For the last few years in Major League Baseball, it seems as if an epidemic has overcome pitchers. This epidemic is shelving them for at least a year, without any game action. What is the epidemic I am referring to? Tommy John surgery, the injury that really can put a halt to a promising career. Some individuals return to their old form, but some never truly recover. Since this injury is so prevalent in baseball these days, I sought to get more information. This next series of articles will provide different perspectives from former players who have endured the rehab, a team doctor, and a former player who now trains and helps rehab athletes that have had the surgery.
Carson Smith. Photo Cred: Christopher Evans
Steve Hayward is a former Red Sox farmhand as well as the founder of the Baseball Health Network. The Baseball Health Network is a network of former players and doctors that strive to provide credible, scientific information and education to the cause, prevention and rehabilitation of baseball injuries, primarily arm injuries. They also strive to clarify some of the myths and misconceptions surrounding these injuries, as well as how the injury and the particular dysfunction can affect performance, but does not have to completely remove you from competition. This is all described on the mission statement of the Baseball Health Network.
I was able to have a few minutes of Steve’s valuable time for him to answer some questions for me about Tommy John surgery and also provide some insight on a few myths that have been floating around as well. These questions should help explain some things that Carson Smith and Brandon Workman had to and are currently going through.
The first question I asked Steve had to do with the mental state of pitchers who have had Tommy John surgery, and if there is any validity to the notion that pitchers throw harder after they have had the surgery. Steve said, the mental state of each player is different. Some players come in excited and positive, but most players come in very depressed and negative. A lot of the players want to focus on where they were and where they want to be, not where they are right now. Oft times he will see a pitcher at the top of their game before the surgery come into rehab and either bounce the ball or massively overthrow their target from 50 feet away. Every player, even those who remain positive, will go through a period of hesitation when throwing. It is about learning to trust the rebuilt elbow, being mentally committed on every throw, getting full extension and finishing with the wrist. A lot of times this hesitation will lead to players trying to compensate mechanically, which leads to stress on other parts of their body, particularly the shoulder area.
One place where Steve differs from other experts on this subject is that he does not believe in the 180 foot long toss, that so many players who experience this participate in. His tried and true method is short range throws with increasing velocity. This is where the doubt starts to set in for some players. With this method it is only natural to feel some tightness and grabbing, as the new tendon is getting used to its new function. The players just have to understand that the surgery did in fact work and this is part of the process. Since this method differs from some others, Steve has worked with over 60 Tommy John players and not a single one has had a second surgery, and all are still playing.
On the myth of “Tommy John surgery makes pitchers throw harder,” Hayward did say that there is zero guarantee that players will throw harder. His partner did a study in which 206 MLB pitchers were tested and in average they actually lost 2 MPH after the surgery and rehab. It may appear initially that some guys are throwing harder after the surgery because there was such a long break from throwing. On average, most players will return to where they were at pre-surgery.
Photo Credit: Jim Rogash Getty Images
The next question I asked was if his rehab program differs for a starting pitcher versus a relief pitcher. Hayward offered this, “The rehab process for all players is the same through the throwing process. I do not have a set program, I strive for the player to make as many throws as possible on any given day. How many throws per day is determined by the player and how they feel that day. On the days they feel good we may push a little harder, and on the days they don’t feel as good we will back off a little. The goal is to throw every scheduled day. My guys do that unless they have a lot of pain, which I have yet to experience with any of my guys.”
In the news, we all hear about guys who had “setbacks” in their throwing programs and needed to be shut down for a few days. I asked Steve to provide some insight into this. His idea of a “setback” is having to stop throwing and return to see a doctor. Soreness or tightness, even low level pain is not a setback, but a natural part of the process. He feels his best skill is teaching players to embrace whatever discomfort they feel, tend to it and stay ahead of the further injuries. Knowing your body and how to give it what it needs is the key to staying out of the operating room.
The last question that I asked Hayward had to do with the general propensity for injuries. Did he think all pitchers would eventually need Tommy John surgery or is there a way to prevent it? Hayward said that no injury in any sport is fully prevented. “I have coached at 2 nationally ranked high schools in New Jersey and in my 16 years not one of my pitchers has ever sustained a serious injury under my care. We throw a lot. The epidemic of injuries is starting with kids as young as 8 years old, with growth plate injuries, HS, College and Professional pitchers having to have Tommy John. It is starting to get out of control. The best way to combat these injuries is to teach proper “throwing” mechanics at the earliest ages. Kids are not using their lower body, no hip rotation, improper rotation in the ball, poor arm finish. It doesn’t just happen in little league, high major college pitchers are doing the same things. If that issue does not get addressed, the problem will only get worse.”
This was a very enlightening interview with Steve Hayward and he presented some great facts. Next week I will present the thoughts of a MLB team doctor. Thank you to Steve Hayward for being such a great sport and letting me interview him. Please be sure to check out the Baseball Health Network.