Have you ever tweaked a muscle and you knew right away something wasn’t right? That’s exactly what happened on July 8,2014 while playing the Indians Masahiro Tanaka, the NY Yankees huge off season pitching acquisition left the game knowing something wasn’t right. An MRI on his elbow revealed a partial tear of his UCL and a faced a tough decision as to how to treat it.
Surgery or no surgery, that is the question.
The UCL or better knows as “Tommy John Ligament” is a relatively small ligament on the inside of your elbow that resists the tremendous forces created by pitching. Studies have revealed that every pitch thrown has enough force to tear your UCL if there was no help from the secondary stabilizers such as bones and other surrounding soft tissue structures. If this ligament is compromised and does not do its job, the surrounding soft tissue structures, flexor-pronator muscles will have to work harder to support the medial elbow. Additional work will have to be done along the kinetic chain, especially the shoulder to make up for the loss of velocity. It is no surprise that Tanaka recently started to have general arm soreness after mound progression and simulated game throwing.
In our opinion, he will most likely wind up going under the knife to repair this torn ligament and could very well return next year as the dominant thrower he left as. I do understand and respect the Yankees decision to try non-op rehabilitation as current literature has shown that the return to play rates for UCL reconstruction are not as high as once thought. That discussion will be for another post.
As sports medicine professionals, it’s our job to identify those at risk of UCL injuries. At Accelerated Physical Therapy we have video analysis systems that can identify flaws in mechanics and help correct them before the body breaks down. We film youth baseball pitchers throughout the Midwest to help put the brakes on this injury that continues to plague America’s pastime.