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Dr. Robert Hartzler on Tommy John (TJ) Epidemic in Major League Baseball

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ESPN recently highlighted a spike in the number of Major League Baseball pitchers undergoing the elbow ligament reconstruction commonly known as “Tommy John Surgery.”  This “epidemic” in MLB should serve as a reminder of the importance of injury prevention in youth baseball as well as professional baseball.  

The baseball throwing motion exerts tremendous force on the elbow and the shoulder. As such, overuse injuries are common for throwers of all ages.  An ounce of prevention is truly worth a pound of cure for our young athletes.

The first step to preventing injuries is recognizing which players are at risk. There are several important risk factors to recognize for shoulder and elbow injuries in baseball:

  • Throwing a high number of pitches during a game and/or throughout a season
  • Playing on multiple teams with overlapping games or seasons
  • Playing with fatigue or on limited rest
  • Poor throwing mechanics
  • Throwing at high velocity or with breaking pitches

We encourage all baseball players, especially pitchers, as well as their coaches and parents to learn about throwing arm injury prevention.

Recommended pitch counts and rest intervals based on age have been published by the American Sports Medicine Institute and Little League Baseball.  Additionally, proper throwing mechanics should be learned and emphasized.  Playing through pain or fatigue should be discouraged by parents, coaches, and trainers.  

Learning to recognize your risk factors and take action to prevent injuries early in your baseball career will help you prevent getting sidelined down the road. Have a fun and safe summer season!

HartzlerDr. Robert U. Hartzler completed his orthopaedic surgery residency at the Mayo Clinic.  He pursued further fellowship training in shoulder and elbow reconstructive surgery at the Florida Orthopaedic Institute in Tampa.  Dr. Hartzler is currently a fellow of Dr. Stephen S. Burkhart, shoulder specialist at The San Antonio Orthopaedic Group. He will complete his shoulder fellowship with Dr. Burkhart and join our practice as a full member in September 2014.


NOTE: We cannot provide medical advice or diagnoses without seeing a patient in person.

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