What is the deal with Tommy John Surgery??

[dieterbrock]

Ok, so today Zach Wheeler of the Mets is now out for the year with Tommy John surgery. He joins teammate Josh Edgin who also had his season end on Saturday.
And Yu Darvish of the Rangers, out for the year this weekend.

How has this become so darned common??

 

[RhodyRams]

you think about the olde pitchers, Koufax, Feller, Young to name a few, pitching every 2 days or so and going 9 innings a game, sometimes pitching both games of a double header, and you really wonder about todays pitchers

 

[fearsomefour]

I train a couple of pitchers in my spare time.
MLB doesn't really know the "cause" of the injury. There are a ton of contributing factors. Mechanics, innings thrown, velocity of the pitcher. Some try to tie it to the growth of travel baseball for youth and teenage players. The level and amount of play for young players is higher than ever with a population of players that are chronically undertrained. Some have tried to say the long term effects of throwing a lot at a young age isn't realized until a player is older. Some point to increased average velocity in MLB. The MLB average fastball velocity has increased a little over a mile an hour in the last several years. It doesn't sound like a lot, but, that sort of increase at the very top level of the game is something relatively new.
The real "growth" in TJ has been in youth baseball. Not enough time off, playing year round and players that are very undertrained contribute to the increase in the amateur game in my opinion. Here are some quick numbers....

Tommy John surgeries by year (MLB players only)

2014 - 16
2013 - 19
2012 - 36
2011 - 18
2010 - 16
2009 - 19
2008 - 18

With the exception of 2012 there has not been a big upswing in the actual MLB. When you factor in all levels of minor league ball, every level of college ball, high school and youth baseball TJ surgery is a nice little industry. I know two kids that have had TJ surgery in the past year, neither a full time pitcher.
One thing I have noticed is there seems to be a rash of injuries in spring training and early in the year and then it slows greatly most years. This, to me, speaks to how baseball tends to train and manage its players.
One thing that really confuses the issue of cause is the pitching motion itself. It is a very individualized movement pattern. It is also (throwing a ball 90 + mph) the most explosive movement in all of sports. There is tremendous stress put on the shoulder and elbow. The estimated strain on the elbow at maximum arm layback when someone throws 90 mph is about the same as hanging a 40 lb weight from your hand with your arm layed back.
I have definite thoughts about amateur pitchers, as for pros, already performing at a high level I think it is maybe the cost of doing business. Like sprinters dealing with chronic hamstring issues or football players dealing with knee injuries.

 

[Dodgersrf]

It happens because more kids are throwing junk balls at a young age.

When I was a kid your coach was the mailman. Now days, we have hired guns and coaches that know how to coach. Which is great for other aspects of the game.
The problem is the natural arm movement is under hand not over hand.

An underhand ball has no pitch count. An over hand ball goes against the natural rotation of the arm.
It's magnified by the twisting arm movements of junk balls.

There are high school kids getting ligament replacements now.

Don't let your kids throw junk balls. Period.

 

[dieterbrock]

"Tommy John surgeries by year (MLB players only)"
I'm certain that if you look across all leagues, the numbers are up, way up
And furthermore, if they average 18-20 per year for 10 years, that's a serious issue,its an epidemic.

Its amazing how different it is today from when I was a kid. I played all levels of little league and pitched my share. I never learned how to throw a curve ball, none of the coaches would allow it

 

[fearsomefour]

"Tommy John surgeries by year (MLB players only)"
I'm certain that if you look across all leagues, the numbers are up, way up
And furthermore, if they average 18-20 per year for 10 years, that's a serious issue,its an epidemic.

Its amazing how different it is today from when I was a kid. I played all levels of little league and pitched my share. I never learned how to throw a curve ball, none of the coaches would allow it

25% of MLB players will have the surgery at some point in their career.....of course, there are guys who pitch 15 years and never have surgery (I have a friend who pitched 18 years of pro ball and never had a shoulder or elbow surgery)....and there are guys who have the surgery in year one of MLB ball and never get back.
The real concern is youth baseball and amateur ball in my opinion.

 

[fearsomefour]

It happens because more kids are throwing junk balls at a young age.

When I was a kid your coach was the mailman. Now days, we have hired guns and coaches that know how to coach. Which is great for other aspects of the game.
The problem is the natural arm movement is under hand not over hand.

An underhand ball has no pitch count. An over hand ball goes against the natural rotation of the arm.
It's magnified by the twisting arm movements of junk balls.

There are high school kids getting ligament replacements now.

Don't let your kids throw junk balls. Period.

Curveballs are actually less stressful on the elbow if thrown correctly. The problem is getting young, uncoordinated kids to throw it correctly. Sliders and split finger pitches are the most stressful on the elbow. Sliders because the elbow is not allowed to pronate after release and split finger because spreading the fingers apart stresses the elbow.
All of that said, because of the time it takes to learn to throw it correctly, I wouldn't allow kids to throw curveballs until they are about 14 or so. Physical development plays a role but the development of a solid base of throwing, mechanics and learning to throw the pitch correctly (pronating after release) is a must.
Kids at 12 or 13 are getting the surgery now, for a whole host of reasons. The one thing I see that is the slowest to change....and it is too bad because it could have the biggest benefit in regards to keeping young players healthy....is the sport is chronically under trained. Kids are massively unprepared to pitch generally speaking.

 

[Dodgersrf]

Curveballs are actually less stressful on the elbow if thrown correctly. The problem is getting young, uncoordinated kids to throw it correctly. Sliders and split finger pitches are the most stressful on the elbow. Sliders because the elbow is not allowed to pronate after release and split finger because spreading the fingers apart stresses the elbow.
All of that said, because of the time it takes to learn to throw it correctly, I wouldn't allow kids to throw curveballs until they are about 14 or so. Physical development plays a role but the development of a solid base of throwing, mechanics and learning to throw the pitch correctly (pronating after release) is a must.
Kids at 12 or 13 are getting the surgery now, for a whole host of reasons. The one thing I see that is the slowest to change....and it is too bad because it could have the biggest benefit in regards to keeping young players healthy....is the sport is chronically under trained. Kids are massively unprepared to pitch generally speaking.

Completely agree.
We don't have this issue as much in any other sport. As least not at the volume of baseball.

 

[fearsomefour]

Completely agree.
We don't have this issue as much in any other sport. As least not at the volume of baseball.

Agreed.
Part of it is a misunderstanding of what it takes to throw hard and to throw safer.
I work mostly with older kids, a couple of college guys now. It's fun and interesting and frustrating as well.

 

[Dodgersrf]

Agreed.
Part of it is a misunderstanding of what it takes to throw hard and to throw safer.
I work mostly with older kids, a couple of college guys now. It's fun and interesting and frustrating as well.

Coaching is a kick. I love it.
I use to coach high school. Not really much to coach at that point. Your mostly managing at that level.

I really enjoy the young kids though. Taking a kid that has never played and within weeks they're doing things they only dreamed of. I enjoy getting a kid hooked on sports and giving them.the proper tools to play at the next level competitively.

I wish I had better coaches when I was a kid.

 

[Yamahopper]

It's always been this way. Before the TJ procedure and the RC surgery a player was just done or became a junk baller. it was classified as a sore arm and as they say that was that.
Some think it's due to having more high leverage innings now, and maybe there is something to that. But a guy either has the arm integrity to pitch or not.
People talk about old timers that pitched all those innings back in the day, and it was impressive. But there are guys in the show right now that could do the same thing. But no one wants to risk it considering the investment teams have in players.

 

[Boston Ram]

"Tommy John surgeries by year (MLB players only)"
I'm certain that if you look across all leagues, the numbers are up, way up
And furthermore, if they average 18-20 per year for 10 years, that's a serious issue,its an epidemic.

Its amazing how different it is today from when I was a kid. I played all levels of little league and pitched my share. I never learned how to throw a curve ball, none of the coaches would allow it

I coached little league and babe ruth (13-15) and never let any of my players throw a curve ball till they were 14. 25 years ago that was a threshold in terms of the body being able to handle it.

We had some great All Star teams and a Babe Ruth team that played in baseball city in Orlando in the Babe Ruth WS. None of our kids threw curve balls. This is my view, if you have a kid who is talented enough at age 11 or 12 to throw a curve ball, teach him how to place a fast ball instead. He will be a better pitcher for it. The best pitchers in MLB know how to place a fast ball, very few win because of a dominant curve ball.

 

[fearsomefour]

F

I coached little league and babe ruth (13-15) and never let any of my players throw a curve ball till they were 14. 25 years ago that was a threshold in terms of the body being able to handle it.

We had some great All Star teams and a Babe Ruth team that played in baseball city in Orlando in the Babe Ruth WS. None of our kids threw curve balls. This is my view, if you have a kid who is talented enough at age 11 or 12 to throw a curve ball, teach him how to place a fast ball instead. He will be a better pitcher for it. The best pitchers in MLB know how to place a fast ball, very few win because of a dominant curve ball.

FB and change is still the best combo in baseball.

 

[fearsomefour]

I coached little league and babe ruth (13-15) and never let any of my players throw a curve ball till they were 14. 25 years ago that was a threshold in terms of the body being able to handle it.

We had some great All Star teams and a Babe Ruth team that played in baseball city in Orlando in the Babe Ruth WS. None of our kids threw curve balls. This is my view, if you have a kid who is talented enough at age 11 or 12 to throw a curve ball, teach him how to place a fast ball instead. He will be a better pitcher for it. The best pitchers in MLB know how to place a fast ball, very few win because of a dominant curve ball.

Working on changing how one of my guys throws the change using a hockey puck. Haven't tried I this way before.

 

[Boston Ram]

Working on changing how one of my guys throws the change using a hockey puck. Haven't tried I this way before.

That's not a bad idea, a softball can help too I hear. I was never much of a pitcher or coach of pitchers but my other coach used to always use softballs to help with change ups

 

[Athos]

F

FB and change is still the best combo in baseball.

The change is such an underrated pitch. It's almost like it's become the ugly stepchild no one wants. But.....that ugly stepchild grows up into a smokin' hot fox all the guys wanna nail.

Michael Wacha's change is devastating. So was Santana's before his injury spell. It's a nasty pitch when used correctly.