Is Youth Baseball Battling a Tommy John Surgery “Epidemic”?

Is Youth Baseball Battling a Tommy John Surgery “Epidemic”?

According to ESPN, Ulnar Collateral Ligament (“UCL”) reconstruction, frequently referred to as Tommy John surgery, is approaching “epidemic” frequency among professional athletes.

The procedure is common among collegiate and professional athletes in several sports, most notably baseball. According to Adam Discepolo, Partner and Clinical Director at Professional Physical Therapy’s Merrick clinic, professional athletes, however, are not the only ones that should be concerned. In baseball, as in many sports, the level of competition has gradually increased in recent years, as we see younger athletes begin to specialize and focus on just one sport. Year-round play and playing on multiple teams have taken the game to another level as far as talent is concerned, but according to some, this specialization at a younger age has become a major factor in the Tommy John surgery “epidemic” affecting the sport.

UCL injuries typically require surgery to reconstruct the ligament located in the inner elbow. Baseball great Tommy John received the first ever UCL reconstructive surgery in 1974, giving the procedure its popular nickname.

“Over the past 20 years, the American Sports Medicine Institute (ASMI) has noted a 30% increase in Tommy John surgery in the youth thrower/high school athlete,” says Discepolo. “What’s important to understand is that by the time the pitcher has reached the professional level, he may have worn out his UCL from prior years of throwing as an adolescent. It’s the cumulative years of play and/or overuse, from youth to mid-20s, that are often times the cause for this surgery.”

According to Joe Trani, Clinical Director at Professional’s Grand Central location, injury to the UCL can occur due to poor throwing mechanics and overuse, making both youth athletes and professional players highly susceptible. “I have seen an increasing number of high school pitchers come in to our clinic post-Tommy John surgery in the past few years,” says Trani. “One possible basis for this to be occurring is that of athletes playing year-round and not giving their elbows proper rest.” Discepolo concurs. “I have kids that play for three teams in a given season. That’s a lot of throwing!”

Correcting and maintaining proper throwing and pitching mechanics plays a large role in preventing injury. “Movement flaws can cause unnecessary stress to areas like your elbow, shoulder, or back, so correcting them early before they become habit is key,” recommends Discepolo.

Although Tommy John surgery does have a perceived high recovery rate, the ASMI reports that 10% to 20% of athletes never return to their pre-surgery level of performance. Both Discepolo and Trani stress the importance of a continued rehabilitation process following this kind of procedure. “I think some players never return because of the hard work which must be done during the rehabilitation phase,” explains Trani. “Most patients feel if they have the surgery, they will throw harder than before. They don’t realize that it’s a process and they must be cautious to prevent further injury,” said Trani.

While the game of baseball continues to change and evolve, players must not lose focus of the fundamentals when trying to improve their performance. “Throwing is an extremely complicated action requiring multiple body parts to work in unison,” says Discepolo. “Increasing velocity is not just a matter of increasing your arm strength, but also the strength of your core, trunk, and legs. There are a significant number of players that can throw in the 90 or 100 MPH range, but that doesn’t mean they know how to pitch. I recommend mastering the craft more than trying to light up the radar.”

Physical Therapists with expertise to rehab patients who’ve undergone Tommy John surgery can also teach and correct throwing and pitching mechanics to minimize the potential for future injury. For more information, visit