Thanks to the work of people such as Drs. Glenn Fleisig and James Andrews, there is clear evidence of arm abuse in youth and amateur baseball -- and, as a direct result, there are mandatory Little League pitch counts that are designed to control that workload. But how does that help Major League Baseball? Sadly, it doesn't.
So, in 2011, Ciccotti's elbow study group started on a job that should have begun years ago -- studying all elbow injuries, including a look at every possible cause, effect and result of Tommy John surgery, in the major leagues and minor leagues.
That study is charting the progress, or lack thereof, of every TJ patient in professional baseball. It tracks the specific diagnosis, the length and schedule of the rehab process, and when (or whether) the pitcher made it back to the mound. It includes personal interviews with every player. And it now includes, as of this spring, a biomechanical profile of each one of those pitchers.
"This research," Ciccotti said, "is so much more focused than in years past. ? And we're sifting through this data right now."
The hope, he says, is that, "toward the end of the season, we'll have something that will help us to give recommendations to the athletic trainers and doctors, that can help us improve in this area in the near future."
And once the biomechanics data is analyzed by mid-to-late autumn, he says, it could provide enough insights that "we may be able to redefine, or at least refocus, some key areas to improve treatment but also to provide us with preventive measures, as well."
Once that ball begins to roll, only then will we start to have a true idea of what's causing this Tommy John surgery "epidemic," and what can be done about it. But in the meantime, pitchers will fire away. Surgeons will reconstruct more ligaments. And the sports-medicine community will keep exploring the mysteries of the human elbow. And that exploration figures to last, well, forever.
"The problem," Michael Ciccotti said, "is that this is not a three-piece puzzle. It's a 10,000-piece puzzle."