By Ken Reed

The number of pitchers getting Tommy John surgery continues to increase, from youth leagues to the Major Leagues.

According to USA Today research, of the top 64 hardest throwers this year in Major League Baseball (MLB), 30 have undergone reconstructive Tommy John surgery on their pitching elbows, or are expected to undergo the surgery soon. That includes Los Angeles Angels two-way superstar Shohei Ohtani. Tampa Bay Rays ace Shane McClanahan is also out with Tommy John surgery. He’s the eighth Rays pitcher to get the surgery since 2020.

“It’s very frustrating to me and my colleagues,” says Dr. Glenn Fleisig, biomechanics research director at the American Sports Medicine Institute in Birmingham.

“Frankly, the number of Tommy John injuries in minor league and major league baseball continues to rise. If you chart the rates of Tommy John injuries compared to the average fastball velocity, it’s scary how the graphs look the same.”

The radar gun is the root of the never-ending quest to throw harder.

“Nobody is really teaching good mechanics,” says Stan Conte, a senior medical director for the Miami Marlins and consultant to MLB. “What they’re saying in college is, you want to get to the next level, you gotta throw 97-99. It doesn’t matter if you hit the bull or can’t throw a strike.”

The American Sports Medicine Institute (ASMI) has called the rise in the number of professional pitchers requiring ulnar collateral ligament reconstruction (“Tommy John surgery”) an epidemic.

Sadly, the issue starts at the youngest levels of baseball.

ASMI biomechanist Tony Laughlin believes you can’t examine the rise in UCL injuries requiring Tommy John surgery at the MLB level without also examining what’s taking place in youth baseball.

“There’s a lot going on in youth baseball, where they’re pitching a lot and pitching year-round, where they’re just riding these ligaments into the ground,” says Laughlin. “We want the focus to be for parents and younger kids to give their arms a rest.”

Ken Reed, Sports Policy Director, League of Fans


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