Elbow injuries in throwers have been a problem since the beginning of baseball.  However, more recently elbow injuries in throwers have been better evaluated and better treated so these throwers can get back to their normal activities. 

This started in 1974 when 31-year-old Tommy John had an injury to his elbow.  A pioneering procedure, done by Dr. Frank Jobe in Los Angeles California, took a tendon and reconstructed and stabilized the inside portion of Tommy John’s left elbow.  Tommy John, although not a hard thrower, had an excellent career and pitched for six or eight more years (2500 innings) after he had his ligament reconstruction.  What is not known is that Tommy John had a significant struggle after his reconstructive surgery in 1974 and had multiple operations.  He endured these operations and came back and had a wonderful career not only with the Los Angeles Dodgers, but also with the New York Yankees.  It was this stage in the reconstruction, in the aspect of his left elbow, that opened the doors and the floodgates for other pioneers in elbow reconstruction in baseball injuries like Dr. James Andrews in Birmingham Alabama and Dr. Timothy Kremchek in Cincinnati Ohio.

Because of the success of this operation, professional pitchers are able to have reconstructive procedures, as well as many younger patients, and come back to continue their careers and continue to throw for many years.

At the Beacon Orthopaedic Center in Cincinnati Ohio, Dr. Timothy Kremchek has been taking care of baseball injuries for the past ten years.  He has done numerous procedures on professional athletes at the major league level and other well known athletes.  He has seen a continual rise in the young athletes injuring their elbows and needing reconstructive procedures to prolong their baseball playing days.  Many of these injuries years ago were not treated surgically and these youngsters went onto stop playing baseball and find other ways to spend their time.  It is Dr. Kremchek’s objective to be able to treat these injuries with state of the art reconstructive procedures if necessary, but his main goal and his mission in his career in treating baseball injuries is to prevent these injuries from ever happening. 

Although the state of the art and very elegant procedures that are performed to get these youngsters back to play are truly an aspect of medical technology at it’s finest, the goal would be to prevent these injuries.  Dr. Kremchek believes that proper education of coaches, parents and the young athletes will help decrease and hopefully prevent these elbow injuries from occurring.  He has, through the Beacon Orthopaedics Center, developed a number of guidelines that coaches and parents can have when addressing their children playing overhead sports and pitching such as pitch counts at certain age groups and the ability to throw certain pitches at a certain age group to place less stress on the elbow.

Dr. Kremchek, and many others in his field, believes that overuse at a young age, throwing too many pitches per season, throwing too many “junk” pitches such as curve balls and sliders are going to cause injury, permanent injury, and possibly surgical procedures for these youngsters.  It is important to understand and limit the number of pitches per pitcher per year and limit the number of innings.  It is also important to use proper mechanics in the legs, the body and the shoulder and the proper conditioning preseason and during the season and the proper guidelines as far as throwing pitches such as curve balls, sliders and other breaking balls that places significant stress on the elbow.  By addressing these issues, Dr. Kremchek hopes to never see a youngster below the age of 15, or any youngster for that matter, in his office that will need a surgical procedure.  If this can be completed, if we can sanction the leagues and legislate such activities such as pitch count, types of pitches thrown at different age levels, number of innings pitched and games pitched per year, then the goal of preventing these injuries in our young baseball players will be accomplished.  We all hope that this day will come and the technology that we need and use to get our baseball players to play will be only used for those major league and professional baseball players that do this for a living and will allow our youngsters to continue playing the game of baseball, “America’s Pastime”.