Tommy John surgery. Three words no athlete, or coach for that matter, wants to hear. However, over the last decade or so that’s exactly what athletes are starting to hear.
    According to recent studies, the rate at which the procedure is done in youth and high school sports, especially baseball, has dramatically increased.
    According to studies from the American Sports Medicine Institute, Tommy John surgeries performed on youth and high school athletes at Andrews Sports Medicine increased from zero percent in 1994 to 23 percent in 2015.
    The baseball season across Georgia and in Bulloch County is in full swing and local coaches are trying to combat what seems to be an ongoing trend in elbow injuries.
    “Honestly and truly, I haven’t heard of arm injuries until now. I never heard of anyone that had an elbow or arm injury until I got into college,” said longtime baseball coach and Bulloch Academy head baseball coach Chris Bishop. “Now if you got out and watch kids play, you either hear of someone having a UCL tear or a UCL strain. It doesn’t take a doctor to see there’s an increased trend.”
    The UCL, or Ulnar Collateral Ligament, surgery is known as Tommy John surgery after Los Angeles Dodgers pitcher Tommy John, who underwent the first UCL reconstruction procedure nearly 40 years ago.
    Since then, doctors have noted that younger athletes are pitching more in today’s game. The increased volume of pitches have added to the increase in surgery, the ASMI reports.
    Bishop said he was a multisport athlete at Hephzibah High School. His parents gave him a choice — play multiple sports, or get a job. For Bishop, the choice was easy.
    “I didn’t want to work so I tried to play basketball. I wasn’t very good at it,” Bishop said, candidly. “We played at least three sports. If I played football, I was resting my other body parts. Now you have kids that specialize in one sport. Dr. James Andrews talked about [UCL injury] prevention. He says every time you throw the baseball, it’s the same arm slot, the same way, the arm is decelerated the same way. Over a period of time, something is going to break.”
    Awareness and pitching regulations are helping curtail the ongoing trend. According to the ASMI, Tommy John Surgery among high school and young athletes have decreased nine percent from an all-time high of 32 percent in 2008.
    In the 2015-2016 GHSA handbook, high school pitchers are limited to a maximum of 10 innings in a calendar day. Pitchers are also limited to a maximum of 14 innings in four consecutive calendar days.
    “It is always one of the toughest decisions on when to take a pitcher out,” said Portal baseball coach Dennis Moore. “You have to trust your instincts as a coach and you have to have a feel for your pitcher.”
    Moore’s Portal Panthers are led by pitching aces Jake Brown and Cole Busby. During the course of the current season, the duo has combined for 57 total innings pitched with 79 strikeouts.
    Moore said his staff has developed a system to make sure none of his pitchers strain themselves.
    “We don’t like them to go past 100 pitches [in a game] and the other guy will close out that game. So in seven innings, we should be around 130 pitches. Friday we reverse it, and the closer becomes the starter,” Moore explained.
    Tommy John Surgery has a high success rate — around 80 percent — but according to the American Journal of Sports Medicine, 20 percent never make it back to their previous level of performance.
    Coach Bishop, a baseball coach of 25 years, said it’s important for parents and coaches alike to research and try to prevent potential injury.
    “I ask [my pitchers] on a scale of  1 to 10, how does their arm feel. If he doesn’t tell me 10, he’s not going to the mound,” Bishop said. “If he doesn’t say 10, then that means in the back of his head, something isn’t right. In 20 years, I’ve never had an incident. I’m not trying to brag, but I pride myself on that.”