Elbow Injury Sidelining Marlins Ace Jose Fernandez Highlights Tommy John Surgery Epidemic

Elbow Injury Sidelining Marlins Ace Jose Fernandez Highlights Tommy John Surgery Epidemic

Jose Fernandez, the 22-year-old ace of the Miami Marlins staff, has torn his ulnar collateral ligament in his throwing arm. The strikeout leader of the major leagues has been advised to undergo season-ending Tommy John surgery.

Fernandez, should a second opinion uphold the first, becomes the 22nd player in the majors requiring the procedure this season. It’s May, and already MLB players requiring Tommy John surgeries have increased year-over-year. Should the current rate continue, the 2012 record of 36 MLB Tommy John surgeries will be shattered in July. Fernandez joins Ivan Nova of the Yankees, Patrick Corbin of the Diamondbacks, and Kris Medlin on a growing list of elbow-injury casualties. What these four have in common, aside from pitching, is age. They’re all under thirty. Increasingly, that’s the demographic going down to elbow injuries.

Sports Illustrated‘s Tom Verducci observes that what used to be an injury for worn-out arms now works as a plague upon just-warming-ups arms. He pegs the average age for MLB pitchers needing the procedure this season at 23.4. Elbow injuries are happening more and more to younger pitchers. “I found that high school pitchers drafted among the top 30 picks from 2010-12 were five times more likely to blow out their elbows than top 30 high school picks from 2002-09,” Verducci writes. “And if Fernandez needs Tommy John surgery, the incidence will grow to six times more likely, with 38 percent of elite high school draft picks getting Tommy John surgery before age 22 (six of 16).”

“It’s unreal,” Tommy John said of the increased demand for the surgery bearing his name in a speech covered by the Watertown Daily Times last month. “And it’s crazy that they would pick 2014 to be an epidemic year, it seems like guys are going down right and left.”

That’s the bad news. The good news is that the success rate for Tommy John surgery now exceeds its inventor’s wildest hopes. Dr. Frank Jobe, whose death preceded John’s comment that the surgery epidemic happens at a “crazy” time, initially thought chances for success stood at 1 in 100 when he performed the experimental operation on Tommy John in 1974. The Dodgers pitcher emerged from the operation to go 10-10 in 1976 and enjoy one of the longest careers in MLB history.

A new study finds that pitchers coming back from Tommy John surgery return better than before. Although they generally pitch fewer innings, they boast a higher winning percentage, a lower ERA, and fewer hits than before. Almost all of those going under the knife return to a life under the lights. “A total of 179 pitchers with UCL tears who underwent reconstruction met the inclusion criteria and were analyzed,” reports the March article in the American Journal of Sports Medicine. “Of these, 148 pitchers (83%) were able to RTP [return to play] in the MLB, and 174 pitchers were able to RTP in the MLB and minor league combined (97.2%), while only 5 pitchers (2.8%) were never able to RTP in either the MLB or minor league.”

Medicine has been able to conquer the injury that killed Sandy Koufax’s career. Baseball, whose enthusiasts have recommended everything from rigid pitch counts to banning breaking balls for youth players to lowering the mound, hasn’t quite figured out how to prevent the injury that leads to the surgery.