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Dr. James Andrews Releases Position Paper on Tommy John Injuries

Dr. James Andrews, the foremost expert on UCL tears, which in most cases lead to Tommy John Surgery, has released a position paper on what is quickly becoming an epidemic around the world of baseball. 

Released through the American Sports Medicine Institute, Dr. Andrews had the following to say.

During the past few years there has been an “epidemic” rise in the number of professional pitchers requiring ulnar collateral ligament reconstruction (“Tommy John surgery”).1 This is like déjà vu, as a similar sharp rise was seen in adolescent pitchers near the turn of the century.

This is a point that has been lost in all the recent news surrounding MLB pitchers missing the 2014 season after undergoing surgery for injured UCL’s. It wasn’t too long ago that little leagues around the United States placed a pitch-count limit on players of a certain age. The idea there was to limit the potential of young kids losing their arm strength at an early age.

Injury prevention for those still gaining strength in the elbow has come front and center.

Injury prevention for those still gaining strength in the elbow has come front and center.

Dr. Andrews continued…

Research has shown that the amount of competitive pitching and pitching while fatigued are strongly linked to injury. Other risk factors may include pitching on multiple teams, pitching year-round, playing catcher when not pitching, poor pitching mechanics, and poor physical conditioning.

Now this last blurb was targeted towards pitchers of all ages, grown-ups included. It goes without saying that a higher pitch count will lead to fatigue, which can then lead to an UCL  injury. The young pitchers in MLB, who are a vast majority of those impacted by UCL injuries, might still be gaining strength in their elbows. Over-throwing and over-use could be the common link here.

Andrews then discussed misconceptions about the surgery itself by responding to the old wives’ tale that getting the surgery over quickly will benefit the pitcher both short and long term.

While there may be instances of pitchers throwing faster after returning from Tommy John surgery, this was due to the surgeon fixing the problem followed by the pitcher working intensely with the physical therapist, athletic trainer, strength coach, and pitching coach. The rest after surgery may have also helped the athlete’s body. However, performance usually decreases over time for MLB pitchers after Tommy John surgery

The main things to take out of this paper, especially from a professional perspective, is Andrews’ take and recommendation on precautions that should be taken.

Do not always pitch with 100% effort. The best professional pitchers pitch with a range of ball velocity, good ball movement, good control, and consistent mechanics among their pitches. The professional pitcher’s objectives are to prevent baserunners and runs, not to light up the radar gun.

Courtesy of MLB.com: Jose Fernandez is the latest in a long line of UCL injuries among youngsters.

Courtesy of MLB.com: Jose Fernandez is the latest in a long line of UCL injuries among youngsters.

In short, the idea of over-throwing could lead to the uptick in UCL injuries among young pitchers in baseball. Notice how the vast majority of those sidelined for the season are not grizzled veterans, who know how to find a happy medium between over-throwing and pin-pointing a target?

In any event, this was an extremely interesting read by Dr. Andrews. We recommend you check it out. 

Photo: CBS Sports

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