Our two-part “Arm care” series features a Q&A with two of the foremost experts on shoulder and elbow injuries:
Dr. Michael G. Ciccotti is a Professor of Orthopaedic Surgery, Chief of Sports Medicine, and Director of the Sports Medicine Fellowship at Thomas Jefferson University. He also serves as the Head Team Physician for the Philadelphia Phillies, and is the President of the Major League Baseball Team Physicians Association.
Dr. W. Ben Kibler is a board-certified orthopedic surgeon specializing in sports medicine and shoulder and elbow conditions with the Lexington (Ky.) Clinic. He has worked with professional baseball since 2001, and has been involved in spring training medical education for all levels of the Houston Astros’ sports medicine staff. He received his M.D. from Vanderbilt University, where he was an All-SEC outfielder for the Commodore baseball team
WHY WERE THERE SO MANY ARM INJURIES AT THE MLB LEVEL THIS YEAR?
Michael Ciccotti: There are so many theories as to why there seems to be an epidemic of pitchers with UCL and other catastrophic injuries. One of the theories is the sports specialization that occurs so early in life. These pitchers that are currently in Major League Baseball in their first, second, or third year seem so protected, pitching every fifth day and with very strict pitch counts. In spite of that, we have this high incidence of catastrophic injury, whereas decades ago we had pitchers that would pitch every fourth day and with virtually no limit in terms of pitch counts in a single game.
Ben Kibler: First of all, it appears that the actual number of elbow and shoulder injuries is going up across the board from about age 15 on up. Secondly, our ability to treat these injuries is less than sterling. We operate on these people and they don’t get back to 100 percent and sometimes not even close to 100 percent.
We seem to hear a lot that players do better after Tommy John surgery and there is some evidence that for a short time you can achieve a level of competitiveness again, but it takes over a year and it makes the career shorter in the long-run. The point is that the treatment is not the answer.
The third point is that the impression of the major league team physicians and medical staffs is that they’re having to play “catch up” once players get into their system. There are a lot of miles on arms and other injuries on these guys once they show up. [The physicians and medical staffs] feel that there is a higher percentage of guys that are being drafted that have some wear and tear, stiffness, bad mechanics, a lot of things that make it harder for them to succeed at the highest level.
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