“Tommy John” is a phrase commonly used to describe the surgery required to repair UCL injuries. This procedure entails the reconstruction of the UCL – a ligament that stabilizes the inner elbow. Due to the specific stresses of throwing a baseball (this applies tenfold to pitchers) this type of surgery is most commonly performed on baseball players.
The risk of UCL injury is present for all baseball players, but particularly so for youth participants. Adolescent pitchers are particularly vulnerable to UCL wear and tear. The biggest risk factor for these young players being exposure to a far larger workload than they should be dealing with. Talented young pitchers can easily find themselves playing all year, inevitably leading to instances of pitching while fatigued. Other common youth league practices such as playing catcher when not pitching (requiring more repetitive throwing) don’t help this situation.
Other risk factors can include improper throwing mechanics or simply poor physical conditioning. Risk of UCL injury also tends to rise equivalent to a pitcher’s velocity.
Any of the following can be utilized to reduce the chances of UCL injury:
1) Varying pitch speeds while on the mound, with a focus on form and control. The goal should never be to throw the ball with maximum effort at each pitch. This can be applied in games, practice, or bullpen sessions.
2) Enhancing communication between players, coaches, and any medical support staff for the team. Players should be closely monitored to assess their response to pitching in order to adjust care accordingly. Adequate hydration, nutrition, and recovery are also essential to help heal the small tissue tears that normally occur with pitching.
3) Players should have their pitching mechanics assessed in order to optimize their form and establish a baseline for each player. Utilization of the entire body in order to maximize performance (i.e.: not letting players isolate their upper extremities in a throw) should be enforced.