Dr. Mark Cohen of Midwest Orthopaedics at Rush meets with Jeff Wolfe, 18, a
pitcher from LaGrange Highlands, who had Tommy John surgery in July. (Photo courtesy of Midwest Orthopaedics)

With his Nazareth Academy baseball team two outs away from going to the state tournament, Colin Schwendt was in his fifth inning of relief work.

The squad’s go-to guy, who had a preferred walk-on spot waiting for him at the University of Miami (Ohio), then threw a pitch that forever changed his baseball career.

“I’d pitched in pain before, but this was excruciating,” Schwendt said. “I finished the inning, but they tied the game on an error. I came in the dugout and threw my mitt down. I knew I was done.”

His injury in the spring of 2009 led him to have Tommy John surgery in August of that year, two days after his 18^th birthday.

Schwendt’s story has become an all-too-common one, according to a team of local doctors. A new study shows that teenage athletes now make up more than half of all patients undergoing ulnar collateral ligament elbow reconstructive surgery, better know as “Tommy John” surgery, named after the former Chicago White Sox pitcher who first had the procedure done.

Research conducted by Midwest Orthopaedics at Rush between 2008 and 2011 and published in the July issue of American Journal of Sports Medicine found that 15- to 19-year-olds are the fastest growing patient group for Tommy John surgeries.

“We noticed in our practices that we were seeing more and more younger kids,” said Dr. Anthony Romeo, part of Rush University Medical Center and one of the co-authors of the study. “The operation is known because major league superstars have had it done, but we are seeing many more surgeries occur with teenagers.”

The study showed that 57 percent of the 790 Tommy John surgery patients nationwide were ages 15-19, followed by 22 percent for ages 20-24. In addition, the increase in the rate of surgery during this time period among patients 15-19 was more than twice that of all other patients combined (10 percent to 4 percent).

Romeo thinks the epidemic is being caused by baseball, like other sports, now being a year-round activity for youths, and coaches not taking the proper precautions with young pitchers.

“Youths are being asked to participate on more than one team. They now have their regular team and a travel team,” said Romeo, who was part of an elbow research committee that drew up the Major League Baseball-backed Pitch Smart rules. “You have coaches without the education or awareness of pitch counts or they simply ignore them.

“There are high school coaches letting their pitchers throw 140 pitches. When the (Pitch Smart) guidelines are pointed out to them, they say, ‘Those are Little League rules. Those are not high school rules.’”

Romeo said the No. 1 reason for more youths having Tommy John surgeries is the number of pitches they are throwing.

After surgery with Rush surgeon Mark Cohen, Schwendt went through a year of rehabilitation, but came back his sophomore year and pitched really well only giving up a handful of hits the entire fall season.

“I topped out at 88 (mph) at some camps,” Schwendt said. “They sent me to an affiliate, their satellite school, Miami Hamilton, and in the spring, I threw a no-hitter in a shortened game.”

Brought back to the University of Miami squad, Schwendt could spot his pitches, but lost velocity.

“I barely hit 82 (mph),” Schwendt said. “As a righty in Division 1, you need to throw hard. A lefty can get away with hitting 82.”

He was eventually cut from the squad. Now an accountant in Chicago, Schwendt said he has no pain in doing everyday activities. The resident of Chicago’s Lincoln Park neighborhood said he is thinking about getting back involved with baseball.

“I miss it. I was burned out for a couple years,” said Schwendt, who played on three travel teams from age 12 until high school. “I am itching to get back to it.”

Schwendt said Cohen, on staff with Rush for 22 years, told him the tear was not caused by too many curve balls (a common belief), but by throwing so many pitches with velocity.

“I used to grit my teeth because I threw too hard,” Schwendt said. “I would throw hard every time, but I would throw strikes.”

Cohen, director of the Midwest Orthopaedics at Rush Minimally Invasive Hand, Wrist & Elbow Institute, said he has gone from doing a Tommy John surgery per year or every other year to doing three or four per week at times.

“We are a tertiary referral center, but part of it is the education and appreciation of the problem in the baseball community,” Cohen said. “I have kids 12 and 13 coming to me, pitchers who hurt their arms, It used to be they would just go play third base. The concept of 13-year-olds going to a doctor because it hurts to throw was not even part of our consciousness a few years ago.”

Cohen noted that the surgery is only a 60- to 90-minute procedure and newer equipment has helped surgeons do a lot less damage to surrounding tissue and muscles.

He said some players are just more susceptible to injury due to the torque from pitching.

“I had a father who brought me the pitching paperwork for five years,” Cohen said. “He was very stressed. He felt he had monitored and protected his son, but still felt responsible.

“It is not always something we have control over. Some kids are more predisposed to problems because of their muscle mass and mechanics. The more you throw the more susceptible you are, but the kid next door can throw three times as much and not have a issue and your son does.

“You do your best to watch pitch counts. Overuse is a risk, but in the end, you can’t always predict what’s going to happen.”

— More teens facing Tommy John surgery–