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.