an unnatural motion (overhand) is the problem.
Was about to say the exact same thing. Think you nailed it, I’m not a doctor or anything though.
ryanjones……. Neither am I. I am relying on the words of people like the late Dr. Jobe, Dr. Andrews, Dr. Fleisig etc. Each has given multiple interviews, there are many videos of Dr. Andrews.
Dr. Felsig is the Research Director, American Sports Medicine Institute and their multiple studies show one thing for sure. The abuse of young arms
Cat Mando Has an excellent point about ligaments
No Dr here either…..but took plenty of Biology, Anatomy & Physiology 1 & 2, and Exercise & Sport Science in college. I concur with Cat Mando fully on the ligament damage.
In addition……there’s a newer set of mechanics that is being taught to pitchers / throwers……that adds speed to the throw…..but wreaks havoc on the tendons & ligaments. $$$$$ is the primary reason for the new mechanics…..because “more speed means more strikeouts”….and better results from pitchers especially ( …although a Shortstop or Catcher could certainly use a couple MPH increase, to do their job better)
Check out Chris O’Leary on twitter….his studies, his results, and his support documentation. Tell Hime That “Montu Masters sent you”…..LOL
I have always wonder about kids even in sixth grade throwing the curveball, how much damage that does on the arm. I have seen kids throw that until they are almost in tears.
Also it is the prevalence odd the slider, mechanically it is the worst pitch on the ligament and it is pretty much the first pitch kids learn after the fastball. If you specialize in say a curve and a located fastball with a change you will last a whole lot longer than a cutter/ slider/ fastball combo
Curve is actually not bad, when you throw one it is mostly forearm a bed wrist strength and technique. For the most part kids aren’t taught it first, they are usually taught the fastball/ slider combo and then learn the change and curve if they get a feel for it.
Dr. Andrews did a 10 year study on this. Too many innings was a major factor, catching and then pitching (or pitching and then catching) added some extra stress, and throwing curveballs didn’t really show any stress, so long as proper mechanics were followed. Which sounds a bit wonky to me because no 12 year old is throwing with perfect mechanics.
Side armers (aka submariners). Fluid motion without stress.
Side arm and submarine are two very different throwing motions.
“Ligament don’t strengthen, muscles do.”
Not according to what I’ve read. There was a doctor that recommended against changing position players into starting pitchers. He found that the connective tissue was thicker and more developed in players who had been pitchers their whole lives. But it takes a long time to develop the connective tissue; much longer than muscle tissue. His theory was that when players suddenly start throwing a lot more the connective tissue hasn’t built up enough to match the quicker muscle build-up making tendon and ligament tears more likely. The one position that does seem to allow a change to pitcher though is catcher, for obvious reasons.
Source?
It was article I read several years ago. All I remember is the main point being made.
I did a Google search for this. A lot of non medical professionals spewing crap they believe. The only link to a doctor provided this: “Exercise cannot build or strengthen ligaments or tendons…”.
Source: optimum-wellness.net/what_is_prolotherapy.php
One article versus many, many other medical professionals tells me it’s nonsense. Just like the doctor that came up with gluten sensitivity – he made up the results in his study.
Payroll. Too much money at stake is what has caused pitchers to be babied. That said, The A’s of the early 80’s had five solid starters with no bullpen and Billy Martin (the original Billy Ball) burnt them out. Both extremes caused injuries pitchers today need to be developed gradually.
Martin was brutal on pitchers. In 1980, his 5 man starting rotation in Oakland each threw over 200 innings. His “closer” had 6 saves, and as a team they had 13.
Well your wrong and have never experienced high level showcase baseball then.
Teams have literally billions of dollars tied up into guaranteed longer term contracts for their pitchers. A TJ takes out a pitcher for a minimum for a year, and sometimes even longer–and the collateral impact on that is more than just dead salaries, but other roster moves/expenses that have to be incurred to fill the slot. If medical professionals believed that less pitching causes more injuries, it doesn’t make sense from a business perspective to take that route.
I think the injury portion of your comment has been hit on plenty, here is the other portion of it, there are some really good pitchers that can keep their team in a game or win games by dominating the opponent and therefore go 7 or 8 innings in a game which puts a few guys over the 200 inning mark, but there are a lot more just average or below average pitchers who have to be pulled because they are giving up 4 or 5 runs in about 5 or 6 innings (or even 3 runs in 5 innings and about to see the lineup turn over again). The fact is even beyond the injuries you have to be a pretty good pitcher to pitch over 200 innings in a season and have your team winning. Teams can throw out a guy like Samardzija who regularly throws a lot of innings but doesn’t typically give his team a chance to win because he is giving up too many runs. If teams are running guys like that out there often they aren’t going to compete.
I think it’s due to kids not playing outside unless their is a practice, and the showcases at the youth level and year round baseball. The young arms need a rest. I always taught kids how to throw a change and fastball at camps.
Buddy you have No idea on this subject !
This post was for AAnders
Sanchez also leads major league catchers:
#1 in Runs scored. (39)
#2 in RBI with 41. Ramos recently passed him.
#3 WAR (T- eith Ramos at +1.3 despite Ramos having .291 BA and 11 HR to Sanchez’s .190 BA 14 HR
#1 Base-running
fangraphs.com/leaders.aspx?pos=c&stats=bat�…
But let’s focus on the passed balls. (Trolls or people who don’t understand the game)
My question to you: Is Sanchez’s .194 BABIP unlucky? Is it No, since it’s close to his .190 BA? Trying to understand BABIP.
That has nothing to do with luck. If you have a 194BABIP it’s going to be hard to put up an average that looks respectable. If you look at his batted profile and he has a lot of hard contact, solid line drive rate etc. then he’s been unlucky. I didn’t look but I’m assuming so. I make this point because Chris Davis has an ugly BABIP too but if you looked at his batted ball profile it would tell you he’s just been bad. The way you’re trying to relate the two with luck is incorrect though. BABIP just records a hitters Batting average of the balls he puts in play. Which obviously excludes K’s, BB’s and Hrs.
Xabial yes Sanchez sporting a .194 is extremely unlucky especially when you consider his exit velocity on balls in play is one of the highest in baseball.
“Trying to understand BABIP.”
That’s the first number you want to look at when trying to determine whether a player has been lucky, unlucky or neutral. Ideally you have several years worth of data to look at. Compare the player’s current BABIP with his career number. If his current number is higher the player is likely benefitting from some luck, if the current number is lower he’s been unlucky. A variation of .020 or less either way is considered insignificant and indicative of nothing.
Not as easy with as little data as Sanchez has put up to date so use .280 which appears to be ~median BABIP, so yes, Sanchez has likely been the victim of bad luck or playing through an injury.
Think your list is a little F’d up. Where is Realmuto? You couldn’t possible tell me he’s having a worse season than Gary
Among Qualified PA. Notice how all of them have min. 250 PA. Sample size, Sample size.
Onlly 7 Catchers qualified, which comes as no surprise because of the brutality of playing the Catcher position.
Realmuto has 255abs so he qualifies. That’s an arbitrary number anyway. Cervelli and Realmuto in particular are higher in WAR w fewer games played. Take that list w a grain of salt.
Tied for 3rd out of 7 kind of diminshes the point you’re trying to make as well…
Today crossed Realmuto over 250 PA. (He was 248 PA before today) anticipate he should be added to leaderboards with qualified PA soon.
He had 248 PA, before today lol. His inclusion should move the list to 8 C w/ min. 250 PA to qualify.
Dude I’m a big yankees fan but even I know Gary Sanchez is probably one of the worst defensive catchers in the league. His arm isn’t even that great. Austin Romine has thrown out a higher percentage of runners. Anyway of the week I’d take Romine at the dish. Gary Sanchez is best suited at 1st or DH. Pretty convenient considering how awful and injury prone Bird is
Gary Sanchez has a great arm. What are you talking about? And stolen bases allowed are not squarely on the catcher. Pitchers have a big part in that too.
Stolen bases are a viable benchmark when your comparing pitchers catching the same staff. That is unless you have one catcher who always catches the same pitcher. Pitcher A is not going to be good at holding runners, and being quick to the plate for one catcher, but not the other.
This, he has a really good arm and pop time. He throws 90MPH from behind the plate and consistently gets his pop time around 1.89 (which is elite). Im certain that guy doesnt know too much about anything other than passed balls, but his defensive numbers outside of passed balls are mostly average to above average. He’s also having a knee jerk reaction to Birds hitting (which is a small sample size after coming off an injury) so i wouldnt take that guy serious
Romine is slashing .167/.217/.310 since June. He’s also 0-6 throwing out runners since taking over after Gary’s injury.
Sanchez big issue is passed balls and defensive quickness behind the dish. It has cost the Yanks several games this year.
His arm is good. He will be back and hit as he is capable of. If both don’t improve he is trade material.
The great Panda will take the Giants back to the playoffs…
Honestly, what a story if he does. This Giants team is hot right now. 8-2 in their last 10 and just swept the Douchebacks.
He’s been surprisingly decent this year especially in taking pitches which is totally out of the panda mold
The giants are cheaters
Please stop. You’re Making all Yankee fans look bad.
Actually, tbh have my doubts you’re even one. Clever name.
a lot of people try to make fun of Sandoval, low hanging fruit and all, but he’s been valuable to the Giants this year, At league minimum he’s played 3 IF positions and helped save the bullpen a little with his mop-up appearance at pitcher. He isn’t going to be anything more than a utility guy/pinch-hitter, but he done okay.
Seeing is believing with Thornberg. If Thornberg stays healthy and productive the rest of the year though, the trade is clearly salvaged. Salvaging is getting something useful on a written off transaction. Trades are supposed to help both teams and hypothetically if Thornberg becomes a huge cog down the stretch on a WS winning team, the trade becomes even better. Travis Shaw was misread by Sox scouting and management so he likely would still have been traded. As of today, the trade is a fat zero from Boston’s perspective but wait until their careers are over before deciding.
I think it’s a combination of bad mechanics and lack of use of the lower body.. Pitchers aren’t using their legs anymore. It’s all upper body with an emphasis on weight lifting. Nolan Ryan rode an exercise bike and did sit ups for a reason…to build up his core mucles and lower body. Watch videos of guys like Ryan and Steve Carlton and compare them to videos of pitchers today. The use of the legs to create drive has greatly decreased. Pitchers are stepping off to the side of the rubber and not using their legs at all.
Another thing is our obsession with velocity. Kids are throwing too hard too early. The ligaments have not developed yet. Teach kids to pitch and use their other pitches. The velocity will come with maturation and a good work ethic.
The core isn’t as important as the pitch type and mechanics. The twisting motion on the elbow with a slider and some fastball mechanics are what strain and tear the ucl
Your core is the most important piece of keeping good mechanics….
I was aware of the alarming trend in the majors of Tommy John surgery, but I had no idea that 75% of all TJs were occurring in the 15-19 age range. I coached HS baseball and HS level fall baseball until 2012, and I wasn’t aware of even one kid having TJ surgery. It has to be attributed to throwing an excessive variety of movement pitches from age 10 onward. The cost of travel baseball does create a sense of urgency on the part of parents relative to comparative performance, and there is a lot of pressure all the way around to produce results because nobody wants a last place finish when each player is paying $1000+ for a roster spot.
In my opinion the most disturbing aspect of the TJ phenomenon is the broad acceptance of it across the sport as simply a fact of baseball life. There seems to be very little – if any – desire to understand the causes.
Solaris601…..This is from MLB’s Pitch Smart program which is generally ignored by parents. It doesn’t include the latest 75% number.
“Youth and high school age pitchers made up a negligible fraction of Tommy John surgeries at the American Sports Medicine Institute in the mid-1990s, but 25 percent of their Tommy John surgeries by the mid-2000s. A study of national insurance records showed that between 2007 and 2011, the number of Tommy John surgeries increased about 4 percent each year overall, but 9 percent per year among high school age pitchers. More than 50 percent of all Tommy John surgeries in that study were on 15- to 19-year-olds.”
m.mlb.com/pitchsmart/tommy-john-faq/
Plenty is done to discover the causes, people just don’t listen. A huge # of kids stll think TJS will make the throw harder and other untruths.
Check out Chris O’Leary on twitter. Plenty of research, results, and support documentation that identifies a few specific things that are part of the problem……….tell him that Montu Masters sent you…….LOL
If you think travel baseball has a “winning” incentive, you don’t know how higher level showcase baseball works. It’s called “showcase” for a reason and “winning” is entirely meaningless.
I keep forgetting Shaw was traded straight up for Thornburg…LOL
I believe that there was two other players Pennington ( who I believe retired, Dubon) I still feel HOF should be great players and somebody who has a tremendous affect on the game therefore don’t you feel that Tommy John the player should be in the HOF for being the first one to try the procedure because I think very few thought it would work.
he’s wasn’t traded straight up for thornburg though…..
I’ll bet a box of six Boston kreme donuts that you could correlate the prevalence of sliders and cutters with the prevalence of TJ surgery.
In adolescents, yes, otherwise….”Understanding the role of pitch types and the likelihood of injury is complicated. Some studies suggest that more curveballs and sliders may be related to injury risk in adolescents, while another study suggests that more fastballs is related to injury risk in MLB pitchers.” (Pitch Smart FAQ….and……. “While existing research has not consistently shown a strong connection between the curveball and injuries, Yang et al., found that amateur pitchers who threw curveballs were 1.6 times more likely to experience arm pain while pitching and Lyman et al, found that youth pitchers who throw sliders are 86% more likely to experience elbow pain than those who do not (Lyman et al.,”2002).” Pitch Smart Risk Factors
m.mlb.com/pitchsmart/
There is no clear evidence.
Wow. Interesting. Painted w/ broad paint brush, always assumed slider possesses the greatest risk.
I’ve never factored age. Awesome stuff! Thanks.
PS: Any chance screwball comes from extinction? Think it was replaced with change, which brought similar results, but much less arm wear tear?
xabial……I’ve never seen specific mention of the screwball. The biggest risks are max effort all of the time, mechanics, fatigue and that goes for all ages.
Ironically the advisory panel for MLB’s Pitch Smart, many of the best orthopedic surgeons around, suggests that MLB pitchers refrain from winter ball yet many are sent every year.
It’s sad because the last in-depth study done by the American Sports Medicine Institute shows that the perception of an 80% success rate is only the case if you consider returning to pitch a game or two success.
Here is much of that study wrapped up in a nutshell espn.com/mlb/story/_/id/12648769/what-missed-tommy…
A screwball is thrown with finger pressure and pronating inward, which is the opposite direction of a slider/curveball
I think it adds even more stress and is completely unnatural
There are other factors; development of the procedure, and advancement and further refinement of the technique, and player salaries. Plenty of pitchers blew out their arms before TJ surgery came along. Tons of guys who came before Tommy John might have as well had the surgery had it been available.
Even after it did, at least for a while, it was easier for teams to just replace a pitcher. Now with the huge monetary investments by teams they are more willing to stick with a guy, and wait the year plus. And the loss of potential future income by the pitchers makes them more than willing to go that route.
So finally a study of parents pushing kids to hard to play a sport.
Now if they will just listen.
Parents listen?
Yeah, what was I thinking?
I’m a parent before anyone gets on me,….if my kids not into a sport that I was into that’s fine. Better parenting comes with supportive decisions in today’s world.
As bad as these injuries are at times, they’re still nothing compared to the parents who push their kids to play football with all the knowledge of CTE out. I’m not taking away from injured arms, but they are repairable the brain is not. I know not the topic of discussion but if you’re going to talk about parenting.
I think the main reason for the injuries for youths is not necessarily the single sport focus, but it is the year round training/playing. Same for pro players. Back in the early 1900s, pitchers routinely pitched 400-600 innings per year and then after the season would go work a regular job until the next season. Now the main reason they did that was that they didn’t make the money current players make, but the human body hasn’t really changed that much in 100 years. The human body needs time to repair itself from injuries made by motion that the arm was never really meant to do, such as pitching. Some people can beat the odds and never succumb to injury, but most do.
Did Panda get injured at the lunch buffet?
I’ve coached HS baseball for 30 years, and I can honestly say that I’ve seen an uptick of kids who are “throwers ” compared to “pitchers”. There’s too much specialization, I see it on other teams. Proper mechanics, plus some basic common and baseball sense, needs to be used.
Take the arm guards off the hitters, stop telling umpires to “overpolice” the pitchers and the rate of TJS will drop. Pitchers MPH will take a slight dip, alleviating pressure on arms. Hitters will be kept honest in the box. Anyone crowding the plate with a big elbow pad won’t have the luxury of protection anymore. Pitchers won’t feel the need to reach back for 100% to finish guys off. Backing hitters off the plate allows the curve and slider to be a more effective pitch. Pitch counts per inning will decrease. Length of games will shorten (which is a goal for the MLB). And records by offensive players will be more legitimate without the padded arms.
Arm guards have been more prevalent the last 25 years, and the TJS have increased dramatically the last 25 years. This would be the first step in protecting pitchers.