Minor League Baseball players deal with Tommy John concerns

Something no player ever wants to hear is Tommy John, unless they’re meeting the iconic pitcher from the 1970s.

Up and coming players worry about their careers coming to an end because of major surgeries like Ulnar Collateral Ligament Reconstruction. The surgery takes a tendon graft from somewhere else in the body, usually the forearm, hamstring, knee or foot and replaces the damaged one in the elbow, according to eOrthopod.com.

The surgery came about in 1974 when Los Angeles Dodgers pitcher Tommy John had torn the ligament in his elbow. The revolutionary procedure was performed by surgeon Frank Jobe which helped John pitch until 1989. John went on to be a three-time All-Star and was a Cy Young candidate four times after the surgery.

Since then, there have been 970 surgeries between Major League Baseball and Minor League Baseball, according to an all-time list curated by Jon Roegele, a writer for The Hardball Times. The list of surgeries shows that 607 of those surgeries were to minor league players.

Dan Savas needed the surgery in 2011 and is now a pitcher in the Arizona Diamondbacks organization.

Dan Savas had his UCL repaired in 2011 and was drafted by the Arizona Diamondbacks in 2014. (MiLB.com)

“At first it was difficult to hear that I was going to have to have surgery,” Savas said. “After hearing the success rate and everything like that it definitely calmed my mind.”

Before joining the Diamondbacks, Savas said that he underwent tests to ensure his elbow was all right. He said that when training with the team he was not treated as someone just coming off Tommy John surgery, but as just another pitcher.

“A lot of it was making sure the shoulder was strong,” Savas said. “Now we do a lot more forearm work, trying to keep everything strong. Before I had surgery I never even worked out forearms or anything like that, now that’s one of the big things. The other thing is changing my motion. We looked through my pitching motion pre-surgery and post0surgery and I pretty much throw the same.”

Brian O’Keefe, catcher for the St. Louis Cardinals organization. (Brian O’Keefe via Twitter.com)

Brian O’Keefe is a catcher within the St. Louis Cardinals organization. He said that as a catcher, elbow injuries are not something he can easily spot.

“There’s things that we can see, but you never know when it’s going to happen and most of the time it happens on one pitch out of the blue,” O’Keefe said. “It’s not like I’m sitting back and I’m like ‘Oh man, he’s got like five more pitches and this thing could go.’”

O’Keefe said that weaker shoulders tend to lead to elbow injuries and pitchers are constantly making sure their arms are strong enough to keep performing.

Jordan Minch currently pitches from the bullpen for the South Bend Cubs (Class A). Minch said that players go through band workouts and a throwing program to keep their arms up to snuff and avoid injuries.

“Something that our coaches do in the Cubs organization, our starters go out there and they’re not doing more than six innings,” said Minch. “If you look at minor league baseball, everyone is training and the coaches are preparing us to be a big leaguer one day.”

Jordan Minch pitches for the South Bend Cubs. (MiLB.com)

Minch said that he has not had arm problems in his career and that as a pitcher coming out of the bullpen he does not see a pitch limit in games.

Pitch Smart, a program developed by the MLB and USA Baseball, outlines a number of risk factors for elbow injuries. One of the factors is not following a proper strength and conditioning program. The program also provides radar gun use as a way young pitchers are inspired to throw harder, which could put more strain on the arm.

According to a study from Sports Health, a journal of sports medicine, youth pitchers who threw fastballs, curveballs and changeups were tested for the amount of torque placed on the elbow with each type of pitch. The study found that high school pitchers placed more torque on their elbow with the fastball than with the curveball. The study showed that this was something that evened out in collegiate pitchers.

O’Keefe said that he does not think that the human body is meant to throw a 100 mph fastball, which is becoming more common across baseball. According to an article by the Pittsburgh-Tribune Review, the average MLB fastball came in at 92 mph in 2013.

“It’s hard not to get sucked into the velocity is king kind of theory,” Savas said. “You see it every year, the guys who get drafted high they’re all guys who throw hard… I think a lot of pitchers try to get into that mindset if I throw hard I’ll go higher, if I throw hard I’ll do good, people will like me more.”

O’Keefe added that the situations players are pitching in could be adding more stress to their arms.

“It’s not so much, necessarily, the amount of pitches that are thrown. I think that has something to do with it,” O’Keefe said. “I think it’s more of the stress of those pitches. When you get in the sixth seventh inning, you have a tight ball game, you’re reaching back for more, you’re trying to throw your slider harder and harder and that’s when I think you’re going to see guys get hurt.”

Both Minch and O’Keefe think that seeing pitchers go under the knife for Tommy John surgery is common, making it not as big of a deal to undergo the surgery. However, just last season New York Yankees pitcher Masahiro Tanaka elected to not have the surgery and rehabbed his arm to return in 2015.

“I think that getting the surgery is the best way to go,” O’Keefe said. “You're getting a brand new ligament in there and then you have to go through the rehab process and that is going to strengthen all of the muscles in your shoulder and the muscles that you need to throw with.”

Roegele’s in-depth chart of Tommy John surgeries over time shows an MLB return rate of 79 percent.

As a position player, O’Keefe noted that not only pitchers undergo Tommy John surgery and most recently Boston Red Sox catcher Christian Vazquez needed surgery on his elbow. The 24-year-old was drafted by the Red Sox in 2008 and debuted in the majors in 2014, playing 55 games. Another catcher, Matt Wieters of the Baltimore Orioles went required Tommy John surgery in June of 2014. the three time All-Star is set to return sometime this summer.

“What a lot of people don’t realize is that we throw just as much as pitchers do, maybe more,” O’Keefe said. “Some of the stress on our arms isn’t the same, but we do throw just as much as them.”

While O’Keefe said he has personally never had a scare with a UCL tear, he wouldn’t be surprised if 10 years down the road it was something that he needed to have done calling it “part of the game.”

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