Photo: www.thenationalpastimemuseum.com
Today’s edition of My 2 Sense is brought to by, Sal Marinello, President, Athletic Development Coaching.
If you follow Major League Baseball, chances are you’re the fan of a team that has had a starting pitcher or two on the Disabled List at some point this season. In the current climate there are no minor injuries when it comes to pitchers and every baseball fan shudders at the prospect that their favorite/team’s best pitcher might have to undergo Tommy John Surgery (TJS).
Every report of a starting pitcher missing his turn, complaint of forearm pain/elbow or shoulder tightness, or arm fatigue sets off a panic in the local fan base that is marinated and stewed (or is it stewed and marinated?) by the local media and sports talk radio. Everyone has their opinion and solution.
When the seemingly inevitable disabling injury occurs and a pitcher needs surgery, the situation is treated as if the surgery is a panacea and, regardless of the severity, the player will ‘be back next year.’ I hear it all the time on sports talk shows and in the print and electronic media. ‘So and so had XYZ surgery, is rehabbing and will be back next year.’
Really?
When you consider that approximately 30% of major league pitchers and 15% of minor league pitchers have undergone TJS, and that research shows 20% of these pitchers will not return to form, surgery can hardly be considered a ‘fix.’ This statistic also means there are a lot of bad arms around. Which, finally, brings me to my next point.
Surgery is not a panacea. Surgery can provide a temporary fix, but surgery, not TJS or ACL surgery, does not return elite athletes to 100%. A joint compromised athlete is always a joint compromised athlete and surgery does not change this reality. Certainly, surgery doesn’t bring athletes back to 100%.
The best predictor of future injury is past injury. The athlete who experiences surgery is at a higher risk for future injury than an athlete who has yet to suffer an injury or undergo surgery. When an athlete who is in the process of coming back from ACL surgery suffers another lower body injury, or any kind of injury, the vast majority of the time the reports say the new injury is unrelated to the old injury.
This is nonsense. The body is a complex structure that produces complex movements and when a major component of it is injured – or breaks – and is repaired, the body adjusts and as a result other injuries can, and do, occur. More on this at another time.
Now back to baseball.
Not only is Tommy John surgery not a guaranteed fix, the positive results from successful surgery aren’t necessarily permanent. Which brings us to the curious case of Jacob deGrom, New York Mets starting pitcher.
He is suffering pain in his pitching arm, and had his Tommy John surgery approximately 6 years ago. According to research, this is about the time when the ligament graft from the surgery starts to degrade. He’s having pain from his ulnar nerve, which runs next to the ulnar collateral ligament (UCL), the ligament replaced by TJS. So the surgeon is going to “move” the ulnar nerve in an attempt to alleviate the pain and numbness the 28-year old deGrom is experiencing in his right arm.
We are not like a Lego set, where pieces can be removed, moved and replaced without consequences. deGrom’s ulnar nerve is likely stressed as a result of his body’s attempt to cope with the stress from a structural issue with his elbow. The Mets’ starter has experienced loss of velocity and pain. Research also shows that loss of velocity is a precursor to injury and is caused by the body’s attempt to reorganize the pitching motion so as to protect the elbow or shoulder.
We are entering uncharted territory, where major league pitchers – all athletes – are pushing the limits of these ligament replacement surgeries with regard to their lifespan. deGrom’s situation is already common. Look at all of the star power pitchers who have experienced a series of injuries that follow from an initial surgical procedure.
As we go forward, these situations may become even more common.
