High-SchoolBaseball: Tommy John surgery
February, 8, 2012
By Matthew Muench | ESPN.com
Gregory Smith/APFormer MLB star John Smoltz is one of the numerous pitchers who've had Tommy John surgery performed by Dr. James Andrews.
When Dr. James Andrews talks about arm injuries in baseball, it would be crazy not to listen to him.
After all, he is arguably the world’s most famous and best orthopedic surgeon, and he has saved the pitching arms of some of the greatest professional baseball players on the planet.
So when he has a request for the sport he loves, maybe it should be wise and listen to his request -- especially at the youth and high school level.
“I think they should outlaw the radar gun,” he said. “Young pitchers, coaches, scouts and parents put so much emphasis now on throwing hard that these kids are hurting their elbows and their shoulders because they're trying to throw 90 mph.”
The radar gun, Andrews said, is one of many injury risks at the youth and high school level in an age of baseball that is seeing more and more teenage athletes on the operating table instead of the pitching mound.
And frankly, Andrews doesn’t like it.
“Every time I see a high school pitcher walk in my office it makes me sad,” Andrews said. “A lot of these injuries could be prevented, and it’s gotten to a point where I am seeing more and more young kids in my office.”
For decades the majority of his Tommy John patients could be found in the dugouts of major league, minor league and college dugouts. But during the past 10 years, Andrews said, a rapid rise of his patients could be found in your local high school yearbook.
Tommy John surgery is a procedure where the damaged ulnar collateral ligament in the elbow is replaced with another tendon on the body, such as from the forearm or hamstring. It’s also the most common surgery Andrews performs on young pitchers.
One of those pitchers is Bolles (Jacksonville, Fla.) right-hander Hayden Hurst, whom Andrews performed Tommy John surgery on in the eighth grade.
Mari Darr-Welch/APDr. James Andrews has treated high-profile athletes like Drew Brees and Peyton Manning.
“I definitely can feel the difference,” said Hurst, now a senior. “Before the surgery it felt like I had a bum arm. Now it feels alive.”
Andrews used to do three or four Tommy John surgeries a year on high school athletes. Now he said it’s up to three to four times a week.
“It is surprising,” Andrews said. “Kids are growing up too fast. They are outgrowing the development of their ligaments. They are getting too big and too strong too quick. Their ligaments in the elbow aren’t ready.
“The first thing you need to do is basically have common sense,” he added. “If you step back and really understand the risk factors you can prevent these arm injuries.”
Here are the five main risk factors that Andrews believes contribute to the rash of elbow injuries among high school pitchers. By paying attention to these, it could lessen the chance of a major injury on the mound.
Like the radar gun, Andrews thinks they should get rid of year-round baseball.
“Young pitchers now are throwing hard all year and that is not a good thing,” he said. “There is no rest period. Baseball is a development sport and the ligaments in the elbow need rest to develop.”
Slow it down, Andrews said. Thanks to numerous years of experience and a multiple of studies, Andrews said there should be a line on how fast a pitcher should be throwing.
“We found that young pitchers who throw over 85 miles per hour have far greater potential of getting hurt,” he said. “When throwing more than 85, it creates a lot of stress on elbows that are still developing.”
This risk factor should be the easiest to understand, Andrews said. It’s also one of the biggest reasons for injury.
“There should be a pitch-limit rule at every high school in the country,” he said. “I have heard of kids who throw 160 pitches in a game and that’s just not safe.”
Andrews said pitchers should never pitch on back-to-back days and should never try and get through an inning when they feel any soreness or tiredness in their pitching arm.
Travel baseball (also called club baseball) also is a big cause for fatigue because coaches from separate teams do not communicate with each other.
“One coach will pitch a kid for five innings one night and then the next day the same kid will go throw five more innings for a different coach in a different game,” Andrews said. “These pitchers should not be playing in more than one league at once. You have to rest to prevent these injuries.”
Social pressure and scouts at showcase events also play a role in arm injuries.
Andrews said many arm injuries are associated with one-day showcase events where pitching prospects go throw for pro and college scouts. Most of the time, it’s not safe.
“A lot of the times they go to these events not in shape or tired because they maybe pitched the night before,” he said. “They throw them off the mound as hard as they can and damage their arm by doing so.”
The radar gun
“Just outlaw it,” Andrews said. “It’s time.”
Maybe it’s time baseball listens to him.
January, 20, 2012
By Matthew Muench | ESPN.com
Courtesy of Terry IversonBolles (Jacksonville, Fla.) senior right-hander Hayden Hurst pitched in the 2011 Under Armour All-America Baseball Game just three years after undergoing Tommy John surgery.
All it took was a glance at a Major League Baseball player to ease the nerves of right-handed pitcher Hayden Hurst.
Of course, he had every reason to be nervous.
Just an eighth-grader at the time, Hurst sat in an Alabama doctor’s office and was minutes away from having major elbow surgery on his pitching arm.
“Then (current New York Yankees pitcher) Rafael Soriano walked right by me,” said Hurst, now a senior at the Bolles School (Jacksonville, Fla.). “I wasn’t nervous after that.”
It helped him realize pro players get hurt, too, and that they can bounce back from Tommy John surgery, a procedure where the damaged ulnar collateral ligament in the elbow is replaced with another tendon on the body, such as from the forearm or hamstring.
It also didn’t hurt that the doctor who performed that same surgery on Hurst happened to be Dr. James Andrews, arguably the world’s most famous and best orthopedic surgeon.
“Imagine my shock when I call on a Tuesday morning at 10 a.m. and I hear "Jim Andrews, can I help you?” Hayden’s father, Jerry, said. “I froze. It was like, here I am on the phone with the most famous orthopedic surgeon in the world.”
One might think it’s uncommon for an eighth-grader to have Tommy John surgery performed by Andrews, who is known more for operating on professional athletes than high school athletes.
But it’s a growing trend, Andrews said. He sees more teenagers like Hurst than pro players like Soriano. He used to see about three to four teenage athletes a year on his operating table. Now he sees three to four a week who need the Tommy John surgery.
“Oh Lord, it is surprising,” Andrews said. “Kids are growing up too fast. They are outgrowing the development of their ligaments. They are getting too big and too strong too quick. Their ligaments in the elbow aren’t ready.”
That was the case for Hurst, who at the time of his surgery was already 6-foot-3 and 205 pounds. He injured his elbow while pitching on varsity for Bolles in the eighth grade.
Andrews used a tendon in Hurst’s hamstring to perform the surgery. And for 12 months, Hurst rehabbed his pitching arm three times a day.
Courtesy of Hurst FamilyBolles (Jacksonville, Fla.) senior Hayden Hurst shows off the scar on his right elbow where he had Tommy John surgery four years ago.
“I knew the surgery wasn’t just going to fix everything,” he said. “So I looked forward to working out and rehabbing.”
Hurst ended up missing most of his freshman campaign while rehabbing. Before the surgery, he was throwing 88 miles per hour. When he returned to the mound 12 months later, he was topping out at 94 miles per hour.
During his second appearance on the mound after the surgery, Hurst was one out away from throwing a no-hitter in the District 4-3A championship game. He fanned 11 and walked just two in the 4-0 win over Fernandina Beach (Fla.).
Hurst went on to help Bolles win the state title that season and was the starting pitcher on the bump when the Bulldogs repeated as state champs the following year. Bolles fell to Episcopal (Jacksonville, Fla.) in last year’s district semifinals.
Hurst helped Bolles win the state title that season and the following year, while the Bulldogs missed the playoffs last season.
Four years after the surgery, Hurst believes his elbow is stronger than ever.
“I definitely can feel the difference,” he said. “Before the surgery it felt like I had a bum arm. Now it feels alive.”
But Tommy John surgery isn’t magic and it’s definitely not for everyone, Andrews said.
“A myth is the surgery will just fix your elbow,” Andrews said. “You still have to develop correctly. You still have to rehab correctly. A lot of people think the surgery is just going to turn you into a great baseball player.
“I knew (Hurst) had potential and that is one reason why I did the surgery. He did all the things correctly that you have to do after the surgery. Yes, the surgery helped, but the rehab and development plays a bigger factor.”
Hurst certainly put in the time rehabbing his elbow, and now he’s reaping the benefits. The 6-foot-5, 235-pounder is one of the elite pitchers in Florida and has signed to play for Florida State next season, though he’s also considered a top prospect for June’s MLB Draft.
And just like his sophomore and junior years, he will be the ace on staff.
“I just let (my arm) loose when I returned to the mound,” he said. “I have no concerns about my elbow. My confidence is right where it needs to be. I knew I could bounce back.”
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