Is UCL reconstruction an epidemic for Major League Baseball?
The problem is by the time they get to us in professional baseball, the damage has already been done in most cases. The answer to prevention must start in the little leagues and extend all the way into the Major League training room. The big key is education. We want to educate coaches, parents, and kids on limiting the amount of throwing that kids do at a young age. We want to teach them about pitch counts. We don't want them to play overhead sports year round. Have them play another sport, but don't have them throw the javelin as the other sport. No extra showcases or radar gun sessions should be done. Don’t allow them to pitch when fatigued. Pitch Smart or Throw Like a Pro has recommended pitch counts for the respective age group, and other important information.
For us as clinicians, as far as prevention, it's good to do screens all players. You can use the FMS, the SFMA for imbalance assessments, or whatever you guys tend to use for these specific screenings. You're always going to look at shoulder flexion, rotation, and horizontal adduction and you want to design prevention programs that stress shoulder and scapular strength as well as dynamic forearm strengthening. You need to keep an eye on mechanics. You want to give your athlete a day off if fatigued. The big thing with this game is, as far as prevention is that UCL injuries are still going to happen. It's the nature of the game because you're not going to be able to change that hundred newton-meters of force that's put on the elbow, 55 of them being absorbed by the UCL, and the UCL pretty much breaking at 32. You're not going to be able to change that. But, if we can kind of make everything else around there operate more smooth, and strong to protect it, there's a chance that hopefully, we start seeing some of these numbers come down over the next several years, and that's our goal right here.