Tommy John - Sounds like a nice guy...but he will put you on the DL for a year.

If you've been around baseball (some other overhead sports, but baseball in particular), you have heard about a particular individual named Tommy John.

Well, maybe not him, but the procedure itself...Tommy John surgery.

The injury associated with this surgery placed 26 MLB players on the DL for 2018....26! I'll give you one guess as to the particular position of >75% of them.....yep.....pitchers.

These guys put so much repetitive torque on their arms throwing bullpens, appearances in games, and just plain warming up that it often falls to the weakest link. Which for most of them is their Ulnar Collateral Ligament.

With the increase in emphasis in velocity, teaching off-speed pitches early to young athletes (who have a hard enough time running the bases in a lot of cases) and significant increase in games played in a calendar year, it's no wonder why it's becoming more and more common in youth sports as well.

The Ulnar Collateral Ligament (UCL), is on the inside of your elbow and helps connect your ulna to the humerus.

And it's not funny when you tear that ligament I promise you.

Because should you choose to want to get fully back to sport (and for MLB players this is most of the time non-negotiable), the rehab process is long and grueling...longer than the dreaded ACL with football players.

9-12 months with the average MLB player undergoing 10-11 months.

So why does it happen??

Well, there's not really a short answer to that question. Many factors play into it and I've listed the most common reasons why below.

1) Imbalances in muscle strength in the shoulder and shoulder blade.

2) Lack of or excessive mobility in the shoulder joint providing too much torque at the next joint down (the elbow).

3) Lack of proper mechanics: Instead of using the entire body to throw, the athlete uses mostly his shoulder and elbow.

4) Poor wrist and grip strength. The flexor carpi ulnaris and flexor digitorum superficialis (these latin names are easy to say) provide about 24% of the stability at the UCL.

5) Not building throwing tolerance/endurance/strength slowly over time.

Each one of these reasons are incredibly intertwined with all of the other ones. So working on just one or two of these is NOT enough to prevent the problem.

I actually strained my UCL pretty badly in High School baseball. I really thought I tore it. My throwing velocity got so bad I couldn't throw the ball 90 feet...and I played short stop...that's kind of a necessity.

Luckily for me it was only a strain that got better quickly with rest from throwing, strengthening and range of motion exercises.

My shoulder is another story that I will tell you at a later date...let's just say when I threw really hard once, my whole arm went numb...

At any rate, for those interested in increasing velocity and performance throwing, I recommend programming that incorporates all the areas listed above by an expert...not just a garage gym trainer.

If you want more information or if you live around the Franklin, TN area and would like to schedule a free discovery session with Dr. D, send an email to No referral is required for the state of Tennessee, so just schedule a session by sending an email to the address above.

-Dr. D

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