The Pitching Epidemic: the rise in arm injuries impacting todays youth

EL PASO, Texas (KVIA) -- This year is the 50th anniversary of a groundbreaking procedure called Tommy John surgery that changed baseball, and unintentionally opened the door for what many are calling a baseball pitching epidemic.

"Tommy John surgery is a reconstruction of one of the major ligaments of the elbow, we use a tendon either from the patients own body or from a donor tendon. Through some holes through the two arm bones we reconstruct the ligament," says El Paso Orthopedic Surgeon Dr. David Mansfield.

More than 1,000 professional pitchers have had their pitching elbow reconstructed since 1974, the year Dr. Frank Jobe operated on former pitcher Tommy John who tore his UCL. Since 2016 there has been a 29% rise in Tommy John surgery for MLB pitchers, according to the American Medical Association.

The crisis has been building for decades, not just impacting MLB pitchers but teenagers playing at the youth level.

Dr. David Mansfield says those who undergo the procedure continues to lower in age on the field.

“Unfortunately its getting younger and younger. You used to only see it in athletes that were a little bit older, usually about 18 or so because that’s when they’ve really started to really pitch a lot. Now it’s getting to be as young as 14 you are starting to see Tommy John syndrome being performed now."

Arm overuse is a risk factor for adolescent pitchers, as studies show athletes who pitch while fatigued are strongly linked to the injury. Other risk factors include pitching year-round, poor pitching mechanics, and poor training. According to the National Library of Medicine, baseball pitchers with faster pitch velocity may be at the greatest risk of elbow injury.

“We should do a better job as parents and coaches in protecting the athletes, and that really is pitch count, it really is having them pitch with appropriate mechanics and not throwing some of the more complicated pitches until their elbow matures," says Dr. David Mansfield.

Americas High School Head Baseball Coach Jesse Munoz says, its common to see young athletes prioritize playing on the field over training leading to the risk of injury.

“Kids play a lot, but they rarely train. You build that foundation to withstand a whole year of throwing, but a lot of the kids don’t have it. The body is going to find the weakest point and that’s gonna get hammered and pretty soon that’s what breaks down.”

Tommy John Surgery for High School and College pitchers has increased at an alarming rate. In the 2023 Major League Baseball draft there were 23 total players selected in the first 10 rounds who had already undergone the procedure. Compare that to the 2011 MLB draft where just three players had the surgery.

El Pasoan Kris Ramirez who spent most of his life on the pitchers mound ended up tearing his elbow and needed Tommy John surgery while playing at Menlo College in San Fransisco.

“I first injured my arm in the middle of a game and felt a pop. I was throwing around 90 miles per hour, and my catcher came up to me asked me if I was alright. I told him I think I messed up my elbow," he said.

Ramirez says he saw a future playing in MLB baseball one day until multiple injuries to his throwing arm impacted his chances of that dream.

“I did get depressed honestly, because that was my second major injury. Its like a history book that stays with you in your profile."

According to an MLB spokesperson the league is conducting a wide-ranging study at all levels of play to examine the origins of the issue and help develop recommendations to address it.