re: Tommy John - Not If, but When?

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One is more prevalent than the others and is a larger factor. They are not all equal. Overuse, Biomechanics, and deficient strength would mean more shoulder injuries too… but that’s not happening. The only correlation between the increase in UCL tears is the increase in velocity. Overuse hasn’t suddenly increased… kids are stronger not weaker… the biomechanics are better overall not worse. It’s the increase in speed and it happening earlier and earlier.

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Why do kids throw harder? Because they work at it to throw harder. They have increased the number of throws and the effort of these throws. This is the overuse component in the equation. It takes more practice and intent to throw harder. Thus, overuse is a major factor.

Again, the vast majority of UCL injuries are cumulative overuse injuries with trauma over time that leads to an acute rupture or tear.

Starting in the late 90’s and ramping up into the 2000’s, UCL injuries began to spike. This was almost completely due increased volume of playing due to year round baseball, along with fatigue.

Now we have that combined with the push over the past 10-15 years for everyone to throw 90+ and of course higher. Now the push for velocity is a major component. But you aren’t going to increase velocity unless you are throwing a lot.