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Can Baseball's Elbow Injury Epidemic Be Stopped?

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Baseball season has arrived, and with it comes endless debates about the best-hitting lineups and pitching staff. However, there's one topic everyone should be following this season: the frequency and prevention of Tommy John surgery. The procedure is so commonplace that many players consider it routine - but should it be?

In this episode, we examine the reasons behind this increase in Tommy John surgeries and how UCL injuries in young athletes can be prevented.

What is Tommy John surgery?

Tommy John surgery reconstructs the ulnar collateral ligament (UCL) of the elbow. A tendon is typically taken from elsewhere in the body to repair the torn or ruptured UCL.

In the past three years, an average of 25-30 MLB pitchers have undergone Tommy John surgery every year. However, it's not just the pros who need the surgery. One study estimates that teens aged 15-19 accounted for nearly 60% of all Tommy John surgeries in the U.S. between 2007 and 2011.

How do UCL injuries happen?

Poor throwing mechanics is often cited as the main risk factor for UCL injuries. A timing flaw in pitch delivery can cause the arm to lag behind the rest of the body, which places extra stress on the shoulder and elbow. Many pitchers who had UCL reconstruction exhibited this mechanical flaw.

Overuse is the second-most common risk factor. Many young athletes specialize in one sport and play year-round to improve their chances of getting a scholarship or getting drafted to the pros. However, they end up engaging in these risk factors identified by the MLB and USA Baseball joint initiative, Pitch Smart:

  • Throwing too many innings over the course of the year
  • Pitching on consecutive days
  • Not taking enough time off from baseball every year
  • Throwing too many pitches and not getting enough rest
  • Playing for multiple teams at the same time
  • Excessive throwing when not pitching

Steps for preventing injuries

  • Set workload limits for pitchers by tracking pitch counts
  • Refrain from throwing for at least 2-3 months per year
  • Include shoulders and elbows in strength and conditioning programs
  • Avoid use of radar guns; they can inspire pitchers to throw harder than they're used to and put more strain on the arm
  • Learn more about preventing UCL injuries

Insuring against these injuries

Elite college athletes who are potential first-round draftees can insure themselves against serious injury through permanent total disability and loss of value insurance policies. Learn more about elite athlete insurance policies.


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