Trend in sport is wearing on arms
Surgeries on the rise due to specialization
Sports specialization in young children has been a popular trend over the past couple of decades, fueled by parents seeking ways to find college scholarship money for their children. Some kids are specializing in a sport by the time they leave elementary school.
The stampede for scholarship money has created unintended consequences in one sport, with leading orthopedic surgeons calling the staggering number of teenagers undergoing elbow surgery as an epidemic.
Young baseball players represent the highest number of athletes getting ulnar collateral ligament surgery, more commonly known as Tommy John surgery. What was once a specialty surgery performed on professional players is now most popular among teenagers because their arms are being overused at such a high rate.
Elbow injuries among adolescent baseball players are at an epidemic level according to the American Sports Medicine Institute. In 1996, according to ASMI, 3 percent of the Tommy John surgeries performed at Andrews Sports Medicine, by famed surgeon Dr. James Andrews, were performed on high school pitchers. By 2008, 32 percent of the Tommy John surgeries performed there were on high school pitchers.
West Allegheny High School baseball coach Bryan Cornell doesn’t need to hear the statistics. He has seen the epidemic first-hand.
Two West Allegheny baseball players missed the 2016 baseball season with elbow injuries. One of them, a sophomore pitcher, had UCL reconstruction. A junior on the team was not allowed to play because of an issue with the growth plate in his elbow.
“I talk with the high school coaches all the time, and we’re all in the same boat,” Cornell said. “There are kids coming into the high school programs with arm problems when they shouldn’t have problems. A 16year-old should not have arm problems.”
Dr. James Bradley, one of Pittsburgh’s top orthopedic surgeons, has witnessed a similar increase in his practice. He does 35-40 UCL reconstructions per year.
Bradley said sports specialization is the reason for the huge increase, and he’d like to see the youth sporting world turn back the clock to an era when children experienced a variety of sports and played the sport that was in season.
Bradley recommends at least three months of rest with no throwing for young baseball players.
“If you’re a parent, the best way to ruin your son’s baseball career is to have them play year-round,” Bradley said. “The UCL needs rest.”
Cornell has similar beliefs. But the problem for high school coaches is they can’t oversee
“This is the problem with parents. They believe their kids will be better than they were before the surgery. They won’t be. — Dr. James Bradley, orthopedic surgeon
their players in the offseason the way those in football do. Parents, or coaches often unaffiliated with high school programs, coach the summer league travel teams in the summer and fall.
There are innings limits in local baseball leagues, but players often compete in showcase tournaments on weekends, too. Ambitious parents who want their kids to be seen by college coaches and scouts will ignore the innings counts.
But even if high school coaches could tell their players when to play and when to rest, there is a larger issue. Most elbow injuries are of the wear and tear variety and have their roots in Little League and travel baseball in the younger age groups. Young pitchers, when they are between 9 and 12, aren’t being properly managed, and their pitch counts often exceed the recommended limits as the sport has become a year-round, or close to year-round, endeavor.
“I’d like to see the kids get away from specializing on one or two sports and go back to the way it used to be when we all played three sports,” said Cornell, who is the defensive coordinator for the West Allegheny football team in the fall. “Your recovery from baseball was football, and your recovery from football was basketball and your recovery from basketball was baseball. Specializing in sports is a bad thing. We’re trying to specialize and for what reason?
“It’s hard to get scholarship money for baseball. There are 11.7 scholarships in Division I baseball, and that’s if the program is fully funded. I just think it’s a lack of understanding on the parent’s part. They don’t understand that. They’re specializing to get scholarship money, and honestly, a lot of them aren’t going to get it.”
Bradley said there is another area where parents are misinformed. He said parents have too much confidence in medicine to correct mistakes in development.
Overall, there is an 8085 percent success rate with UCL surgery, but the baseline for success is merely getting back to previous form. It’s a myth that new ligaments allow pitchers to throw harder. It’s merely the rigorous rehab from the surgery that might add velocity. And that only happens on rare occasions.
Prevention is the best course, not surgery.
“This is the problem with parents,” Bradley said. “They believe their kids will be better than they were before the surgery. They won’t be. It’s always better to have the original ligament than the ligament we’re putting in there.”