Arm Problems Aren't Just a Worry for Old Ball Players

The Athens (Ohio) News—October 24, 2008

Brian Conway was tough to hit.

With a good fastball and pitching repertoire full of curveballs and sliders, Conway dazzled opposing hitters during his days in Little League Baseball.

As a teenager, he made the most of his talent. Conway played for two travel baseball teams and pitched almost every day in the summer before high school.

He was the star, and he didn't want to let down his teammates.

"Of course, being so young I was attracted to that feeling of being the star," said Conway, of Queens, N.Y. "That was my biggest mistake, feeling that I had to please both coaches, both teams, and not really looking out for myself in the long run."

By end of the summer, Conway's arm ached every time he threw. The injury that started as a twinge had become unbearable.

The pain in his elbow was too much to ignore, and something had to be done if he wanted to continue playing baseball.

So as a 14-year-old high-school freshman, before he even threw a pitch for his high-school team, Conway had reconstructive elbow surgery.

His story is not unusual. Recent studies show more young baseball players are having Tommy John surgery than ever before.

The operation, named after the L.A. Dodgers pitcher who first had it in 1974, replaces a damaged elbow ligament (ulnar collateral ligament) with a tendon from elsewhere in the person's body.

The procedure was once reserved for Major League pitchers, but has now become increasingly common in teenage pitchers. That fact has alarmed some doctors.

"It used to be extremely rare where you would be (performing surgery) on 15- and 16-year-olds," said Dr. Joshua S. Dines, a sports medicine physician with Hospital for Special Surgery in New York.  "But now, unfortunately, they are using the term epidemic."

Conway's story is a cautionary tale for young pitchers filled with talent.

The best players on the team, usually a pitcher, often have the most arm trouble because they get overworked, Dr. Dines said.

In dealing with these injuries, most doctors have identified overuse as the common theme. Players throw year-round, and rarely give themselves adequate rest in between outings, physicians said.

"You talk to some of these people, and the only time they aren't throwing is the week between Christmas and New Year's," Dines said.

Other risk factors Dines identified include inadequate warmups and throwing breaking balls at a young age.

Recovery time is nine months to a year, Dines said, and sitting out an entire season at a young age is difficult to overcome. Even with the structured physical therapy post-operation, some players never come back as the same pitcher.

Read the full story at athensnews.com.