Juvenile arthritis is the term used to describe arthritis in children younger than 16 years. Juvenile arthritis is twice as common in girls as boys and the most common type is juvenile idiopathic arthritis (JIA). Juvenile idiopathic arthritis is an autoimmune disorder affecting the joints of the knee, hands and feet. It causes pain, swelling, stiffness, and feeling of warmth in the joints. The probable causes of JIA include autoimmune condition, genetic factors, and environmental factors.
Golfers elbow, also called Medial Epicondylitis, is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and microtears in the tendons that attach to the medial epicondyle. The medial epicondyle is the bony prominence that is felt on the inside of the elbow.
Pitching in his fourth game in three days, Matt Blaney headed back to the mound for the last two innings of a travel-league championship game because that was where his competitive drive steered him.
It didn’t matter that Blaney’s Chicago-area team led 9-0. It didn’t matter that Matt’s father, Tom, kept trying to make eye contact with his son in the dugout to give him the signal to stop throwing. It didn’t matter that, at the time, Matt was 14.
This was baseball life as the Blaneys knew it. This is the reality many families of promising pitching prospects live, a dangerous mindset that plagues all levels of the sport and contributed to Illinois becoming one of 44 states to impose pitch limits on high school hurlers.
“I’d motion to Matt with my fingers to my neck, like, ‘OK, cut it off now,’ and he would shake his head no,” recalled Tom, who accepted responsibility for not being more assertive. “On the way home from games like that, we’d get ice on his shoulder and arm. He’d be like, ‘Dad, I’m not coming out. If they want me to go, I’m going.’ I was like, ‘You’re going to hurt your arm.’ ”
Tom’s words proved prophetic in August 2015 when his worst fears were realized. At a summer-league game on the Illinois-Chicago campus, Matt struggled with command. The right-hander’s 85-mph fastball lacked its normal zip, suspicions confirmed by the ever-present radar gun that registered 78. At a tournament in Kentucky a week later, the wildness continued.
“My body felt I was throwing hard, but there just wasn’t any velocity,” Matt said. “It really dipped. Something was wrong.”
A recommendation landed Matt in the capable hands of Dr. Mark Cohen, a surgeon at Midwest Orthopaedics at Rush respected for his experience dealing with elbow problems. Cohen advised six months of rest, with the hope of avoiding surgery, but an MRI after the layoff confirmed the inevitable. If Matt ever wanted to pitch again, he would require Tommy John surgery — which replaces the elbow’s ulnar collateral ligament with a tendon harvested elsewhere in the body.
“My dad and I looked at each other and thought, ‘Oh, God’ …more devastation than anything,” said Matt, who underwent surgery May 10, 2016.
“When I started 24 years ago, we’d see one or two (teenage Tommy John patients) a year, but now we’ll see four or five in a week every summer,” Cohen said.
The surgery has evolved into such a popular, proven alternative that Cohen knows of young pitchers who have sought the procedure to improve their performance. He chuckled at the recollection.
“The myths are incredible and, yes, we have parents and kids coming to essentially become bionic and see the surgery as almost a rite of passage,” Cohen said. “They all know one of three major-league pitchers has had Tommy John surgery, so it’s something they perceive as advantageous. Of course, it’s all false. You don’t throw harder after Tommy John surgery. You throw back to your potential.”
Matt Blaney’s pursuit of his own potential continued this week back at practice for Lincoln-Way East. A 5-foot-9 senior hoping for appointment to the Naval Academy, Blaney expects to slowly build back arm strength by pitching in relief by the end of the month before working his way back into the rotation.
“It will be long-awaited,” he said.
A 6-inch scar on his right elbow serves as a constant reminder for Blaney, the first to admit the ordeal strengthened more than his arm. He credits the mental toughness necessary for rehabilitation for making him a better student and a smarter pitcher who learned to throw to contact. He blames nobody but himself for piling up innings that eventually converted him from pitcher to patient.
“I don’t think I was overused; I was a competitor,” he said. “I wanted to stay in games. I always wanted to go the next inning. Coaches would let me keep pitching, but they were only doing what I asked to do.”
Hopefully, the new IHSA rule making emotion moot and limiting the number of pitches to 105 per game — with four days’ rest mandated after throwing the maximum — results in a trickle-down effect. Too much glory surrounds extreme examples such as Illinois State pitcher Brady Huffman throwing 167 pitches for Genoa-Kingston High in a 10-inning game last spring. The legend of Kerry Wood’s 175-pitch outing for Grand Prairie, Texas, in a 1995 high school regional always should be more instructive than entertaining.
“I’d like to see the rule applied to every level of youth baseball,” Lincoln-Way East coach Paul Babcock said of pitch limits. “Most high school coaches would agree.”
“Nowadays, there’s such a premium placed on winning that you hope the people making these decisions respect the parameters,” Cohen said. “We need coaches, families and kids on board. Guidelines are only as good as the people who follow them.”
The IHSA implementing more to protect young arms represents a quality start.
Improve your Understanding of Trimming of Torn Labrum with this 3D Animation and Brochure
The shoulder is a complex multi-directional ball-and-socket joint which allows movement in many directions. Shoulder instability and dislocation occur when the shoulder capsule is stretched or torn, and/or when the labrum is detached from the glenoid.
Visit our Patient Education page for the full Library of 51 specific Orthopedic Surgical Procedures in 3D Animation. Produced by an experienced team of medical writers, 3D animators, and project managers with a detailed understanding of anatomy and surgery; they take complex surgical procedures and animate the steps to tell a visually stunning story in 3D that is both educational and entertaining. Each animation is embedded with an illustrated script which can be shared, viewed or printed separately.