Thursday, April 27, 2017

Healthy Habits: Elbow Injuries and Tommy John Surgery

Millions of boys across the U.S. age 4-16 will play one of the most old and loved sport  – baseball.  One of the most common injuries to children and  even athletes in baseball is an injury to the elbow.  I had a chance to interview expert Sports Medicine doctor and orthopedic surgeon, Dr. Derek Ochiai, in Arlington, VA about Tommy John surgery and exactly how common it is in both children and adult athletes

What are some common causes of elbow injuries?  Most commonly, elbow injuries are from repetitive overuse.  By far the most common is tendonitis, commonly known as tennis elbow (on the outside of the elbow) and golfer's elbow (on inside of the elbow).  These are from overuse of the tendons on the outside of the elbow, and can cause pain.  Ulnar collateral ligament injuries (Tommy John injuries) are also usually from repetitive overuse, but this causes the ligament to slowly tear over time, and then one pitch completes it.  While it is typical in pitchers, over throwing athletes can get this injury as well.
What is Tommy John surgery?
Tommy John surgery is reconstruction of the ulnar collateral ligament on the inside of the elbow.  This ligament helps to stabilize the elbow from valgus force (tension on the inside of the elbow).  The surgery uses a tendon graft that is secured to the bones of the humerus (upper arm bone) and ulna (forearm bone).  This replaces the torn ligament.
What alternatives are there to Tommy John surgery?
Certainly, Tommy John surgery is not required for life.  Many times in professional athletes, if they have a ulnar collateral ligament tear, they may choose to retire instead of having the surgery.  There has been some recent interest in repairing the ligament (sewing it back together) as an alternative treatment.  Rest and directed physical therapy can help in some cases, and should usually be tried before surgery.
How can parents help kids protect their elbows? The best defense against getting an elbow injury is to not overdo overhead athletics, such as pitching.  Pitch counts in youth baseball is there to protect the player's elbow, and is not something to "try to sneak around a pitch count".  If a young athlete starts to complain of elbow pain, have them stop doing the sport that is hurting their elbow, and seek consultation with a sports medicine physician.

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