Rise in Youth ‘Tommy John’ Surgery Concerning

Young baseball players watching the All Star Game may have aspirations of becoming a big leaguer someday. However, a sports medicine expert warns of a growing trend - more young athletes needing surgery as a result of doing too much too soon.

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CLEVELAND – ‘Tommy John’ surgery – a procedure designed to re-construct a torn elbow ligament – is routinely performed on Major League Baseball pitchers.

However, experts say the number of high-school age athletes undergoing the procedure has risen in the past decade.

In fact, one study shows the number of athletes between the ages of 15-19 needing ‘Tommy John’ surgery rose by more than 50 percent since it was first performed in 1974.

Doctors believe the uptick in surgeries among youth athletes is often the result of too much, too soon.

“Overuse is responsible for the vast majority of these injuries,” said Paul Saluan, M.D., a sports medicine physician at Cleveland Clinic. “The best way to take care of these injuries is not let them happen in the first place – we need to pay attention to pitch-counts; and pay attention to throwing in any and all leagues.”

Dr. Saluan said even though the ‘Tommy John’ procedure is a trustworthy surgery for major league athletes, seeing more youth baseball players with these types of injuries is cause for concern.

He said it’s always worth discussing all options for young players before undergoing a complete reconstruction procedure.

Dr. Saluan said if a youth athlete tears the elbow ligament, there are repair procedures that use different techniques and different materials that some children may be candidates for.  A 2017 study shows non-surgical management can provide equivalent outcomes for specific types of medial ligament injuries.

He said the bigger picture parents and coaches need to consider is why these injuries are happening in the first place.

We tend to underestimate the amount of throwing our children are doing, so keeping pitches to a minimum, and allowing for proper rest is key. Dr. Saluan said experts generally recommend three months off from a sport every year. This is especially important for young, overhead throwing athletes.

It’s also important to make sure athletes have strong core muscles and proper mechanics so they are not placing too much stress on their arms.

“Teaching them proper mechanics; letting them play and not train, is your best approach,” said Dr. Saluan.

Dr. Saluan also stressed that unlike pro athletes, a youth athlete should never push through pain in order to continue playing.

“Pay attention to pain with your child,” he said. “If there’s any pain that starts developing in a young person, we have to pay attention and we have to get it evaluated. Young people with elbow pain or shoulder pain should not ignore it.”

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