The Tommy John .... Dilema?

Earlier last week, one of the top young pitchers in baseball, Jose Fernandez, had an MRI that revealed damage to his Ulnar Collateral Ligament (UCL). Shortly after, sports writers/analysts/etc. across the country began searching for the reason why there seems to be a rise in UCL reconstruction surgeries (Tommy John Surgery). Many of these people even seemed somewhat angry that MLB teams "don't do more to protect their pitchers' elbows."

I'm suggesting that they shouldn't be blaming the MLB organizations, but maybe the parents/coaches of those MLB pitchers when they were ages 5-18.

Jose Fernandez of the Miami Marlins

I found out this past week that a lot of fans and sports writers are quick to point fingers at MLB and the organizations for the amount of TJ surgeries we've seen in baseball the past few years.

The numbers say that more MLB pitchers are having TJ surgery than ever before. Is it because the MLB teams aren't doing enough? Are they neglecting their pitchers? Are they throwing too much? Are they "babying" them too much? I'd argue that most MLB teams are doing everything right.

When it comes to UCL injuries, it's not due to a lack of knowledge that we're seeing more injuries. You can find journal article after journal article on Tommy John surgery, how it's performed, what causes UCL tears, preventative strategies, etc. etc.

It's due to a lack of execution or action on the parts of coaches and parents at the lower levels when kids first start throwing up until they get drafted. A perfect example would be just a few days ago when a high school pitcher threw 14 innings and had 194 pitches, IN ONE GAME. That's absurd. The reality is that he'll likely never get drafted, much less make it to the Majors (as the odds are extremely low in the first place). But let's imagine a world where this kid does get drafted by some MLB organization. That org. likely has a workout program designed for pitchers throughout the minors both during the season and after the season concludes. The program probably focuses on building rotator cuff strength, scapular stabilizers, thoracic spine mobility, and large amounts of lower extremity strengthening, among other things. I'd wager to say that program would be common among exercise programs for minor league pitchers for each organization. I'm sure they also limit the amount of throwing these minor leaguers do in the offseason (as they should).

That last sentence is something many young baseball coaches do not monitor. It seems like more and more over the past few years that kids are becoming "specialized" in just one sport. When young Johnny, 9 years old, is playing baseball year-round, he's not only increasing his chances for an arm injury in the future, but he's also becoming less athletic.

It is extremely important that kids take at least 2 months off from throwing, AT ALL, every year. Period. Ideally, give them 3-5 months off to let their arms rest, heal, and decrease chances of elbow/shoulder injury. It also gives them a chance to play other sports (basketball, soccer, etc) which allows them to learn more about how their body moves, helps their proprioception, and who knows, they may like one of those other sports more.

As they grow up and become teenagers, they may decide baseball (pitching) is what they want to do and nothing else. That's fine. But as a coach or parent, you must monitor how much your child throws.

Throwing year-round can provide short-term benefit. There's a chance your velocity could increase as your arm/body become more and more accustom to the unnatural motion of throwing a baseball (not necessarily a good thing). However, there's a much greater chance that your arm will fall off, blow up, and/or completely disintegrate before you can receive any benefit from the increased velocity (if you're one of the lucky few that actually sees an uptick in speed). And that increased velocity likely increases your odds of tearing the UCL in the elbow, as that ligament can only hold up for so-long before enough is enough. Those MLB pitchers that you see throwing 97-98+ on the regular are a ticking time bomb. It's not a question of if, but when.

The take-home message here is that Major League teams are not the reason for increased Ulnar Collateral Ligament damage/tears in their pitchers. It's parents and coaches at the youth level that don't monitor their child's or athlete's throwing and allow/make them throw too much as they grow. Give them rest. They'll thank you. As will their elbows and shoulders.