The 50th anniversary of the first “Tommy John” surgery falls this month.
Baseball was revolutionized by the groundbreaking elbow treatment that was initially applied to Tommy John, a left-handed pitcher for the Los Angeles Dodgers, on September 25, 1974. Through tendon grafting from another area of the patient’s body, the damaged ulnar collateral ligament is repaired during the treatment.
Pitchers now have a second (and occasionally third) opportunity to finish their careers because to Tommy John surgery. However, it’s not always necessary to celebrate this anniversary. There has been a significant increase in Tommy John surgery in recent years due to the focus on and hype surrounding a pitcher’s throwing velocity. This week, left-hander Brandon Williamson of the Cincinnati Reds became the most recent player to be informed that he need Tommy John surgery.
Timothy Kremchek, a nationally renowned Tommy John surgeon and former medical director of the Reds, declared, “I’m calling it an epidemic.” It’s been an issue for some time. I used to perform 10 to 25 Tommy John surgeries annually, ten years ago. I currently do ten a week.
Kremchek is among the medical professionals who founded Beacon Orthopaedics and Sports Medicine in Cincinnati. In addition, he still serves as a consultant with the Reds, doing Tommy John procedures on a number of their pitchers. He talked about why he’s seen so many Tommy John cases in an interview with The Enquirer, as well as how baseball may lessen the amount of injuries that require surgery.
Around the middle of the 2000s, Major League Baseball’s steroid era came to an end, and home runs became the main focus. Pitchers began to take center stage in baseball as velocity—also known as “velo” by insiders—became more and more of a focus.
Scouts and coaches of all stripes began highlighting velo. Their firm grew by offering pitching labs to young and high school athletes. Media professionals and seamhead broadcasters began becoming velo-fanatics.
How did we get here, concentrating so much on velocity?
Kremchek: Everything went crazy ten years ago. Pitchers in high school began tossing pitches into a radar gun. They desire to be seen and added to a list by someone. You have to toss something 90 miles per hour in order to be added to a list. You’re on another level than everyone else if you can throw a ninety-nine. Guys are throwing 110 % on every pitch to stay in the game.
Particularly in the summer leagues, coaches put pressure on their players. Between the high school season, summer leagues, and fall leagues, high school students participate in 80–90 games annually. We’re exhausting these youngsters, so why are they being hurt, you ask? It never ends. Three months is not enough time for kids to toss. I would advise them to take up other sports and improve their abilities.
According to a survey conducted last year, 36% of MLB players had undergone at least one Tommy John procedure, according to Kremchek. He also mentioned that the Reds would not choose a player who had undergone Tommy John surgery in the late 1990s. Now that many of the pitchers in the draft have already undergone the procedure, they really don’t have an option.
It makes sense that some high school and youth coaches are ignorant of proper arm care techniques. However, why do pitchers in the major leagues continue to have more Tommy John surgeries?
Kremchek: MLB is currently attempting to compete with soccer. The game has to be more thrilling and faster. Guys are throwing down their best effort on every pitch, and now there’s a pitch clock. Guys are getting gassed quicker as a result.
We’ve also cleaned the ball of muck. (In 2022, MLB outlawed some compounds that pitchers had been using to the ball to make it less slippery.) Their arms are getting tired because they have to grasp the ball harder now in order to throw it farther.
This cycle is terrible.
Kremchek attends meetings with MLB officials regarding injury concerns and matters related to the game as a member of a group of physicians and medical professionals.
Is there a way to lower the amount of pitchers who sustain the kind of damage that requires Tommy John surgery?
Kremchek: Baseball acknowledges the issue. The players’ union is being heard by them. Seek agreement from the pitchers regarding the modification of the pitch clock. The pitch clock should be extended by a few seconds, especially when there are players on base. Adjust the timer such that you should receive a few extra seconds if you throw more than 50 pitches.
