Let’s recap what the UCL tear is. A UCL tear is a tear in the ligament that occurs after repetitive throwing motions. At the age of 10-16 year’s kid’s bodies are really starting to develop. The growth plate is still open in their elbow during that time, meaning that kids shouldn’t be putting any more stress on that elbow than they need too. Ten to sixteen year olds are throwing the ball more and more and at the same time the number of young pitchers who are having Tommy John surgery is also increasing. Coincidence? I think not. Take Stephen Strasburg for example. He had surgery at the age of 22. Part of the reason why he injured him self was poor mechanics, but also because of the amount of throwing he had done up to that point in his career.
How can we help to lower the risk of kids one day injuring their UCL? Kids cannot stop throwing the baseball all together because we would not have baseball then, but what we can limit is the type of pitches kids are throwing. The human body is not designed to throw a baseball like we do, especially at such a young age. What can be done is limiting the number of throws a kid takes not only during the game, but after the game also. People make a big deal about pitch count, but don’t pay attention to the pitch count kids add up while throwing the ball with their friend in the yard, when they are warming up for the game, when they are warming up in-between innings and while they practice. Parents and coaches need to limit those types of throws and so does the individual, as they get older. Parents and coaches also need to give their kids time off during the off-season. Let the arm rest and recover for a few months and when they do start to throw again slowly ease back into it, don’t just start doing a lot of throwing. Lastly parents and coaches need to wait to teach their children how to throw breaking balls. Wait until the child is at least 14 until they start to throw the curveball or slider, so that their body and arm can develop and have as little stress as possible on it.
How do I know all this? I know this because I was also that child. I hurt my elbow when I was about 13 years old. I don’t blame my parents because I was one who chose to push my self, but I messed up looking back on it. From the age of 11-15 I would play baseball year round not taking a week off. In the summer it was baseball everyday and offseason it was three days of constant pitching with a pitching coach. By the time I got to high school my arm would start to hurt after a couple of innings. I ended up only playing one year, in large part because of that. In order to stop this alarming number of Tommy John surgeries that go on every year, we need to start from the beginning and educate the parents and players on how to keep their arm healthy and not over use their arm.
Before 1974 when a pitcher had a UCL tear his career was effectively over. When Tommy John had surgery in 1974 to repair his UCL tear he was give a 1 in 100 chance of returning to the MLB and pitching effectively. Tommy John returned from the surgery better than he was before. Now, in 2013, the chances of a pitcher coming back from Tommy John surgery are 85-92 percent. That recovery rate and return to form percentage is great, but what is alarming is the number of current pitchers who have had Tommy John surgery. On MLB opening day 2013 there were about 360 pitchers on opening rosters. Of those 360 pitchers, 124 of them, nearly one third, all had Tommy John surgery done at some point during their career. That brings us to the question of, does a pitcher need to have Tommy John surgery at some point during their career to be successful or if they have surgery will it end their career?
Tommy John was just the first of a long line of pitchers to have UCL surgery and make a full recovery. In 2007 Josh Johnson of the Miami Marlins underwent Tommy John surgery and returned in 2008 and pitched a phenomenal season earning 15 wins and 191 strikeouts. Four years later, 22-year-old Washington Nationals, pitching prodigy Stephen Strasburg underwent Tommy John surgery. Strasburg returned in 2012 with similar dominant numbers compared to Johnson, earing 15 wins and striking out 197 batters.
For every Stephen Strasburg type success story, there is another story where one does not return to form. A name that comes to mind for all Toronto Blue Jays fan’s is B.J. Ryan. Ryan underwent surgery in 2007 and came back to baseball in 2008. He had a good 2008 season, but after that it all went down hill. Ryan pitched in 2009, but his command was all over the place and was being hit on by anyone who stepped into the batters box. Ryan never pitched in another MLB game after 2009.
What is interesting about the list of MLB pitchers who have had Tommy John surgery is that there are two distinct groups of players that have had it. There is Tim Hudson, Billy Wagner and John Smoltz who were at the end of their prime and careers when they had it and then there is Stephen Strasburg and Josh Johnson who had it at the beginning of their young careers.
In the end Tommy John surgery is just re-adding life to a pitchers arm. The surgery is strengthening and re-doing what had been worn down over all of those years of pitching and almost essentially giving a pitchers arm a reboot for the remainder of their pitching career.
What Is It?
Ulnar Collateral Ligament (UCL) reconstruction surgery; a surgical graft procedure where the UCL in the medial elbow is replaced with a tendon from somewhere else in body like the right or left elbow. Now hearing just that, doesn’t that sound like a painful surgery? So does anyone out there even know what that surgery means? What if I were to tell you what it is infamously called? Does Tommy John ring any bells? Tommy John surgery is the name most often used when someone goes through UCL reconstructive surgery. The surgery is called Tommy John because Tommy John, a MLB pitcher from 1963-1989, was the first pitcher to have UCL reconstructive surgery.
Check out this video on Tommy John surgery by in their ESPN series 30 For 30 : Tommy And Frank
Up until 1974 Tommy John surgery had never been performed or even been developed yet. Before 1974, when a pitcher had a UCL tear, their only option to try and fix it was rehab their harm and play through the pain. It was largely known though, that a pitcher’s career was over if he suffered the tear. In 1974 there was a doctor by the name of Frank Jobe, the LA Dodgers team physician, who came along and forever changed the landscape of pitching arm injuries in the MLB. Tommy John was the one that actually approached Frank Jobe and told him to fix his UCL tear, so that’s when Frank came up with Tommy John surgery. When having the surgery done, Tommy was given the chance of making it back to the MLB of 1 in 100. Tommy John made a full recovery from the surgery and actually became a better pitcher because of it. It took Tommy one year from when he had the surgery to pitch in a game. Tommy John went on to win 288 games in the MLB with more than half of those wins coming after he had the surgery.
Photo Courtesy Cal State Fullerton Athletics
What Causes It?
A UCL tear is most commonly caused when the UCL ligament becomes stretched, frayed or torn from stress on ligament because of repetitive throwing motions. After years or even months of throwing hard and putting stress on elbow and the ligament, is when the tear begins and ultimately ruptures. After this pro longed stress on the ligament, is when the ligament ruptures while the pitcher is pitching and the pitcher hears a “pop” noise in their elbow. This noise is their UCL ligament rupturing and them now needing Tommy John Surgery.