Tommy John Surgery in Young Athletes: What Parents Need to Know

At our pediatric physical therapy office, we often work with young
athletes recovering from injuries. One of the most talked-about
surgeries in youth baseball is Tommy John surgery, a procedure
to repair the ulnar collateral ligament (UCL) in the elbow. While this
​surgery can be successful, the best approach is injury prevention--
starting with Dr. Brianna's proper pitch count guidelines for kids.

What is Tommy John Surgery?
Tommy John surgery, named after the MLB pitcher who first underwent the procedure, is a reconstructive surgery that replaces a damaged UCL with a tendon from another part of the body. This injury is most common in baseball pitchers due to the repetitive stress placed on the elbow during overhand throwing.

Why Are Kids Getting Tommy John Surgery?
The increasing frequency of Tommy John surgery among young athletes is concerning. Overuse, improper throwing mechanics, and lack of adequate rest are major contributors. Specializing too early and playing year-round baseball without breaks can significantly increase the risk of UCL injuries.
​
Pitch Count Guidelines for Injury Prevention
One of the most effective ways to prevent UCL injuries is to follow established pitch count recommendations. The guidelines from organizations like Little League Baseball and USA Baseball help ensure that young pitchers do not overwork their developing arms. Here are some general recommendations:
·Ages 7-8: 50 pitches per game, 75 per week, and at least two days of rest after 20+ pitches.
·Ages 9-10: 75 pitches per game, 100 per week, and at least two days of rest after 20+ pitches.
·Ages 11-12: 85 pitches per game, 100 per week, and at least three days of rest after 35+ pitches.
·Ages 13-16: 95 pitches per game, 125 per week, and at least three to four days of rest after 40+ pitches.

Additionally, young pitchers should avoid throwing breaking balls (like curveballs and sliders) until their arm is more developed, typically around age 14-16.

Strength and Conditioning for Injury Prevention
Physical therapy and targeted strength training can help reduce injury risk. Exercises that focus on shoulder stability, core strength, and proper throwing mechanics are key components of injury prevention. Stretching and recovery routines are equally important in keeping young athletes healthy.

 
​While Tommy John surgery can help athletes return to the game, prevention is always the best strategy. Parents and coaches should monitor pitch counts, ensure proper rest, and encourage young players to participate in multiple sports to avoid overuse injuries. If your child is experiencing elbow pain or discomfort, early intervention with a pediatric physical therapist can make all the difference. 

At our clinic, we specialize in helping young athletes stay strong, recover effectively, and prevent injuries. Contact us today to learn more about injury prevention programs for your child!