Sadly, this is timely again as it was announced on Monday that Hunter Greene would undergo Tommy John surgery. A few years ago, I wrote a series of posts about Tommy John Surgery. Conclusion at the time:

“Ulnar collateral ligament (UCL) injuries are a huge and growing problem for major league baseball. We’re figuring out the cultural factors – single-sport, year-round baseball, emphasis on velocity – that push young pitchers beyond where they can safely go. But as long as wins, scholarships and professional contracts appear to be connected to those factors, changing youth practices will be difficult.

Reconstruction surgery has become a routine and viable one-time solution for the vast majority of pitchers. But even in the best case, pitchers lose at least an entire season if they have the Tommy John procedure.

As our understanding develops about prevention, the old model of simply limiting workload – innings limits and pitch counts – is being exposed as insufficient. Most major league organizations – some much faster than others – are shifting their prevention paradigm toward biometric analysis and real-time measurement of stress on elbows.”

The science and data has advanced a bit since then, but the articles largely hold up. If you’re interested in learning more about the surgery, you could start here.

Part 1: The Wreckage | anatomy of the elbow, what is a ligament, valgus stress, the epidemic

Part 2: The Causes | youth sports, seduction of velocity, stronger shoulders, risky behavior

Part 3: The Surgery | famous pitcher and doctor, the elbow, surgical procedure, tendons

Part 4: Prevention | rewiring incentives, new research, monitoring elbow stress

Part 5: Changing Paradigms | outmoded workload rules, motion analysis, biomechanics

Part 6: Prognosis | getting back to the bigs, timeline, performance, positive cases, playing piano

About a year later, I followed up with an article (The Limits of Innings Limits) that went into more detail about how old-school innings and pitch limits were failing due to the illusion of knowledge, and the need for clubs to switch to an emphasis on bio-mechanical analysis.

4 Responses

  1. Ghettotrout1

    There is a really good book by Jeff passan about TJ surgery he follows Todd coffee and another pitcher or two who had the surgeries. I think the book is called the arm for anyone interested.

  2. Big Ed

    Steve, this is just too depressing to think about, especially after a 1-4 start. There is a cloud of doom over the Reds right now, before they even tee off at the Masters.

    I do remember reading the series when you wrote it, and found it excellent.

  3. Kyle Famer

    I’ll second the recommendation of Jeff Passan’s The Arm. Great book with some Redleg connections. It’s disturbing because it shows that coming back from TJ is far from a sure thing and also because it shows how little we really know about protecting the UCL.

    • enfueago

      And I will go thirds on recommending “The Arm.” Interesting how the surgery has become so common and the surgeons adept but there is still a high percentage of guys who just don’t get back.