For several decades after Los Angeles Dodgers pitcher Tommy John underwent the surgery that now bears his name, only professional baseball players needed reconstruction of the ulnar collateral ligament (UCL) in their elbows. But with kids today throwing too much, too soon, for too long without enough rest, we shouldn’t be surprised that they now suffer adult injuries.
A study presented at the 2015 American Orthopaedic Society for Sports Medicine Annual Meeting found that 56.7 percent of the UCL reconstructions performed in the U.S. between 2007 and 2011 were on patients between the ages of 15 and 19. Basically, a majority of the Tommy John surgeries are performed on high school pitchers, not major leaguers.
Last week, the National Federation of State High School Associations took steps to protect young pitchers. Starting next season, each state must regulate how many pitches a player can throw in a game. Each pitcher will have a mandatory rest period between outings based on the number of pitches he throws.
Previously, high school pitchers in South Carolina could not throw more than 10 innings within a 72-hour span. We don’t yet know what the specific pitch count limits will be in the state. The S.C. High School League and Baseball Coaches Association are expected to set the actual number of pitches allowed when they hold meetings in North Charleston next week.
In 2014, Major League Baseball partnered with USA Baseball and medical experts from around the country to create Pitch Smart. The organization teaches young pitchers and their parents and coaches about the risks of overuse shoulder and elbow injuries. It also offers guidelines for pitch counts and rest periods based on a player’s age.
Pitch Smart recommends that players ages 15-16 throw no more than 95 pitches in a single outing and ages 17-18 no more than 105 pitches. If a pitcher throws more than 75 pitches, then he must rest at least four days.
Hopefully South Carolina adopts a rule along those lines. We have seen countless examples of high school teams with only one or two good pitchers use those kids too much in order to win. This spring, a junior high school pitcher in Kansas threw 157 pitches in 10 innings in a regional championship game. Summerville pitcher Bo Gobin threw 143 pitches in a 10-inning game in the Class AAAA state championship series.
Other aspects of the rule will need to be worked out. How will the rule be enforced during the game? Who will keep track of the number of pitches thrown? What happens if a pitcher hits the limit during an inning, or in the middle of facing a batter?
Even with those issues waiting to be resolved, this rule change is a reasonable first step to protecting these kids’ arms. Tommy John surgeries are completely preventable. Limiting the number of pitches that high school players throw can keep them on the mound and out of the operating room.
David Geier is an orthopaedic surgeon in Charleston. For more information about baseball injuries and other sports medicine topics, go to his website at drdavidgeier.com.