By Cory Armstrong-Hoss / Herald Forum

I’m worried about my son’s arm.

Specifically, I’m worried about the ulnar collateral ligament (UCL) on his right arm, a triangle shaped ligament on the inside of his elbow.

He’s a right-handed baseball pitcher in Wesco athletics, and the injury rate for kids like him — trying to throw hard, trying to get noticed and make it to the next level — has never been higher.

First, a little background on UCL injuries and why they’re increasing so quickly:

During pitching the UC ligament is “subjected to tremendous stress and injury if the force on the UCL … exceeds the physiological limits of the ligament” Players with UCL tears can opt for “Tommy John” surgery — named for a former MLB pitcher — a procedure to repair a torn UCL, pioneered back in 1974. “The surgery … repairs the elbow [by] removing a tendon from the thigh or forearm and grafting it into the elbow to reconstruct the damaged ligament.”

A 62-page report released last month by Major League Baseball found that “injuries sustained by pitchers in professional and amateur baseball have increased substantially over the past several decades.” The authors interviewed more than 200 experts, including MLB pitchers, orthopedic surgeons, college coaches and athletic trainers, and found a multitude of factors that’ve led to the current arms race, and a ton of concerning data.

For example: the number of major and minor league UCL surgeries jumped from around 100 in 2010 to 240 in 2024. Concurrently, youth players experienced a similar dramatic increase. At Andrews Sports Medicine & Orthopedic Center in Alabama, the percentage of UCL procedures for youth and high school pitchers has risen from under 10 percent of total Tommy John surgeries in the mid-1990s to over 40 percent in 2023. One surgeon interviewed shared that young pitchers “figure it’s worth it, it’s what I’ve got to do to be an elite pitcher, which is to throw 100 mph on every pitch or as hard as I can … and take my chances, and if I get hurt I’ll get it fixed.”

Kids today feel pressure to throw harder, at a younger age, than at any point in baseball history.

What’s driving these trends? Here are three big factors:

The relentless focus on increased velocity and maximum effort. Scouts, college coaches and private baseball academies reinforce the need for young pitchers to get their fastball to 90 mph as soon as they can. Places like the Texas Baseball Ranch will gladly take our money — $3,000 for a three-day Elite Pitchers Boot Camp — to help our son “break the 90-mph barrier.”

At the same time, coaches at the highest levels are moving away from one durable starter pitching six innings, generating weak hits to the infield or easy pop-flies. Instead, managers now go to their bullpens early and often. They expect each hurler to throw max effort for two to three innings before they bring in a new arm.

An orthopedic surgeon sums up the issue: “Anybody who works in baseball agrees on the main driver of pitching injuries; velocity. Velocity places more stress on the elbow.”

The emphasis on good “stuff”: In baseball, “stuff” is a “term that describes composite movement characteristics of pitches, including horizontal movement, vertical movement and spin rate.” Throwing good stuff like a curveball or sinker requires either pronation, where the forearm rotates inward, or supination, where the forearm rotates outward, all of which “exposes the UCL to increased forces.”

Jeff Passan, a sport journalist who’s covered the surge in pitcher injuries for years, believes that the rash of pitching injuries is, in part, a result of the focus on killer stuff, “of men pushing themselves to do something the body never intended it to do.”

Metrics vs. wins: The key statistics used to evaluate pitchers have changed, and technology accelerates the problem. Instead of wins and durability — pitchers who can give you six or more innings in 30 starts a season — pitchers are now measured on velocity, spin rate and stikeouts. Pitchers at many levels of the game, including my son’s, can get reports from specialized training centers, with data from radar guns and iPads. One former MLB pitcher shared that athletes competing for a roster spot are always being measured: “With all the Rapsodo [cameras] on pitchers from day one in spring training, it’s very hard not to go close to 100percent. … They’re tracking everything you do.”

I’ve seen coaches squeeze out over 100 pitches from a 12-year-old starter in a tournament game. I’ve heard stories of young men in their 20s with blown-out shoulders or elbows, adults who couldn’t play in a co-ed softball league, after devoting years to the game.

I need to balance the dreams our son has now with the ones he has yet to imagine.

When my son’s baseball ride is over, I want him to live without pain. To shoot hoops in a rec league, swim at Silver Lake, or hit golf balls with his friends at Top Golf.

And be able to pitch to his own kid one day.

Cory Armstrong-Hoss lives in Everett with his wife and three kids. His kids have played a number of different sports. He’s a lifelong athlete, and he’s served as a coach, ref, and youth sports administrator. Find him at substack.com/@atahossforwords