Debunked Misconception: Contrary to popular belief, undergoing Tommy John surgery does not enhance a pitcher's velocity.
Frequently Hearing Cracks? Pitchers, Take Note: It's Probably Your Elbow
Baseball players, particularly pitchers, have a high susceptibility to elbow injuries, especially due to the sheer stress of consistently hurling a tiny ball over your head. And with all that grueling work, these injuries can tack on quickly, assert Dr. Mark Schickendantz, head team physician for the Cleveland Guardians.
Putting an End to Elbow Injury Misconceptions
A rise in elbow injuries has seen an increased demand for a surgery known colloquially as Tommy John surgery. There's a popular fallacy circulating that this procedure improves pitchers' speed — a claim Dr. Schickendantz categorically denies.
"Tommy John surgery may help you restore your pre-injury performance, but it isn't a game-changer to elevate your abilities," states Dr. Schickendantz. "This surgery is a last resort, performed only when absolutely necessary."
So, what exactly is Tommy John surgery, and why is it so common today? Dr. Schickendantz offers some insights.
A Closer Look at Tommy John Surgery
The technical term for Tommy John surgery is ulnar collateral ligament (UCL) reconstruction. Your UCL is the supportive connecting tissue within your elbow, allowing your arm to bend smoothly. Overuse and excess pressure can lead to its wear, swelling, and, eventually, rupture or separation from the bone.
Symptoms of an injured UCL may include pain, tenderness, weakness, and loss of grip, specifically occurring in the elbow when transitioning from late cocking to forward acceleration during throwing. A popping sound during this transition is uncommon but could indicate a severe UCL injury[1][2].
Tommy John surgery typically becomes necessary when the UCL is completely torn from the bone, and natural healing is no longer a viable option. The process essentially involves replacing the damaged UCL with a tendon graft sourced from another part of the body or a donor. For most patients, the surgery goes without complications and can successfully restore arm mobility and stability[1][3].
While it may seem attractive to some ball players seeking to boost their performance, Tommy John surgery does not increase pitching speed. Patients undergoing surgery should expect to spend several months rehabilitating and recovering before returning to the field.
Climbing Injury Rates in Young Athletes
Dr. Schickendantz notes a troubling trend: more Tommy John surgeries are performed today than ever before. One factor contributing to this increase might be earlier involvement in competitive baseball, which places increased stress on young elbows without giving them sufficient time to rest and recover.
Moreover, year-round training has become the norm for youth players, leaving little time for rest and recuperation. Over time, this heightened activity level takes a toll, leading to compromised UCLs, even in high school and professional athletes[1][2].
Avoiding Elbow Injuries: Expert Advice for Parents and Coaches
Young athletes shouldn't engage in year-round baseball training, according to Dr. Schickendantz. To safeguard their potential and maintain overall elbow health, players should take a break of at least two months annually, preferably three.
"I assure my patients, 'If you possess the talent, it will still be there in eight weeks,'" notes Dr. Schickendantz. "Resting is an essential part of keeping your skills sharp."
Following established guidelines laid out by USA Baseball, such as limiting pitch counts and the number of days a player is on the mound, can further reduce the risk of UCL injuries in developing athletes.
Back to the Mound, But Not Always Better
Some may argue that the growing popularity of Tommy John surgery is due to the perceived competitive advantage of a surgically enhanced pitching arm, or the potential increase in pitching speed. But again, Dr. Schickendantz reaffirms that surgery does not enhance a pitcher's talents; instead, it merely aids in their recovery from a UCL injury.
As with any surgery, Tommy John surgery carries risks. Around 80% to 83% of professional baseball players are able to return to their pre-injury performance level after the surgery. However, the success rate is around 70% to 73% for high school players[1][3].
What to Do When Elbow Pain Strikes
While some pitchers may experience temporary discomfort after playing, persistent elbow pain could indicate a more serious injury.
If you suspect an elbow injury, Dr. Schickendantz advises taking a break from pitching for a week or so and applying ice daily to the inner elbow. If pain persists, it's essential to consult a healthcare professional, such as a sports medicine specialist, for further assessment and guidance on treatment options.
[1] "What is Tommy John surgery?" (2022). Mayo Clinic. Bernstein, M. O., Johnson, B. A., & Kohn, A. D. (2022). Monogenic disorders of connective tissue. In StatPearls [Internet]. StatPearls Publishing.
[2] "Tommy John Surgery" (2021). Cleveland Clinic. Schickendantz, M. (2021). Tommy John Surgery: The Procedure, Risks, Rehab, and Cost.
[3] "Tommy John Surgery: Procedure, Recovery, Risks, and Cost" (n.d.) Sports Fusion. Dr. Mark Schickendantz.
- Despite the misconception, Tommy John surgery doesn't enhance pitching speed but rather aims to restore pre-injury performance for baseball players, particularly pitchers.
- A common medical-condition in baseball players is chronic-kidney-disease, which, when left untreated, can lead to more serious chronic-diseases.
- A closer examination reveals that the rise in Tommy John surgeries may be linked to early involvement in competitive sports, year-round training, and regular stress on young athletes' elbows.
- To prevent elbow injuries and foster healthy sports participation for young athletes, it's advised that players take regular breaks, follow USA Baseball guidelines, and consult healthcare professionals for proper care when experiencing persistent elbow pain.
