Tommy John at 15

Sorry for the bad news. Would be curious to know if your son has been playing year-round ball.

DPElite99,

quote:

“Lousy day, son just found out he may need TJ surgery.”

Pain overlying the UCL usually means the 4 muscles and tendons that drive pronation of the forearm are out of shape and have been overstressed. The UCL itself has no pain receptors accept deep into the insertion of the bone, this is why most partial tearing until complete failure produces no pain, he may have a partial tear of the UCL also. Pain in this area comes form the overlying pronator muscle groups.

quote:

“His pitch counts never went above60”

If he produces “forearm bounce” it does not matter much how many he throws because the UCL is micro tearing with each pitch. This injury is totally preventable by eliminating forearm bounce by transitioning the forearm/humerus earlier then getting the elbow up before the acceleration phase.

quote:

“Mechanics seem to be where they should be or a little advanced for his age”

This would be the opinion of most of the traditional pitching coaches everywhere and is totally false when dealing with the transition phase of his delivery!

quote:

and physical makeup. (at least according to the college coaches who have seen him).

The more physical they are (fast twitch to slow twitch percentages) the faster the traditional pitching motion degrades them.

quote:

“Our first ortho diagnosed as tendonitis and to take "Aleve". Kicking ourselves now...”

If you have not had an MRI with contrast yet, how would they know? They do not and are quessing like all have done in the past, hope everything turns out better than it looks.

quote:

“Anyone in Orlando area know of good rehab folks around here please let me know.”

He must rehab performing a changed mechanic by overloading specifically!
If he returns to the way he pitched previously the new UCTendon? Will degrade even faster. Go to DrMikeMarshall.com and learn how to rehab specifically and he will be ready to pitch competitively in 11 mo. from the time of surgery!

Roger,

Yes to year round ball but I have to qualify that somewhat as it amounts to 6-10 innings per month, if that and there are at least 2-3 monhs per year where it doesn't even approach that.

The surgeon explained it is probably bad mechanics coupled by the fact he is very tall (not that i would necessarily know what I am looking at) but we found a respected exercise physiologist who works with pitchers, and he was trying to improve the mechanics from the previous instructor. Some of which had to do with lack of follow through and not using his legs as much as he should which puts more strain on the elbow.

DP,

How tall (and how much does he weigh) is your son? Did he play any other sports?

It is not uncommon to injure the UCL in other ways besides pitching, it just may be that because he pitched it was discovered. One wouldn't need to have it repaired unless they played baseball or another sport that required it to be 100%.

A ML baseball player I know bumped the inside part of his elbow against a pole and the next thing you know TJS was required as it was torn (not a pitcher so recovery was quicker). Could have actually been torn for awhile, but because he didn't throw as much or as hard as a pitcher, maybe he didn't know it was torn.

Anyway, what WAS the final outcome?

quote:

Originally posted by Proud Dad 24:
DP,

How tall (and how much does he weigh) is your son? Did he play any other sports?

What does height and weight have to do with it? There is NO correlation between ht/wt and TJ.

DP,
Has his velocity taken a big jump? Sometimes that can cause it and sometimes it just happens. Hope it really doesn't turn out to be TJ. We were convinced my son had it but when the surgeon saw the MRI he said the UCL was in great shape. Don't jump to conclusions.

My son also just found out he may need TJ surgery. Our MRI is Tuesday. He is a freshman in college, and had a chance to compete for a spot in the starting rotation. It is about the last thing we expected to happen. He has never had arm or elbow problems previously, although a few years ago he had a shoulder strain that was handled with rehab and PT.

I am hopeful to hear that the symptoms could be for other reasons. We get the final diagnosis on Thursday.

Best of luck to your sons on their recovery.

Stu

All: Thanks for the encouragement. An MRI has already been done, what is next is an MRI in which they inject a dye which will tell them what is torn and how much. The surgeon told us not to jump to conclusions but in his opinion, without seeing the new pictures (which are delayed until next Friday) he expects to see a tear.

He is 6'-4" and 187 and still growing as he is 15. According to the surgeon, that can not be the cause, but couple that big lever, with the younger age and the imperfect mechanis it all plays a part. He had an 8 year old two weeks ago that suffered a torn ligament as well

DPElite99,

quote:

“found a respected exercise physiologist who works with pitchers”

All respected pitching coaches do not understand why this injury is produced and will exacerbate the problem by not giving him the proper fix by changing the way he brings the ball back then up at the right time early with the hand under the ball! Ask him if your son should bring the ball up with his hand under the Ball thumb up supinating? And see what he says, if he says the hand should be on top of the ball pronating with the thumb down then he teaches what everybody else teaches and the problem will persist by not having the humerus transitioned early enough to prevent forearm bounce during the acceleration phase.

quote:

“and he was trying to improve the mechanics from the previous instructor”

Pitching coaches that have better perceived credentials who teach the same mechanics produce the same affects. Ask him if he is aware of Dr.Marshall and what he thinks?

quote:

“Some of which had to do with lack of follow through”

Tell him that follow through after release produces no stress in the elbow but does produce stress in the shoulder from across the chest recovery.

quote:

“and not using his legs as much as he should which puts more strain on the elbow.”

This is exactly the opposite!!! The more power delivered from the legs will add stress not relieve it. We actually want more leg power but delivered to a proper arm and shoulder mechanic. Legs have nothing to do with UCL overstress and misuse.
Show these comments to him and bring him here to HSBW if wishes to comment on these contentions. If he refuses to look at least look into this information at the correct source (Dr.Marshalls web site) you have a decision to make.

quote:

Originally posted by DPElite99:
He had an 8 year old two weeks ago that suffered a torn ligament as well

8 year old's having torn ligaments can't be from overuse.

DPElite,

Sorry to hear about your son. Be sure to let us know what the results of the MRI w/ Dye were and if surgery was needed. My son who is also 15 just had his TJ surgery on the 23rd of December. His innings were monitored closely as well but still tore up his UCL. While not as big as your son he is still good sized for 15 (6" 2" and 190lbs) and threw hard. After the fact the physical therapist found that his shoulder was extremely weak and likely was a culprit in the elbow blowing out. The weak shoulder led to his dropping his elbow due to tiredness which put strain on the elbow. Couple that with him having a 7mph jump from the prior year (1st winter working with a pitching coach really helped plus a couple inch growth spurt)and throwing with max effort too often it isn't surprising that his still immature arm couldn't handle the stress and blew out. UCL tears aren't just from overuse. sounds like your son's injury is more along the same as my sons. I hope it all works out for the best but if it a torn UCL and TJ surgery is required at least they are young enough to bounce back in time for their all important junior year and summer of junior year recruiting wise.

Good luck and keep us posted!!

Redsox8191,

quote:

“My son who is also 15 just had his TJ surgery on the 23rd of December.”

If he rehabs correctly by performing “sport specific” overload interval training with a changed mechanic allowing him to transition his Humerus and Forearm earlier he will be pitching competitively by Nov 23rd 2011. If he rehabs the way it is recommended by Orthos and rehab guy’s still today he will not be ready and still have the same mechanic that put him on the operating table the first time.

quote:

“His innings were monitored closely as well but still tore up his UCL.”

Innings and pitch counts have nothing to do with why his UCL failed other than it takes some pitches to degrade it with his particular mechanic. Mechanics are why this happened and a change in them is required to keep it from happening again.

quote:

“While not as big as your son he is still good sized for 15 (6" 2" and 190lbs) and threw hard.”

Size has nothing to do with why his UCL degrades nor how hard he throws, even skinny slow twitchers degrade and fail their UCL’s.

quote:

“After the fact the physical therapist found that his shoulder was extremely weak and likely was a culprit in the elbow blowing out.”

His perceived weak shoulders have nothing to do with why his UCL degrades and one of the reason this injury persists today is because of explanations as the one you were given leaving the mechanical problem without the proper change.

quote:

“The weak shoulder led to his dropping his elbow due to tiredness which put strain on the elbow.”

This is not why the UCL degrades! The UCL degrades for one reason and a couple of inches in difference from the start of a game to the finish puts the same stress in the inside of the elbow if he bounces his forearm backwards higher or lower at the start of the acceleration phase and supinates his drive on some or all of his pitches.
Outwardly rotating your Humerus at the back takes little strength in your shoulders to make it happen at the proper time. Strength in the shoulders is important for shoulder injury problems.

quote:

“throwing with max effort too often”

Pitchers should pitch at maximal effort with all pitches and having non injurious mechanics and proper fitness ensures that this can be produced with no ill effects.

quote:

“it isn't surprising that his still immature arm couldn't handle the stress and blew out.”

Immature arms will only be ill affected at the ossification centers (growth plates) with non injurious mechanics, leaving injurious mechanics with two problems to deal with.

quote:

“sounds like your son's injury is more along the same as my sons.”

Yes, it is all caused by the exact same thing in all pitchers and catchers, they both bring the ball back with their hand on top of the ball pronating it on the way back then up, then when they start their transition (outwards rotation of the Humerus) to be ready to start the acceleration phase its to late and they must bounce their forearm and humerus backwards causing micro tearing with each pitch until it macro tears or fails.

Fortunately this is all preventable even with a replacement Tendon.