Tommy John Surgeries on the Increase

The tiny ulnar collateral ligament—barely more than two inches long—is a major worry for major league baseball. According to Ronald Blum, an AP sports writer, more than a dozen major league pitchers have already undergone Tommy John surgery—the replacement of their elbow ligament with a tendon from some other part of their body.

Blum reports that all-stars Patrick Corbin, Josh Johnson and Matt Moore have had the surgery, and National League Rookie of the Year Jose Fernandez is scheduled to have his operation soon. A 2013 survey, referred to by Blum, showed that 25% of big league pitchers and 15% of minor leaguer pitchers have undergone the Tommy John procedure. Glenn Fleisig of the American Sports Medicine Institute, who conducted the survey with Stan Conte of the Dodgers, told Blum, “This does not include the guys who didn’t make it back. These are the success stories.”

So how many balls can a pitcher throw before he puts his pitching arm in jeopardy? A study published in 2011 examined 481 pitchers ages 9-14, and then checked with them 10 years later. The study found that those who threw more than 100 innings in a year were 3.5 times more likely than pitchers throwing fewer balls to need elbow or shoulder surgery. Or they had to stop playing baseball.

Blum noted that the USA Baseball Medical/Safety Advisory Committee recommends limits of 50 pitches per game and 2, 000 pitches per year for 9- and 10-year-olds, and 75 pitches per game and 3, 000 per year from pitchers age 11-14. The limit rises to 90 at ages 15-16 and 105 for ages 17-18, with no more than two games a week.

Major League baseball officials agree there is a problem and they are looking for ways to protect the pitchers’ valuable elbows before surgery becomes necessary. Officials say they plan to launch a research project “to help figure this out.” They agree that the problem has “gotten everyone’s attention.”