Youth baseball players who participate year-round and join multiple teams are facing a higher risk of elbow injuries, according to Dr. Marc Richard, an orthopaedic surgeon at Duke University Health System. This trend may be linked to the increasing number of high-school athletes undergoing Tommy John surgery.
“Kids are starting sports at younger ages, they are playing on travel teams and school teams at the same time, and are playing baseball year-round,” said Dr. Richard, a hand and upper-extremity specialist. “There’s no longer an off-season. Studies show the number of innings pitched and the number of pitches per outing are directly related to the increased prevalence of throwing injuries.”
Dr. Richard also noted that changes in pitching technique could play a role in rising injury rates. “The way people throw now is different from how people threw in the past. There may be some changes in technique that are contributing to the increase in pitching injuries as well.”
Tommy John surgery, formally known as elbow ulnar collateral ligament reconstruction, involves replacing a damaged ligament in the elbow with a tendon from another part of the body. The procedure is common among major league baseball players seeking to extend their careers but requires about a year of rehabilitation.
Some young athletes believe that Tommy John surgery will improve their performance, but Dr. Richard refuted this idea: “In multiple large studies, only eight out of 10 patients are able to return to pitching at the same level they were at the time of their injury,” he said. “That means one in five patients are not even able to perform as they were before their surgery.”
While Tommy John surgery is widely recognized due to its coverage in professional sports media, Dr. Richard pointed out that youth pitchers face other risks because their bones are still developing. These include growth plate injuries, other ligament injuries, stress fractures, medial epicondyle fractures, and osteochondral defects (OCDs). He advised evaluation by physicians familiar with these conditions.
To reduce overuse injuries and avoid surgical intervention, several preventive steps were outlined:
– Work with qualified pitching coaches who can assess technique.
– Focus on overall strength development rather than relying solely on arm strength; strengthening thighs, core, and back muscles helps protect elbows.
– Improve shoulder flexibility since stiffness can lead to more shoulder and elbow injuries.
– Avoid pitching when experiencing pain or fatigue.
– Warm up properly before practices or games.
– Ensure adequate rest periods; taking breaks or participating in non-throwing sports during the off-season lowers injury risk.
These measures aim to help young pitchers maintain their health while pursuing competitive opportunities.
