Dodgers' Dustin May to undergo season-ending Tommy John surgery

Chris Sale’s prolonged recovery from Tommy John surgery not a concern (yet)

When it comes to major league pitchers, UCL tears and season-ending Tommy John surgery is big—and frequent—news. In the last few weeks, there have been similar updates on Dinelson Lamet and Adrian Morejan of the Padres, Luis Avilan of the Nationals, and several others.

The Ulnar Collateral Ligament (UCL) consists of three bands of connective tissue that keep the bones in place and stabilize the elbow. The UCL can be injured by a fall, but more commonly, the ligaments are torn from overuse. Overuse that is quite common in major league baseball.

Prior to the mid-1970s a baseball player with a torn UCL knew his career was over. In 1974, when Tommy John of the Dodgers injured his UCL, his surgeon planned to repair it, but discovered it was beyond repair—it was missing. Completely torn.

So, he experimented by using a ligament from John’s right wrist to create a new UCL. Miraculously, once healed, the pitcher returned to the mound and was able to throw like his old self. Hundreds of “Tommy John” surgeries have been performed on pro and college baseball players since.

What doesn’t make the weekly headlines is that over half of Tommy John surgeries are now done on high school boys.

"The most rapid rise in injury rates is actually occurring among players ages 15 to 19," Dr. Christopher L. Camp, an orthopedic surgeon at Mayo Clinic notes. "That's most likely due to overuse from year-round play. These kids sometimes pitch daily, and even on days when they're not pitching, they're playing different positions in the field. The arm's not getting a break."

Like Anterior Cruciate Ligament tears, UCL tears often lead to surgery and a long rehabilitation period. And while experts work to improve treatment and identify risk factors, they also encourage prevention as in a Mayo Clinic campaign:

To reduce the risk of UCL injury, take the following preventive steps:

1.    Use pitch counts – Little League and the National High School Federation have pitch counts to limit overuse.

2.    Schedule time off – Young players should avoid playing year-round or competing in multiple leagues at once.

3.    Conditioning – Proper strength training and coaching in good mechanics is critical to avoiding injury.

Overuse injuries in young pitchers provides another example of how we need to adjust our thinking about youth sports. More is usually not better.

Finding the sweet spot of enough for one’s age, the day, or the week is more likely to lead to long-term success, on the pitcher’s mound, and in life.

Read more

UCL Injuries: Defining risk and improving treatment, Mayo Clinic

Let’s strike out unnecessary pitching injuries, Mayo Clinic infographic

Ulnar Collateral Ligament (UCL) Injuries of the Elbow, Johns Hopkins Medicine

Just who is Tommy John, and why does everyone talk about his surgery all the time?, Chris Landers, February 2019, mlb.com

CBS: Dodgers' Dustin May to undergo season-ending Tommy John surgery, Mike Axias, May 4, 2021

Mastrodonato: Chris Sale’s prolonged recovery from Tommy John surgery not a concern (yet), Boston Herald, May 5, 2021

Disclaimer: I am not a medical professional. Statements are based on personal experience, credible news articles and medical resources. My intention is to raise awareness. Please learn more and discuss questions and concerns with your family's physician.