As year-round baseball grows, Tommy John becomes more likely

The scar remaining from Stony Brook pitcher Connor Doyle's Tommy John surgery. Doyle had the surgery in 2014. Taken by Brogan Harte.The scar remaining from Stony Brook pitcher Connor Doyle's Tommy John surgery. Doyle had the surgery in 2014. Taken by Brogan Harte.

By Brogan Harte and Chris Gaine

Connor Doyle was coming off of his freshman year as a pitcher for Stony Brook Universitya��s baseball team.

One day on the mound following that season, in July 2014, he began feeling some discomfort in his right elbow– his pitching elbow. He was in the midst of rigorous daily throwing regimen to get ready for the 2015 season.

a�?It started to hurt a little bit,a�? Doyle said of his elbow. a�?But all I felt was discomfort, it wasna��t a sharp pain or anything. So I continued to throw throughout that week and by the end of the week my elbow just kept getting worse.a�?

Doyle eventually spoke to his pitching coach and Stony Brooka��s team doctor, James Paci, about getting his elbow examined that month.

What he thought was discomfort turned out to be a pitchera��s worst nightmare: A torn ulnar collateral ligament. Doyle needed Tommy John surgery to repair the tear, and missed the 2015 season.

Tommy John surgery is a procedure, typically performed on pitchers, in which the patient’s elbow is opened. Once open, holes are drilled to make room for a new tendon– which typically comes from another part of the patient’s body such as the palmaris tendon in the wrist or the patella tendon in the knee.

The surgery is named after former MLB pitcher Tommy John, who first had the surgery in 1974. It has become nationally prominent at the professional level; more MLB pitchers had the surgery in 2014 than they did in the entire decade of the 1990a��s.

a�?For two decades, from about 1974-1994 it was a relatively flat number of surgeries per year in the country,a�? Dr. Glenn Fleisig said. A�a�?But the next two decades have had a steady increase. Not just at the pro level, but all levels. Especially at the High School level.a�?

Fleisig works with world-renowned Dr. James Andrews at Andrewsa�� American Sports Medicine Institute in Birmingham, Alabama. He also advises MLB, USA Baseball and Little League Baseball on elbow injuries. Dr. Fleisig said that the primary cause for this uptick in surgery is overuse at a young age.

a�?Compared to the 1970a��s, [todaya��s] high school baseball players end up specializing in one sport,a�? Fleisig said. a�?They tend to play just baseball instead of playing baseball in the spring another sport in the fall or winter. The pitchers pitch year round, statistically we’ve done studies that show the amateur pitchers who pitch more innings are more likely to [have] injuries.a�?

Doyle believes that overuse was a factor in his injury. A�He estimates that he threw 100 to 110 pitches once per week in high school. He graduated from Benjamin Cardozo High School in Queens after transferring from Townsend Harris High School in his sophomore year.

a�?[Townsend Harris wasna��t] that good so they needed as many innings as they could out of me,a�? Doyle said. a�?So I feel like that definitely had something to do with [the injury].a�?

The school’s athletic director, Lauren Caiaccia, said that the injuryA�could have happened for many reasons.

“While at Townsend Harris [High School]A�Connor Doyle did not specialize in baseball as he competed in both Varsity Basketball and Baseball in the PSAL,” Caiaccia said in an email. “During his time at Townsend Harris [High School]A�as a two-sport student-athlete, the boys basketball and baseball team competed in the B Division, which is lowest division of PSAL competition. His injury could have happened for many reason.”


With more training, due to year-round baseball, pitchers are able to throw with more velocity. Increased pitch velocity creates more stress on the elbow.

a�?If you keep throwing 100 miles per hour over and over again you’re going to get into trouble eventually,a�? Paci said. a�?The elbowa��s only made to handle so much stress and the number one risk factor for injury is fatigue. So the harder you throw the faster you’re going to fatigue.a�?

To solve this problem, MLB and USA Baseball have guidelines for pitchers titled a�?Pitch Smart.a�?

Dr. Fleisig is an advisor for Pitch Smart.

a�?What they can do is to tell pitchers not to throw so hard,a�? Fleisig said. a�?That works medically but ita��s not a realistic solution. But there are some things that can be done. One thing is at the amateur level, the pitchers are playing too much… So with MLB and USA Baseball, we made a website,, and this is a website that has guidelines for how much pitchers should pitch.a�?

According to, the average pitcher takes 12 to 16 months to return from Tommy John surgery. notes that the surgery has an 80 to 85 percent success rate.