Why Tommy John Surgery Is SKYROCKETING (340% Increase Explained) — Part 1 #MLB #Baseball #Pitching

Tommy John surgery has skyrocketed over 340% in the last two decades with teenagers now accounting for over half of the procedures. In honor of opening day, let's break this down starting with the data and epidemiology. When the pitching motion is slowed down frame by frame, a pattern emerges, most UCL injuries occur during the late cocking phase when the shoulder externally rotates to around 170 to 180° while the forearm lags behind. That's about 35° more external rotation than the average quarterback throw. The arm is essentially one back like a spring, generating massive VGUS torque at the elbow. Shoulder mobility also matters. Repetitive throwing leads to posterior shoulder adaptations leading to posterior capsule thickening, rotator cuff tightness, and hummeral retrotors, aka a slight backwards twist of the humorris, altogether reducing rotation, and shifting stress to the elbow and UCL. When that loss of mobility exceeds more than 5° when compared to the non-throwing shoulder, it's called a total rotational motion deficit, which is associated with a 2. 6 times higher risk of elbow injury. And the real world data reflects this. One large epidemiological study of more than,400 professional pitchers showed UCL surgeries in the MLB and minor league have risen sharply since the late 1980s. Today, about one in four Major League Baseball pitchers has undergone Tommy John surgery. But the most dramatic increase is happening in younger athletes. Between 2003 to 2014, UCL reconstructions increased by 343% with the highest incidents occurring in athletes aged 15 to 19. In a separate large US private payer database study, that same age group accounted for 56. 8% of all Tommy John surgeries in the nation. So if these injuries are occurring during the same phase of the pitching motion, and they're increasing dramatically, especially young athletes, what's driving this epidemic? This is part one of our deep dive tongue John series with sports ball.