HOUSTON – When Astros’ pitchers Cristian Javier and José Urquidy went down last month with Tommy John surgery, there were questions about whether or not that specific injury is on the rise.
The short answer: Yes.
However, it’s not just with major leaguers. Throwing-based arm injuries are surging with a demographic of pitchers that experts say were rarely mentioned just a decade ago: teenagers.
Houston is considered by many as arguably the largest youth baseball market in the nation. The city’s weather allows the sport to be played throughout the year by select baseball players as well as little leagues that play spring and fall schedules.
Because of this, pitchers are being stretched to their limits like never before, pushed—in search of wins, scholarships and big-league dreams—by parents and coaches who do not have the proper knowledge on arm care.
As a result, major league injuries are occurring years before major league dreams become a reality. Significant arm injuries for baseball pitchers are growing in regularity, according to one local physical therapist.
“I’d say I see anywhere from four to five new patients a week under the age of 18, for throwing injuries,” said Corbin Hedt, a physical therapist with Houston Methodist.
One of Hedt’s patients is Daniel Valenzuela Jr., who told KPRC 2 digital producer Michael Horton about the shock of being diagnosed with a serious elbow injury.
“I was just in awe; I couldn’t believe it,” he said.
Valenzuela is not the only Houston-area teen we spoke with; Will Young is a recently graduated pitcher who had Tommy John surgery at the age of 17. Both have had to undergo extensive therapy to rehabilitate their ulnar collateral ligaments, or UCLs.
“That was from my first surgery” said Young, as he pointed to a scar inside of his right elbow.
The tear of the UCL usually happens after heavy pitching workloads, whether in practice or at play. Most athletes are completely unaware as to how easily it can happen—until it is too late.
“We hear about it, right, whenever half the Astros roster goes out on the IL,” said Hedt, adding that most parents tend to think of the injury as one that only affects major league pitchers.
Dr. David Lintner, the medical director for the Houston Astros and the former president of Major League Baseball’s Team Physician Association, has been alarmed with number of young Houston-area kids in need of Tommy John Surgery.
“What we really struck me, is when we started to see the 15-year-olds, the 14-year-olds, the 13-year-olds, the 12-year-olds show up with ligament injuries that could require a Tommy John surgery,” said Lintner.
That is when, Lintner says, reality hits hard for the parents and the young athletes involved.
“It is heartbreaking—ACLs or UCLs especially—to see the anguish on the athlete’s face and their family,” said Lintner.
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Dean Doxakis has seen the anguish time and time again.
“When things are going really well, people don’t normally seek out help, but when things aren’t going well, is when they start looking for help, and they usually come here,” said Doxakis, who serves as vice president of Tom House Sports, the company that operates the National Pitching Association.
He is also considered one of the foremost pitching performance coaches in the nation by both professional players and physicians.
“There are a lot of doctors that trust me, because I have more experience in the field than them,” said Doxakis.
Protecting a pitcher’s arm involves several strategies, including increasing functional strength, enhancing mental and emotional performance, improving nutrition and being aware of biomechanical movements when on and off the mound.
“That mound, just that 10-inch rise, that incline is adding six-times body weight to the arm, to the elbow specifically,” said Doxakis.
So, what does a pitching session with Doxakis and his team look like?
A lot of arm care exercises to start. In fact, the first 25 to 30 minutes of a session captured by our cameras were spent on exercises where no pitch was thrown off a mound.
Young was taken aback by the approach when he first saw it in action.
“It’s like a ‘What?’ reaction,” Young said. “You wouldn’t think that. Most people, when they go to pitching lessons... [Pitchers] walk-in, stretch your arm then get on the mound, but that is not going to lead to the benefits that you want it to lead to.”
At the end of the day, the benefits are simple: consistent strikes while avoiding an arm injury that may require Tommy John surgery.
For Doxakis, the process begins with a mental approach, long before a ball and glove ever get picked up.
“You shouldn’t throw to train, you should train to throw, and that’s boring and it’s tedious and it’s hard work, but that is what takes to be a health-first performance model,” said Doxakis.
While it is easy to blame a coach or parent for causing Tommy John, the simple solution according to experts we spoke with, is education. A player along with their parents and coaches should be armed with the knowledge as to how much a pitcher should and should not be throwing.
One Houston Little League already is taking precautionary measures to help reduce the potential of one of their young players developing arm injuries.
According to one of its members, Bellaire Little League has an orthopedic sports physician attend the mandatory meeting held at the beginning of each season to inform coaches of the potential risk for injuries and how to avoid them.
Full disclosure: KPRC 2 Investigates reporter Mario Diaz first researched Tom House Sports over a decade ago. In fact, one of his former interns in New York City moved to the Los Angeles area to work with House and his team. For Diaz, this assigned investigation was personal. He too is the father of 12-year-old pitcher, Hudson. At least five kids that Hudson knows, including Valenzuela who was mentioned in the piece, have suffered from significant arm injuries that sidelined them from the diamond for periods of time. Hudson also is client of Doxakis and his team at the National Pitching Program.
