Youth athletes who play baseball more than eight months a year and play on multiple teams are increasing their risk for elbow injuries, said Marc Richard, MD, a Duke orthopaedic surgeon. That may explain why more high-school athletes are undergoing a procedure called Tommy John surgery.
“Kids are starting sports at younger ages, they are playing on travel teams and school teams at the same time, and are playing baseball year-round,” said Dr. Richard, a hand and upper-extremity specialist. “There’s no longer an off-season. Studies show the number of innings pitched and the number of pitches per outing are directly related to the increased prevalence of throwing injuries.”
At the same time, Dr. Richard said, pitching technique is a contributing factor. “The way people throw now is different from how people threw in the past. There may be some changes in technique that are contributing to the increase in pitching injuries as well.”
Tommy John surgery is performed frequently on major league baseball players, who often rely on it to extend their careers. During the procedure (also referred to as elbow ulnar collateral ligament reconstruction), the ligament in the elbow that connects the upper arm bone to the forearm bone is replaced with a tendon from elsewhere in the body. The surgery requires months of rehabilitation, Dr. Richard said.
Perhaps because of its prevalence among major league players, some young players mistakenly believe that Tommy John surgery can make them throw harder and faster. That’s a fallacy that Dr. Richard quickly dispelled with facts. “In multiple large studies, only eight out of 10 patients are able to return to pitching at the same level they were at the time of their injury,” he said. “That means one in five patients are not even able to perform as they were before their surgery.”