2016.12.23
Updated 2017.2.10

While the increasing numbers of pitchers who require Tommy John surgery is troubling, at the end of the day it isn't that big of a deal. In the worst case, the Tommy John Twist can mean retired pitchers have trouble combing their hair or brushing their teeth with their pitching arm, or their shoulder aches when it's going to rain, when their playing days are over.

Matt Harvey 2014

The far more troubling part of the epidemic is the hockey-sticking increase in the incidence of Thoracic Outlet Syndrome, a problem that can lead to disability or even death.

pitching-induced Thoracic Outlet Syndrome

I have identified a number of tricks, shortcuts, and general movement patterns that pitching coaches employ because they often yield quick velocity boosts. The problem is that these tricks and shortcuts work by overloading and pushing pitchers' arms to the limit.

And, as I discuss in The Epidemic, increasingly beyond it.

What's worse, it seems that these problematic tricks, shortcuts, and movement patterns may be causing problems beyond just elbow and shoulder problems.

By that I mean problems like Thoracic Outlet Syndrome (TOS).

Why do I say the incidence of Thoracic Outlet Syndrome in baseball pitchers is hockey-sticking? According to one source, there were...

  • 7 cases of TOS in M/MiLB pitchers from 2001-2015.
  • 6 cases of TOS in M/MiLB pitchers during 2016 alone.

Another source says 13 MLB pitchers underwent surgery for TOS from July 2001 through July 2014, which is far less than the current trend of at least 7 cases of TOS in 2016.

While Dr. Glenn Fleisig of ASMI has been receptive to some of my observations and suggestions, the Mayo Clinic continues to advocate what in my opinion is an at least ahistorical, and in my opinion problematic, movement pattern called the Power Position.

Mayo Clinic Pitching Power Position

Mayo Clinic Pitching Power Position

In my opinion, the Mayo Clinic is selling as safer a movement pattern that is instead extremely dangerous and perhaps life-threatening, likely because they are blindly following and advocating, rather than questioning, the Stinkin' Thinkin' that characterizes the conventional wisdom abut pitching mechanics.

That's something that you'd hope a prestigious institution like the Mayo Clinic wouldn't be vulnerable to, but nobody seems to be thinking particularly well about pitching mechanics and injuries at the moment.

What's the big deal, beyond career-ending injuries?

The Problem

I believe pitching-induced Thoracic Outlet Syndrome (piTOS) is the result of problematic cues like...

  • Get your elbow up.

...and a general movement pattern that I call the...

Telling pitchers to get their (Pitching Arm Side) elbow up can lead to a problem that I call...

I lay out the terrifying implications of Pitching Induced Thoracic Outlet Syndrome in...

Incidence

College, minor, and major league baseball pitchers who experienced Thoracic Outlet Syndrome, Paget-Schroetter’s syndrome, or blood clots  include...

1980 J.R. Richard
...
...
...
1988 Dennis "Oil Can" Boyd
...
...
...
1994 Kevin Rogers
...
...
1996 David Cone
...
...
...
2001 Kenny Rogers
...
...
2004 Aaron Cook (pulmonary embolism)
...
2006 Tom Glavine
2006 Kip Wells
...
2008 Jeremy Bonderman
...
2009 Matt Harrison
2009 Noah Lowry
...
...
2011 Taylor Hammack
2011 Tom Lemke
2011 Bobby Parnell
...
2012 Chris Carpenter
2012 Dillon Gee
...
2013 Josh Beckett
2013 Shaun Marcum
2013 Clayton Richard
2013 Chris Young
...
2014 Jaime Garcia
2014 Drake Curry
2014 David Thompson (POSITION PLAYER)
...
2015 Mike Foltynewicz
2015 Dominic Taccolini
...
2016 Cam Bedrosian
2016 Richard Castillo

2016 Matt Harvey
2016 Luke Hochevar
2016 Phil Hughes
2016 Tyson Ross
2016 Kyle Zimmer

Some of these cases likely have a genetic/physiological basis. However, I am concerned that the incidence of Thoracic Outlet Syndrome in baseball pitchers is likely rising due to how baseball players are being taught to throw and pitch.

Mike Foltnewicz Pitching Mechanics

Mike Foltynewicz

Mike Foltynewicz's problem is particularly troubling because it doesn't involve (pronounced) Hyperabduction. Rather, his flaw is Premature Pronation and the Tommy John Twist as a result of following the common cue to Point the Ball at Second Base.

How Dominant & Durable Pitchers (Actually) Throw

Pitching-Induced Thoracic Outlet Syndrome often results from a misunderstanding of how great pitchers (actually) throw the ball.

Justin Verlander

Notice how, into foot plant, rather than getting his pitching arm side elbow up ABOVE the level of his shoulders, Justin Verlander's Pitching Arm Side elbow is just BELOW the level of his shoulders.

Justin Verlander

Root Causes

Pitching-induced Thoracic Outlet Syndrome can result from a number of things...

References