The Epidemic of Elbow Injuries – Tommy John Should Have Gotten a Trademark

I’ve written a couple of times this season about the ever-increasing number of starting pitchers suffering season-ending and career-threatening elbow injuries that have required “Tommy John” transplant surgery*. While my focus was on starters, relief pitchers are just as susceptible to these serious injuries, as evidenced by many of the most recent pitchers who have fallen prey to this injury. This week alone, veteran Angels’ reliever Sean Burnett, who missed almost all of 2013 and who had pitched only two-thirds of a single inning over three appearances this season, and budding Dodgers’ star reliever and future closer Chris Withrow have both gotten the fateful news. They join such other relievers such as the Mets’ Bobby Parnell, and additional starters Jose Fernandez of the Marlins and Martin Perez of the Rangers, in the the ranks of those suffering this injury since my last post on the issue.

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Since the death of the creator of the Tommy John surgery, Dr. Frank Jobe, the unquestioned top dog in the field is Dr. James Andrews, who since 1987 has run
the American Sports Medicine Institute at St. Vincent’s Hospital in Birmingham, Alabama. Dr. Andrews has done considerable research not just on the treatment of this type of injury, but also on its etiology, and has now posted a wealth of information his his website, providing insight into the most likely causes of the injury, and a discussion on how to avoid its occurrence.

In their “Position Statement for Tommy John Injuries in Baseball Pitchers, May, 2014“, and in their “Position Statement for Youth Baseball Pitchers, Updated April, 2013“, Dr. Andrews, Dr. Glenn Fleisig, and the ASMI staff have listed risk factors and misconceptions about the injury, and provide a detailed list of recommendations for reducing the risk of injury. They believe that the seeds of such injuries are sown at a young age, as I have said

before, and are significantly related to overuse, that the amount of throwing and fatigue at an early age is directly related to the likelihood of developing elbow strains and ultimately tears. Their recommendations are based around limiting the amount of throwing, proper rest and recovery time between games, and limiting the total numbers of games, innings, and pitches, with up to four months of rest between seasons.
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They also believe that pitchers should NOT always throw with “maximum effort”, that trying to throw every pitcher harder than the last one is a sure-fire race to injury. They specifically state that the radar gun should not be used in youth baseball, and that a pitcher should never play catcher between starts, that the additional significant number of throws a catcher must make will increase the risk of injury.

Their research and records show that there was a rash of such injuries a dozen or so years ago in adolescent pitchers, and that improper methods employed then caused injuries back then, and those injuries have worsened over the years, and are now causing, in part, the current rash of Tommy John surgeries occurring now.

*Rough Time to be a Pitcher, But Who is Responsible?; This Week in Pine Tar and Other Bad Stuff in Sports

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