The Tommy John Epidemic

[imref]

Pretty good article:

http://espn.go.com/mlb/story/_/id/10831700/is-mlb-midst-tommy-john-epidemic

15 players already this year, versus 19 all of last year (but 36 the year before that).

[imref]

on the heels of yet another TJ, comes this:

http://espn.go.com/mlb/story/_/id/10935698/dylan-fosnacht-rochester-high-school-throws-194-pitches-14-innings

[mmzznnxx]

Has there been done any studies on this? About how different arm angles, types of pitches, genetics, frequency of pitching, number of pitches, etc., lead to UCL tears?

I wonder because I hear of so many pitchers of the past throwing complete games as the norm. And I wonder if they were pitching with freaked up UCLs, or if pitching has changed to ruin arms.

I'm almost beginning to wonder, due to how many players come back from TJ successfully and how many end up needing it, if it's something that "comes with the territory" of being a baseball player, especially a professional one.

I know it's a major surgery and I would hate to have it, but I'm starting to think that like bad knees in basketball and concussions in football, as well as southern dental appearance in hockey, if it's a concession that should be expected with the sport. It might not be the majority, but it's increasingly common.

Definitely a crazy grey area right now, though, and if I was a parent of a pitcher, I'd make sure he had adequate rest even if he wasn't slated for much in the baseball world.

[HalfSmokes]

BOb's effectively wild podcast has been talking about this, I think it's just a matter of more velocity expected from starters. I don't think it comes with the territory- bp throws out an 85% success rate, I think most players wouldn't go under the knife unless they really needed if there was 15% chance of failure

[Lintyfresh85]

I thought the Braves were the root cause of all tommy john surgeries.

 

on the heels of yet another TJ, comes this:

http://espn.go.com/mlb/story/_/id/10935698/dylan-fosnacht-rochester-high-school-throws-194-pitches-14-innings

As the kid said... who cares? He's not going to play in college, this could be his very last game... let him go out his own way. Of course, I'd feel differently if the kid had a future ahead of him in baseball... but if he knows it's near the end of his "career" let him throw till he can't anymore. Is it hypocritical of me to have different rules for prospects and the guys that see the end of their playing days in high school? Absolutely... but that's how I see it.

[HalfSmokes]

It's not hypocritical, if you're never playing agian, the ability to throw a fast ball is on par with the ability to juggle chainsaws- i.e. useless

[Ali the Baseball Cat]

Pretty much, unless your last line of defense during zombie apocalypse happens to be a baseball factory. 

Aren't most baseballs made in Haiti?

[blue911]

Pretty much, unless your last line of defense during zombie apocalypse happens to be a baseball factory. 

Aren't most baseballs made in Haiti?

Costa Rica

[Vega]

I am unconcerned about the number of surgeries. What concerns me is the repeat surgeries for Parker, Medlen, Hudson, and Beachy. Before this year, that was uncommon. Sure, Brian Wilson and Kyle Drabek had two, but they were years apart and could reasonably be considered anomalous. Before this year, TJ usually was a durable surgery. There was always a chance that one would not regain one's prior ability, but it usually did at least fix the elbow. Those four guys requiring TJ again so soon after their first really shakes my confidence in the operation.

[Lintyfresh85]

Dr. Andrews and the American Sports Medicine Institute have released a paper on the rise in TJS.

http://www.asmi.org/research.php?page=research&section=TJpositionstatement

[spidernat]

"We are not now that strength which in old days
 Moved earth and heaven, that which we are, we are;
 One equal temper of heroic hearts,
 Made weak by time and fate"

[Kevrock]

on the heels of yet another TJ, comes this:

http://espn.go.com/mlb/story/_/id/10935698/dylan-fosnacht-rochester-high-school-throws-194-pitches-14-innings

This is abuse.

[Kevrock]

As the kid said... who cares? He's not going to play in college, this could be his very last game... let him go out his own way. Of course, I'd feel differently if the kid had a future ahead of him in baseball... but if he knows it's near the end of his "career" let him throw till he can't anymore. Is it hypocritical of me to have different rules for prospects and the guys that see the end of their playing days in high school? Absolutely... but that's how I see it.

Have you ever pitched? 194 pitches is ridiculous. I remember how my arm felt after 120.

A coach needs to look out for his players. No 18 year old is ever going to want to come out of a playoff game EVER. It's the coach's responsibility.

Arm injuries can affect life outside of baseball. Arm surgery and recovery cost money and is no fun. Kid might want to lift his arm above his shoulder someday (or play catch and pitch to his son), so no, his arm is not expendable just because he isn't a prospect.

Anyway, I'm sure that coach will feel the affects of his decision. If my kid was in line to play with him it would be off to private school or anything to avoid the guy.

[Kevrock]

Dr. Andrews and the American Sports Medicine Institute have released a paper on the rise in TJS.

http://www.asmi.org/research.php?page=research&section=TJpositionstatement

Great read

7.Be wary of pitching in winter league baseball. The UCL and body need time to recover and build strength, so the concept of annual periodization should include adequate rest from full-effort pitching.

This is huge. The rise of year-round baseball started in this area in the late 90s and hasn't gone away. High school coaches pressure kids to play summer and fall league and then work out all winter in clinics and weight room.

It used to be HS baseball in the spring -> Legion in the summer... Football, basketball or take some time off. Now kids play year round and aren't noticeably better, just more likely to burn out.

It's too much throwing.

[Kevrock]

8.Exercise, rest, and nutrition are vital for a pitcher’s health. Performance-Enhancing Drugs (PEDs) may enable the athlete to achieve disproportionately strong muscles that overwhelm the UCL and lead to injury.

Another interesting tidbit. Especially when you factor that in with the point about max-effort pitching. PEDs allow more max-effort pitching and faster recovery but that will abuse the UCL more.

[spidernat]

Another interesting tidbit. Especially when you factor that in with the point about max-effort pitching. PEDs allow more max-effort pitching and faster recovery but that will abuse the UCL more.

This may be the biggest contributor.

[HalfSmokes]

Of all the theories, I'm inclined to blame youth baseball, both the all year nature and the increased competivenes. Taking kids who may have played football in the fall and basketball in the winter and having them pitch year round seems as good an explanation as any

[Mr Clean]

This report should be required reading for all baseball coaches from little league up.

[imref]

I saw an interview the other day with Strasburg in which he talked about the high rate of TJ.  He, like many others, blamed overuse of youth players in travel leagues.

I last coached 2 years ago, a team of mostly 9 year-olds.  One of my kids was a stud pitcher who was on the league's travel team and usually pitched every sunday.  I couldn't bring myself to use him more than 2 innings a week even though I had a green light from the travel coach to pitch him more.

[Kevrock]

The absurdity of 9 year olds playing travel baseball in the first place.

It's all these for-profit teams, they've ruined local baseball and are super shady. I could go on a long rant about them.

[imref]

here's the strasburg interview, he also talks about what he thinks led to his own TJ:

http://mlb.mlb.com/news/article.jsp?ymd=20140524&content_id=76665738&notebook_id=76675416&vkey=notebook_was&c_id=was

[imref]

The absurdity of 9 year olds playing travel baseball in the first place.

It's all these for-profit teams, they've ruined local baseball and are super shady. I could go on a long rant about them.

our travel team was part of the larger league, the travel players still had to play on a "regular" team and they only played travel ball on Sundays.  But yeah, there are half a dozen "pure" travel teams around here.  It's not just baseball, pretty much every sport has travel teams now.  A friend mentioned he pays something like $1,200 a year for his kid to play travel soccer.

[HalfSmokes]

The absurdity of 9 year olds playing travel baseball in the first place.

It's all these for-profit teams, they've ruined local baseball and are super shady. I could go on a long rant about them.

it's not just for profit. We started my daughter doing soccer more than anything just to get her running around and it was great - a bunch of three year olds kind of kicking a ball, but as you looked up the fields and you got older, you could see serious coaches and parents screaming at kids who couldn't have been older than six. Youth sports in general seem to be taking their cue from texas high school football

[imref]

it's not just for profit. We started my daughter doing soccer more than anything just to get her running around and it was great - a bunch of three year olds kind of kicking a ball, but as you looked up the fields and you got older, you could see serious coaches and parents screaming at kids who couldn't have been older than six. Youth sports in general seem to be taking their cue from texas high school football

everyone wants to get out of coalwood, and not everyone can be a rocket scientist.

[HalfSmokes]

everyone wants to get out of coalwood, and not everyone can be a rocket scientist.

except most of the parents at Gunston aren't exactly coal miners