Oh, Snap! A Look at Tommy John Surgery

Manhattan pticher Tom Cosgrove looks at the signs being given by catcher Mikey Miranda during a game against Fordham on March 11. Photo taken by Jonathan Reyes.
Manhattan pticher Tom Cosgrove looks at the signs being given by catcher Mikey Miranda during a game against Fordham on March 11. Photo taken by Jonathan Reyes.

The need for a pitcher to undergo Tommy John surgery — repairment of the ulnar collateral ligament — is an epidemic.

Between ‘05 and ’11, the average number of TJ cases in MLB per year was 16. The number of TJ surgeries skyrocketed from ’12 to ’14, increasing 75 percent in just two years. In the latter year, there were more TJ surgeries conducted than in the entire 1990s: 80, according to ESPN’s Sport Science.

The surgery’s success is 80 percent, which is high but still leaves pitchers with a one in five chance of failure, according to USA TODAY Sports.

“It’s not so much the MLB organizations but the pitchers, even going back to youth baseball, which is problematic,” “New York Daily News” baseball insider Andy Martino says. “A lot of times pitchers are drafted already well along the way in having this kind of damage because of overuse. … There are all kinds of debate. Nobody knows the answer. Teams are trying all sorts of different things and there’s no evidence that anything is really helping or hurting. It’s just hard to figure out.”

From ‘94 to ‘97, those who had TJ surgeries done at the American Sports Medicine Institute, 100 percent were adults. Skip to ‘10, the procedure has spiked to 40 percent for teenagers.

The overuse Martino mentions is seen in one-sport athletes, specifically baseball, more so than in a multi-sport athlete, Montefiore sports medicine specialist Dr. Tony Wanich says, who sees about five TJ cases each year.

“You do see it in other sports it’s just most of time those players don’t need surgery,” Wanich says. “It’s really just the baseball players that end up needing surgeries because of the unique stresses that get put on by throwing a baseball.”

This stress Wanich is referring to is called a valgus stress. The arm is able to rotate further back more than the average person can. As pitchers throw too much and too long on high school and travel baseball teams all-year round, their age, weight and bone development aren’t being monitored because of how many places they are pitching, Wanich says.

“It’s the younger years, where we’re just throwing and throwing and throwing,” Manhattan pitcher Mike Scarinci, who first injured himself in April 2013, says. “That needs to be limited. As a kid, we’re not doing the same things as we’re older. We’re not long tossing every day to develop arm strength. And obviously we’re not doing what’s called ‘pre-hab’ — shoulder exercises — to strengthen everything up to avoid rehab.”

He rested for two weeks after his injury and rehabbed but couldn’t get himself to 75 percent.

“I felt a tightness and then I was pitching in a game, and it just got worse and worse,” Scarinci says. “And then eventually it was at the point where I was throwing the ball 55 feet, I couldn’t get it to the plate. My velocity dipped eventually. Every pitch was just screaming pain as if someone was stabbing me in the elbow.”

The first doctor’s opinion he received said it was a partial tear of his UCL and the second and third opinions said it was full blown.

He later underwent TJ surgery in June of that year and returned to the mound this season.

Partial tears are developed throughout a career without a pitcher realizing it, but breaks between pitching heal the UCL and helps their longevity, Wanich says. That’s why he says he encourages them to play other sports between seasons.

“Every pitch that anybody’s ever thrown, from the time they started throwing, is where it counts,” Wanich says. “This injury is not this one time throw that just pops it. It’s this chronic, every little by little insult that it experiences to build upon the previous one. … When you focus on one sport so exclusively, overtime it just takes that toll.”