High School Baseball

Epidemiology

Epidemic of Elbow Injuries in High School Baseball Pitchers Requiring UCL Reconstruction (“Tommy John Surgery”)

1. Petty DH, Andrews JR, Fleisig GS, Cain EL. Ulnar collateral ligament reconstruction in high school baseball players: clinical results and injury risk factors. The American Journal of Sports Medicine 32(5):1158-1164, 2004.

2. Fleisig GS, Kingsley DS, Loftice JW, Dinnen K, Ranganathan R, Dun S, Escamilla RF, Andrews JR. Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers. The American Journal of Sports Medicine 34(3):423-430, 2006.

In recent years, there has been an epidemic of elbow injuries in baseball pitchers requiring UCL reconstruction (“Tommy John Surgery”). For example, Dr. James R. Andrews performed Tommy John surgery on 164 baseball pitchers (81 professional, 63 collegiate, 19 youth & high school, and 1 recreational) between 1996 and 1999, on 446 baseball pitchers (151 professional, 207 collegiate, 86 youth & high school, and 2 recreational) between 2000 and 2003, and on 588 baseball pitchers (133 professional, 307 collegiate, 146 youth & high school, and 2 recreational) between 2004 and 2007. Comparing these consecutive four-year periods, the total number of surgeries continues to rise. Most notably, the number and percentage of patients at the youth & high school level has gone up most dramatically. It is impossible to speculate what part of these dramatically increased numbers are due to an epidemic of increased number of injuries versus other factors, such as improved ability to identify injuries and improved recognition of our senior author’s expertise in this field. Regardless, elbow injuries requiring UCL reconstruction due to baseball pitching are clearly a growing problem at all levels, and particularly at the high school level.