Sunday, March 13, 2016


Anybody who has followed baseball over the past few decades, in particular the last decade or so, is bound to be familiar with Tommy John surgery. For those who don’t know, the surgery is ulnar collateral ligament reconstruction and more can be found HERE. We see it all the time on ESPN when big leaguers undergo the procedure, but what is often left out is talk of the increasing frequency in which amateur athletes are now dealing with when it comes to the procedure... and arm issues in general.

I came across an article on citing a study of the likelihood of particular Major Leaguers who are at risk of having to undergo the procedure. One of the players high on the list, Marlins reliever Carter Capps. Capps just had Tommy John surgery on March 8.

What caught my attention was that Yankees starters Masahiro Tanaka, Luis Severino and Nathan Eovaldi are all at high risk too, according to the study. The study used certain factors, including previous Tommy John procedures, release points and days on the disabled list with other arm issues.  The whole thing got me thinking about what some of the causes of these injuries are and factors that could increase the likelihood of a UCL injury. I reached out to a guy who is known as one of the leading experts in this field. Steve Hayward of Baseball Health Network.

After finishing up his playing career in the minor leagues, Hayward partnered with New York Yankees team physician Dr. Christopher Ahmad who is a recognized expert in Tommy John surgeries and elbow injuries. Together, they created Baseball Health Network. Their goal is to reverse the trend in arm injuries by bringing baseball coaches, trainers and doctors together in an attempt to keep players arms healthy.  Baseball Health Network just launched it's website, and I would highly recommend checking it out.

(In Photo: Steve Hayward, Dr. Ahmad)
While talking with Hayward, great points were made. We discussed pitch counts and how the number of pitches a player throws should not be determined by the league’s rules, but by how prepared the player is. Notice that's in bold.  If, for example, a kid in youth baseball is allowed to throw 85 pitches in a game, that doesn’t necessarily mean he should. If it’s game one and he has maxed out at a 40 pitch bullpen, what would make you think he is ready to rear back and throw 85 pitches? He did not build up his pitch count and arm strength enough leading up to this first start. See what I mean?

And that leads us to the second point. Pitchers need to throw often as the season approaches...

(In photo: Andrew Miller at Spring Training 2016)
BYB: If you had one thing to tell young pitchers about arm health and how to avoid injury, what would it be?

Steve Hayward: “Pitchers need to be conditioned to pitch, not pitch to get conditioned.”

It may sound a little funny, but think about it; You don’t go out and run two miles then decide you’re ready for the marathon, right? No. You would build up stamina and strength over time so when the time comes to run 26.2 miles, you have trained to get to that point without injuring yourself. The same goes for your arm. You have to build up your strength and stamina over time.

A lot of people preach taking time off from pitching and both Hayward and I agreed on that point. But there are many variables involved when talking about time off:

As far as the no throw period, there is plenty of time to rest from throwing throughout the year, a week here, a few days there, during each season. It's not like your telling kids to throw every day, even every other day. The sensible baseball people, that provide a sensible schedule for their players recognize this. It's the not so sensible people that schedule 55-60 games in 70 days I worry about. 

The 'off season' throwing could be to throw a couple days a week, to maintain conditioning and consistency. That throwing could be anywhere from 50% to 75% intensity and as little as 30-40 total throws and anywhere from 30-60 feet. I'm not a doctor but I am a thrower and have been for over 30 years, I understand what makes throwing arms feel good and stay healthy. My methods have been proven over the past 15 years and are the reason one of the country's best doctors has partnered with me in creating the Baseball Health Network.”

As for youth pitchers, age 15 and below say, one factor Hayward pointed to was simply physical strength and muscled mass. This is interesting...

Hayward said, “Kids these days just don’t have the strength. When you look at their physical makeup, many young players are just not in very good shape.”

We discussed how some players can’t even successfully execute five proper push-ups. FIVE! These young athletes, by not having adequate strength, make themselves very susceptible to growth plate injuries, which you can read more about HERE. This should be something all young players and their parents should really take a look at.

I’ve seen it myself as a coach, and so has Hayward. Young players have to condition their bodies by staying active, doing strength exercises and baseball specific exercises like using arm bands (correctly). Plus, diet's important! Eating a proper diet and getting adequate rest is a great thing. Without the proper physical makeup, injury risks increase.

If you think about the elbow, it is surrounded by the triceps, biceps and forearms. Those muscles help keep the elbow held together. Without adequate strength and flexibility in those muscles and ligaments, the elbow could become a ticking time bomb.

A factor all of us baseball people have encountered at one time or another is field conditions. We have all had that mound that has a huge hole where the pitchers landing spot is.

Having a poor landing spot, or filling it in with unstable material like sand, adds to the risk of injury believe it or not. Hayward suggests the only way to fix that is through the hard work of communities and its members.

For us coaches, Hayward specifically mentioned the type of player we should keep an eye on. We all want our kids to be tough and willing to battle through discomfort and general soreness. I know I do. But one group of players that Hayward suggested we strongly monitor are the kids who have 'huge stones’.  You know, the ones who don’t admit when they're hurt, and play through pain they shouldn’t. Young players, and older ones, need to know the difference between being sore and being hurt. Slight muscle fatigue and general soreness is expected after pitching, but players need to know when to speak up and tell their coaches, trainers and parents when they feel a pain. A sharp or biting pain should always be looked at immediately.

Still there? Good, because this is one of my favorite points Hayward makes, and it is probably debatable depending on who you talk to: ‘There is healing power in throwing’.

Hayward:  “Throw. Throwing (the day after pitching, while sore for example) below the threshold is how I describe it. Throw at an intensity level that is tolerable. Throw at a short distance, low to medium intensity for as long as it takes for the arm to feel better.”

Hayward and the folks he is working with at Baseball Health Network, including Dr. Ahmad who performed Tommy John surgery on then Yankees right-hander Chase Whitley in 2015, are attempting to create a one-stop shop for all your baseball training needs to learn about off-season routine, season maintenance, injury rehab among other things.

For instance, an interesting development in the treatment of UCL injuries, in particular of partially torn UCL’s, is the development of Platelet Rich Plasma, or PRP, Therapy; the treatment that Masahiro Tanaka went through in the summer of 2014.  It appears that this treatment is becoming more common and effective.  More info on PRP can be found HERE and we will cover that topic more in the near future here on Bleeding Yankee Blue.

Look, someone really needed to put this out there to raise awareness of this terrible trend. While speaking with Hayward and corresponding with Dr. Ahmad, it was easy to tell they are truly passionate, and want to make a difference in the baseball world.  Make sure you check out Baseball Health Network on Facebook and Twitter too.  Their handle is @BaseballHealth.

Thank you very much for your time and effort in trying to tackle this issue head on, Coach Hayward. We applaud you here at Bleeding Yankee Blue.

To our BYB audience... yes, we are a Yankee website, but many of us have kids in baseball.  Many of us have seen kid pitch longer than they should, kids hurt from arm injuries as well as the Yankees or athletes in general.  It's great to have experts out there to provide this helpful information.  That's why we wanted to bring it to you.  And we will continue with much more down the road.

We hope you enjoyed this.

--Dan Lucia
BYB Senior Writer
Twitter: @DManLucia

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