Hard-throwing teens draw scouts, scholarships. More and more, they may also need Tommy John surgery

Updated Mar. 15, 2024 6:00 a.m. ET

Associated Press

TEMPE, Ariz. (AP) — Most teenagers celebrate their high school graduation with friends, family and maybe a party.

It's been nearly 50 years since the game-changing procedure — which reconstructs a torn ulnar collateral ligament in a pitcher's elbow — was first performed by Dr. Frank Jobe on Tommy John's left arm in 1974. Since then, over 2,200 pros have tried extending their careers with the operation, most of them successfully.

In a more recent development, it's also helping teenage baseball players — some as young as 14 — get back on the mound after injuries early in their playing careers. Compton was 18 when he had the surgery on May 26, 2022, following his senior season in high school.

“Mentally, it killed me,” Compton said. “And I bet it’s the same for everybody. You’re a young player, you’re going into college at a Power Five program, you’re going to win all the time. That’s not how it worked out.”

But two years later, he's playing baseball for Arizona State.

Compton's not alone in his early Tommy John journey. In 2023, there were 23 players selected in the first 10 rounds of the MLB amateur draft who had already had the procedure, one year after a record 31 players in 2022. To compare, just three players fit that description in the 2011 draft.

The relative success and normalcy of the surgery has been a boost for dozens of careers. But why do so many more young players need Tommy John?

“The past 15, 20 years, there’s been a large increase in the number of tears,” said Dr. Braiden Heaps, who works in the Phoenix area. “And they’re getting younger."

Dr. Gary Waslewski — who works with the Arizona Diamondbacks — said there are a number of factors that can cause a young baseball player to suffer an early elbow problem, including overuse, which has long been blamed for injuries.

Another culprit is something Waslewski called “chasing velocity," which he defines as trying to add a few more miles per hour to a pitcher's fastball before a teenage body is ready. Waslewski did his fellowship for legendary orthopedic surgeon Dr. James Andrews in 1998, so he's been doing Tommy John surgeries about 25 years.

Waslewski said young players should be very wary of throwing with weighted baseballs or attending camps that promise to add velocity in a short period of time.

“Velocity is the worst thing for the ligament,” Waslewski said. “Especially artifically trying to get your velocity up quickly. One of the biggest risks to ligament damage is a big personal gain in velocity. It's not how hard you throw — but these big jumps in personal velocity over a short time are very damaging to ligaments.

“It's definitely part of what's driving some of the younger injuries. Velocity kills elbows.”

Hayden Hurst's personal Tommy John story fits that profile — he had the surgery at 14 after his eighth grade school year. The 30-year-old is now an NFL tight end for the Carolina Panthers, but in his teenage years, he was a high-level baseball prospect and eventually pitched in the Pittsburgh Pirates organization for a couple seasons.

Hurst said he wasn't chasing velocity as Waslewski described, but grew so quickly during his junior high years that he was 6-foot-1 by the time he was 14 and able to throw much harder than before.

“I was this eighth grader throwing 90, 91 mph,” Hurst said. “It was crazy.”

Sure enough, Hurst's elbow gave out.

“The lucky thing for me is it happened when I was so young, so naive,” Hurst said. “Twelve months for a 14-year-old, you’re just like, OK, well I can play video games. Honestly, it flew by."

It's understandable why young pitchers are trying to light up the radar gun. Pushing a fastball from 85 mph to 89 mph — even just for one pitch, if seen by the right scout or recorded by the right computer — could be the difference in getting offered an NCAA Division I scholarship or getting noticed for the draft by MLB teams.

Waslewski said that young pitchers seeking more velocity should wait for their bodies to mature and do it the old-school way — with long toss. It's basically just playing catch, but slowly increasing the distance during a session so that eventually the player is throwing the ball as far as possible. Waslewski said long toss allows the shoulder to build strength more naturally and doesn't put as much stress on the elbow.

Heaps said one good development over the past 15 years is that teenagers already understand a big chunk of the Tommy John process when they walk through his door. Both Waslewski and Heaps said that because the surgery requires such a long recovery, they'll only do the procedure on teenagers who have a future in the sport.

“You’re doing a surgery to get a kid a free education, or helping him as a professional prospect,” Waslewski said.

Otherwise, he said, the surgery is largely unnecessary. A torn UCL isn't the end of the world unless you're trying to throw 95 mph.

“You can do everything in life except throw a baseball at maximum velocity,” he said.

Waslewski said if a teenage baseball player has the right mindset coming back from Tommy John surgery, he can thrive. Compton was one of those players, attacking the rehab with passion as he worked to get on the field with Arizona State.

“I can focus on eating well, stretching, lifting,” Compton said. “Doing everything I can to be as good as I can a year from now. I’m super fortunate to be here."

Though he's still working to come back as a pitcher, Compton's already found a niche as Arizona State's starting designated hitter, with a team-high .429 batting average and four homers in 14 games.

“It’s almost a gift,” Compton said. ”You’ve had a year off to focus on development that you wouldn’t get if you were on the field every day. You get to build good life habits and that you can’t take this game for granted.”

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