The Creation of an Epidemic: Tommy John Surgery in Baseball (Part One of Two)

                In baseball, a player with the ability to throw a ball with uncanny velocity and incredible movement has become an indispensable resource. Teams will pay millions of dollars for this kind of talent. In consequence, young players will do anything to secure that million dollar contract by pitching year round, maxing out their inning limits and forcing themselves to throw harder than ever. In actuality, these kids are throwing until their arm falls apart. Throwing a baseball at velocities upwards of 90 mph puts tremendous strain on the elbow. Putting too much strain on the elbow leads to injury and eventually to surgery. This is known as Tommy John surgery, a reconstructive surgery for the ulnar collateral ligament in the elbow named after pitcher Tommy John. Within recent years, Tommy John surgery has plagued Major League Baseball. Pitchers have received the surgery at rapidly increasing rates, creating an epidemic within the game of baseball.

According to Pitch Smart, over the past three years, the number of baseball pitchers receiving Tommy John surgery has increased yearly. As of 2012, approximately 25% of Major League pitchers and 15% of Minor League pitchers have had the surgery during their career. The rate of players receiving Tommy John surgery has also increased by 50% since 1990. Overuse has caused this epidemic. According to Doctor Glenn Fleisig, the research director at the American Sports Medicine Institute and advisor to Major League Baseball, Tommy John surgery usually occurs in 15-20 year old pitchers throwing more than 80 pitches per game and pitch in eight or more months a year. Pitching beyond these constraints generally results in pitching fatigued, leading to overuse of the throwing arm. According to Fleisig, throwing 100 pitches a game every fifth day is unnatural for the arm. This excessive throwing year round causes the inflation of Tommy John surgeries in baseball.

            Nineteen year old pitcher Brady Aiken, provides a great example for arm fatigue. Drafted first overall by the Houston Astros, Aiken did not sign his professional deal because the Astros organization noticed elbow inflammation in his throwing arm, outlined within an ESPN article. In this article, the writer acknowledges Aiken’s rise as a dominant pitcher and the leading cause of his elbow problems. Up until his junior year of high school, Aiken pitched all year round. Once Aiken’s senior year came around and knowing about the rise in elbow problems in pitchers, Aiken and his coach developed a plan to reduce his innings in order to save his elbow. Aiken took the winter season off because of a doctor recommendation. They kept him on a pitch limit and avoided any pitching outside of his regular starts.

            However, a major league scout contacted the two of them and wanted Aiken to pitch at the MLB showcase for promising talent. The showcase would take place during the winter, when Aiken was not throwing. In order to pitch, Aiken would need to build up his elbow strength by throwing every day to ready himself for the showcase. At first, Aiken did not want to start throwing in order to save his perfectly healthy elbow, but the scouts pressured him into ignoring the doctor’s recommendation. The scouts told Aiken that pitching would secure his place in major league baseball, his ticket to a million dollars. Aiken decided to pitch at the showcase. The following baseball season, the same season the Houston Astros drafted Aiken first overall in Major League Baseball’s amateur draft, Aiken would feel soreness in his throwing elbow. The team picked up on the inflammation in Aiken’s elbow during his physical. Houston would retract their offer to Aiken and Aiken would elect to receive Tommy John surgery.

            The sad part about this story is that it occurs regularly in the game of baseball. In today’s world, athletes must accept injury if they want to survive in the world of sports. According to Doctor Mary Lloyd, the competitive nature of sports has programmed youth players to think that they must bend the borders of injury as far as possible, which leads to the increase in elbow injuries. Lloyd warned players about the temptations to push themselves in order to pursue money and scholarships, saying “The 21^st century athlete of any age or sport must throw faster, play harder, earn the scholarship, and don’t tell anybody you’re hurt." The money causes the students to push the barriers and major league baseball takes advantage of the player’s wants. Aiken did not receive Tommy John surgery for the benefit of his health. He received the surgery because without it, Aiken would never make it to Major League Baseball. The surgery saved his career and his chance at earning millions of dollars.

            Rarely does a baseball organization hold it against a pitcher like Aiken for throwing too much. Most baseball organizations do not keep track of potential draftee’s innings nor worry about the overuse of a pitcher’s arm. According to Sam Miller, the author of the article on Aiken, most teams draft players solely based on their velocity and ball movement. So pitchers also disregard their inning limits and force themselves to pitch harder than their arm can handle. If a pitcher destroys their arm in the process, Major League Baseball bares no responsibility either. As shown in the Brady Aiken case, the team just retracts their offer and saves their money while the player forces themselves to undergo Tommy John surgery in hopes of prolonging their baseball tenure.