Number of young baseball players having Tommy John surgery is up

We want our student athletes to learn the fundamentals of the game and have fun, but more and more teen baseball players are undergoing a surgery to repair elbow injuries.

The surgery is called am Ulnar Collateral Ligament Reconstruction (UCLR). In a new survey presented at the American Orthopedic Society for Sports Medicine’s Annual meeting, researchers find the number of surgeries have increased by 9.12% between the years 2007-2011.   

Researchers discovered more teens in the Southern region of the United States are having the surgery.    

15-19-year-old athletes make up 56.7% of the patients, followed by 20-24-years-old.

Surgical procedures rose in the 15-19-year-old group from 79 per 100,000 in 2007 to 106 per 100,000 in 2011, while the numbers in the 20-24-year-old age group were only 39 and 34 per 100,000, for the same time period.
The surgery has been dubbed Tommy John Surgery.  It’s named after L.A. Dodgers pitcher Tommy John, the first professional baseball player to have undergone the surgical repair.
Dr. Brandon Ericson, a fourth year orthopedic resident at Rush Medical Center and the author of the study, says the majority of the surgeries are performed on baseball players.   

Dr. James Andrews, an expert in the field, has spearheaded many of the campaigns to counter act this trend.  During his interview with FOX 13 in 2007, he expressed concern about the growing number of teen athletes presenting with injuries previously seen only at the college or professional level.  

In a 2004 American Orthopaedic Society for Sports Medicine article, Dr. Andrews, et. Al., outlined six potential risk factors thought to contribute to the injury.  They included overuse – year-long or seasonally, fast balls with a velocity more than 80 mph, and curve balls, or breaking pitches before age 14.   
Overuse was addressed in part with the use of pitch counts. Previously, Little League pitchers were rested based on the number of innings they pitched. In 2007, coaches were required to count the actual number of pitches instead.  

Even though surgical numbers are up, Dr. Ericson says he  still agrees with the pitch count rule. He believes the reason it has not reduced the number of injuries is likely due to the reality that many young athletes play in multiple leagues, making pitch counts difficult to enforce.  
Once an athlete develops symptoms, the treatment involves rest, ice, and anti-inflammatory therapy. There has been some interest in the use of PRP injections (Platelet Rich Plasma and it’s derivatives) to help heal partially torn ligaments.  However, Dr. Ericson stresses the need for rest that may be required for two months, with gradual strengthening of muscle groups to take the stress off the ligament prior to a return to competitive pitching. 
Dr. Ericson believes another factor that may be contributing to the increased number of surgeries is a misconception that the surgery will improve a pitcher’s performance. A 2012 study out of Columbia University found that 30% of coaches, 37% of parents, 51% of high school athletes, and 26% of collegiate athletes believed that Tommy John surgery should be performed on players without elbow injury to enhance performance.   

In reality, recovery from the surgery may take a full year and although it is very successful, Dr. Ericson says about 10-20% of patients are not able to return to competitive sports.