The Hidden Epidemic: Why UCL Injuries Are Rising Across All Levels of Baseball
Beyond The Cut: A Blog Series Dedicated To UCL Injury Risks
It’s a familiar yet gut-wrenching scene — a young pitcher, barely 10 years old, feels a sharp pain in his elbow during a late-inning game. The diagnosis? A torn ulnar collateral ligament (UCL). This injury, once rare and confined to seasoned MLB veterans, has become a devastatingly common story across all levels of baseball. In 2023, more professional pitchers underwent Tommy John surgery than in the entire decade of the 1990s combined. At the youth level, the statistics are just as alarming: 20% of young baseball players (ages 9–15) seek medical attention for elbow pain every year, and half of those cases stem from preventable overuse injuries.
What’s fueling this epidemic?
From the relentless pursuit of velocity to year-round specialization, baseball has evolved in ways the human body can’t always keep up with. As the Head Team Physician for the New York Yankees, I’ve witnessed this crisis unfold firsthand. In this blog series, we’ll explore why UCL injuries are skyrocketing and, more importantly, how we can protect the next generation of players.
The Numbers Behind the Crisis
In 2022 alone, Major League Baseball (MLB) teams spent $486 million on players sidelined by elbow injuries, totaling 30,728 lost days of play. But the problem starts long before the professional level:
• 74% of youth baseball players report arm pain while throwing.
• 80% say the pain lingers into the next day.
• Nearly 1 in 4 high school players will experience a UCL injury by graduation.
The data paints a stark picture: UCL injuries are no longer just a risk — they’re a near inevitability for many pitchers.
Why Are Injuries Skyrocketing?
1. The Pursuit of Velocity
Pitchers are throwing harder than ever before. The average fastball velocity in MLB has increased by 3.5 mph since 2002, with many players routinely breaking the 100-mph barrier. This emphasis on power places extreme stress on the UCL, often exceeding its natural limits.
2. Year-Round Specialization
Youth players are specializing in baseball earlier and playing more games year-round, often without adequate rest. This relentless schedule prevents the UCL from recovering properly, leading to overuse injuries.
3. Early Pressure to Perform
The pressure to secure scholarships or draft opportunities pushes young athletes to prioritize short-term performance over long-term health. Many play through pain, ignoring early warning signs of damage.
The Human Cost
Behind every statistic is a story of a young athlete facing surgery, months of recovery, and the uncertainty of ever playing again. Take the case of a high school pitcher I treated earlier this year. At just 17, he had already undergone two elbow surgeries. His dream of a professional career is now uncertain, not because of a lack of talent but because his body was pushed too far, too soon.
A Call to Action
If we want to preserve the future of baseball, we must act now. This starts with:
• Educating players, parents, and coaches about the risks of overuse.
• Implementing rest and workload limits at every level.
• Rethinking the emphasis on velocity and year-round competition.
By understanding the forces behind this epidemic, we can break the cycle and give young athletes the opportunity to thrive — not just on the mound, but in life.
Stay tuned for next week’s blog, where we’ll dive into the anatomy of the UCL and why it’s so prone to injury.
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