Tommy John Surgery. Three words that no pitcher ever wants to hear. Jose Fernandez, the young ace of the Miami Marlins staff, has become the latest member of this club, one which nobody wants to be a part of. It's becoming quite alarming how many pitchers have to go under the knife to get this surgery done. To be exact, Tommy John Surgery is ulnar collateral ligament (UCL) reconstruction. It is a surgical graft procedure in which the ulnar collateral ligament in the medial elbow is replaced with a tendon from elsewhere in the body. The number of baseball players who need to have this operation is quite alarming. This leads to two big overall questions. Does Major League Baseball have an "epidemic" on their hands? Is their a solution to this problem?
Is this a major epidemic? Not in the same sense as say Swine Flu no. But it is becoming a major problem. When you start seeing players getting hurt with this kind of an injury with as much frequency as they have, then it is really becoming a problem. For a long time, if you had to have Tommy John Surgery, it would mean that it was sort of an injury of attrition. Most pitchers having the operation had been pitching for a long time, with the average age being 30 years or older. Now we are seeing guys in their early twenty's having to undergo this procedure. The reason? There could be a number of factors, but two that keep popping up in reports are too many innings and too much velocity at a younger age. Here's some interesting numbers. The first surgery was performed in 1977. Between then and the turn of the century in 2000, there was an average of no more than ten surgeries performed in a year. From 2000 to right now, the numbers have skyrocketed. Here's the number of Tommy John Surgery's by year from 2000-2014 (among MLB players only. Numbers according to ESPN):
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
That's freaking scary that there are that many players who are having to go under the knife for this operation. And in some cases, players have had to have the surgery a 2nd time. Most of the time, players are able to come back from this operation and resume their careers. It hasn't been a perfect 100% success rate, but its been a very successful operation, with some 90-95% of the surgeries being a success (ESPN).
Sure it's great to see that this surgery has been a success, as a lot of guys have gone on to resume careers. What is really making me worry, though, is that players have to even go under the knife for the operation to begin with. Now the big question is, how do you stop pitchers from having to go under the knife in the first place?
There's no real, exact way to be able to stop and control pitchers from having to undergo this operation. There are ideas being put out there as to how to try and prevent this from happening.
Everybody has their own theories as to how to possibly cure this problem. Some say it has to do with bad mechanics in pitching. Some pitchers are being taught to pitch "downhill" which is where pitchers are being taught to throw towards the bottom of the strikezone. That seems to be putting more strain on the arms of pitchers. Some people believe that the drop and drive pitch style that made Tom Seaver so successful, and was used by many pitchers in the 70's and 80's, allowed pitchers to have better mechanics, stay healthier and pitch more innings. Some mechanics can play a factor in this. A lot of that is taught in youth baseball, which is another cause to the problem.
A study was done recently that showed that some youth pitching to be a culprit for players having surgery at later points in life. Some studies show that pitching past fatigue and pitching year round really isn't good for such young arms. Pitching past fatigue isn't allowing the young arms to be able to rest and recover the way it should. Same thing goes for pitching year round. Pitchers aren't getting the proper rest for their arms. The results might not be harmful right away, but they have shown up later in life. So resting young pitchers and changing their mechanics could go a long way to helping out pitchers avoiding having to take the surgery.
It's not just youth baseball either that can undergo changes to help save pitchers arms. It should really start at the Major League level as well. Some people are trying to push to get the pitching mound lowered, something I think they have a valid argument for. The argument for this was being made at a MLB roundtable last week by Mets team physician Dr. David Altchek and biomechanics expert and former pitcher Tom House that the greater the slope of the mound the greater the forces that are applied to the arm. Reduce the height of the mound and you reduce the forces upon the arm (Sports Illustrated).
It really makes perfect sense, because it really would put less strain on the arm of a pitcher. And it can be passed down to the youth and armature level as well. The reason to throw this in is that, according to some reports, 13 year old kids are pitching off Major League size pitching mounds. Doing that is really putting a ton of strain on the arm, which later in life is going to be harmful, possibly leading to having this surgery. So if you lower the pitching mound, that might alleviate some of the pressure on the pitching arms.
This is just some thoughts and theories as to somewhat cure Tommy John Surgery. There's no set rule or way to take the pressure off the arms of pitchers, but at least steps are being taken in the right direction to get this problem taken care of.t
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