Tommy John Surgery: The Realities and Myths

[Thegrin]

I came across this excellent article. It relates quite well to the Twins pitching difficulties and the many pitchers that have already had TJ Surgery.

Read the article from Bleacher Report.

It makes me wonder how many pitchers, who have not had the surgery, do the "Thrower's 10"exercises? and should they ? and if they're not, why not?

[Heezy1323]

Been reading twins daily for a year or more but haven't yet posted anything. I have some expertise in TJ surgery and felt I could answer a couple of the above questions. The article was indeed a good overview of the surgery, etc.

As far as the 'throwers 10" I would say just about every pitcher does some version of these exercises though the specifics vary from team to team and are usually regulated by that teams training staff. The current literature doesn't really tell us if using these exercises decreases the risk of sustaining a UCL injury, but it seems to make sense that it would help. There does seem to be a correlation between loss of shoulder motion (and strength) and UCL injury, but this is still being worked out.

There were a couple of specific details of the story that are inaccurate, but overall I think it was very well done and is good information. Hope this helps. Happy to try and help with other questions.

[Thegrin]

We'd be happy to hear what was inaccurate, unless it is about operating details, the names of the ligaments they use and other medical stuff like that.

[Heezy1323]

Yes the things I noticed were some minor operative details. The remaining info was pretty sound I thought. I think one thing to consider about the increasing incidence is that our understanding of the problems and ability to diagnose injuries using advanced MRI techniques has improved to where we are picking up more injuries than we were able to in the past. Also, the public's knowledge has improved and as a result they are more likely to recognize the issues and seek appropriate care.

[Willihammer]

Hope this helps. Happy to try and help with other questions.

 

Its pretty well accepted at this point that in order to prolong your starting pitchers' careers you want to give them 4 days rest at minimum and keep them on a 100 pitch count limit. In your opinion, should there be a similar rule for relievers, (or is there one already)?

[Heezy1323]

Keeping in mind I'm in the medical field and not on the baseball side, I will give you my impression/opinion. There is not to my knowledge a current 'rule' for relievers- I believe teams differ in their willingness to use relievers back-to-back days, extended innings, etc. I do believe (again, this is my opinion) that teams are generally more conservative with starters and to a certain extent view relievers as more replaceable. I believe a 'rule' for relievers would be in the best interests of both the player and the teams, but exactly what that rule should be is very tough to know. Pitching back to back days is probably hard on your arm, but many pitchers do this for a career and never have a problem. Great question and a good area for some well done research (though perhaps there is some out there that I'm not aware of).

[Heezy1323]

To our discussion, a link from today on grantland.com:

 

How Concern Over Pitcher Usage Can Actually Give College Coaches a Recruiting Edge - The Triangle Blog - Grantland