By Myatt Murphy
Foreword by Tommy John
Read by Dr. Tommy John
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Beginning as early as age 6 and continuing through the teenage years and on into their twenties, both male and female athletes are more at risk of serious injuries at younger ages than ever before. Dr. Tommy John, son of lefty pitcher Tommy John and also a sports performance and healing specialist, offers an invaluable diet, lifestyle, and movement plan (Rethink. Rebuild. Replenish. Recover) for injury- and performance-proofing young athletes in every sport. Dr. John explores the sudden rise of Tommy John surgeries being performed on young athletes today, as well as the many injuries–and the surgeries required to fix them–increasing at an alarming rate in baseball and all youth sports. Dr. John’s book outlines the three top causes behind this “injury epidemic”: The American lifestyle, the business of youth sports (from coaches to corporations), and the decisions we believe as parents are truly benefiting our children. Minimize Injury, Maximize Performance focuses on prevention, and also offers tips on how to tailor the advice for athletes coming back from an injury, with over 120 black and white photographs.
You know, over the decades, I’ve been asked a lot of questions about my twenty-six-year career as a professional athlete. Questions ranging from “Who did you like playing for the most—the Dodgers or the Yankees?” to “What’s the one pitch you wish you could take back?” I’ve been interviewed about every team I’ve either played against or been a part of, and every ball player I’ve ever competed or partnered with along the way.
But what’s always surprised me is that no one has ever bothered to ask about what baseball was like for me as a kid growing up in Terre Haute, Indiana.
Maybe it’s because most fans would rather hear about the glory days instead of when I was just starting out playing ball with my friends. Then again, I now wonder whether it’s because sports parents today that I meet just assume that all pro athletes—me included—had the same type of childhood that their kids are going through. A life of around-the-clock practice with access to top talent coaching and state-of-the-art training tools. All of which made me the best possible athlete I could be—a young athlete able to earn his shot in the big leagues.
But in reality, my childhood wasn’t like that at all.
In fact, it was pretty much the exact opposite of what’s being pushed on many kids today.
Growing up in Terre Haute, I never had a professional baseball lesson—not one lesson—and the only coach I ever had from the time I was eight years old until I got into American Legion ball at sixteen was my dad. The only coaching I ever had (if you want to call it that) was when I saved all my money one year to buy a book called How to Pitch, by Bob Feller. I read it, picked up a few tips—and that was about it.
Sure, we had indoor facilities, but they weren’t the massive multipurpose sports complexes that parents today spend big bucks on to have their kid play tournaments and practice year-round in to hone their skills. If someone said they were going to an “indoor facility,” it just meant they were going to use the bathroom. Because indoor sports facilities didn’t exist!
And when it was time to quench your thirst, there weren’t any fancy sports drinks to be pushed on us. When we practiced bunting, my dad would put shin guards down on first base and third base. If you hit the shin guard three times, you got an A&W root beer float as a reward. If you didn’t, then you knew where the water fountain was.
Don’t get me wrong. My friends and I were active all year, but we never played a single sport year-round. Indiana was (and still is) a basketball state, so baseball was just something you did between basketball seasons. We practiced basketball from September through March until the state tournament was over and then we were done—a total of seven months, tops. But from April through part of August, we played baseball before starting the cycle all over again.
Even during baseball season, we didn’t have the complicated schedules and multilayered practices most kids suffer through today. The way we did it in Terre Haute, we had games on Tuesday and Thursday nights for the first half of the season, then played on Monday, Wednesday, and Friday evenings the second half of the season. And on the days we didn’t have ball games, we practiced, but all we ever worked on was bunting, fielding, running the bases, and playing the infield—you know, just throwing the ball around and getting batters out.
And that was it.
There were no travel teams to contend with. None of us ever felt the anxiety that a lot of kids feel today about falling behind in the sport because we weren’t doing all the “right” things. I never felt that I had to be good at baseball or felt any pressure from my parents whatsoever. In fact, if my dad had applied any pressure to me, my mom would’ve coldcocked him.
I just went out and played baseball. That’s all I ever did—and all of my friends ever did. Every last one of us were all the same in Terre Haute. None of us had anything that gave us an edge. We were just a bunch of kids playing baseball, and more important, having fun.
And guess what?
Throughout my entire career, playing among the legends of the sport throughout the ’60s, ’70s, and ’80s, I came to find out that pretty much all pro athletes—no matter what position we played, or for that matter, what sport we played—had a similar type of childhood.
We all played multiple sports growing up. We all took time off and never overdid it. We all grew up feeling no pressure and played sports simply because we loved playing them—not because we ever felt we had to. No one among the teams that I played on came from wealth or had access to extra coaching and top-of-the-line equipment when they were kids. But—most of all—none of them were having unnecessary surgeries, I can tell you that.
We all lived the same kind of life—when youth sports were merely a pastime. And not the business they’ve become today.
When I became the first person to have ulnar collateral ligament reconstruction surgery in September 1974, I was happy that the procedure saved my arm. But I never would have guessed my name would be attached to an operation now more common with kids than pro athletes, thanks to what youth sports have become.
It was a decade later—around 1984—when I first heard the term “Tommy John surgery.” When I asked Dr. Frank Jobe (the surgeon who pioneered the method and had operated on me) where he came up with the name, he admitted it started because he got tired of saying what the real name was! As he began sharing his knowledge with other orthopedic surgeons about the procedure, it was easier for him to refer to it as “you know, the surgery that I did on Tommy John.” A little further down the road, all he needed to do was say, “You know, Tommy John surgery.” And from that point forward, it just stuck.
But it wasn’t until around 2000 when I first heard of the surgery attached to kids.
Back then, the first few times, the news reported how young athletes were wearing out their elbows from specializing in one sport and having the procedure done, and it surprised me. Now, truthfully—I pay no attention to it. That’s because it’s happening so often that I’ve become used to it. And if I’m used to it—the guy whose name is attached to it—just imagine how “normal” the procedure (and all the surgeries now being routinely performed on kids) must seem to parents with sons or daughters playing sports today.
When did injury and overuse become the norm? It shouldn’t be—because it never was in the first place. And with this book, I know it will stop being the norm—because I firmly believe that things happen in our lives for a reason.
I truly believe that what ended my son Tommy’s baseball career—a botched arthrogram that infected his shoulder—was because there were better things meant for him out in the world other than playing ball. Tommy was a very accomplished baseball player who had great potential before that incident, and it ended his baseball career—and ultimately changed his life. But because of it, he became Dr. Tommy John and helped so many young athletes that have come through his practice and listened to his lectures.
The truth is, any dad would be proud to see his son follow in his footsteps, especially if he’s spent a lifetime doing something that he loves. But this book was written by my son in the hopes that your child never follows in his dad’s footsteps. So that they never undergo surgery—or even just end up benched—for an injury they should never have suffered from in the first place.
And if Tommy saves one kid—just one—from having to go under the knife, then the book you’re holding in your hands is a success. The only question really left is this: Will that kid be yours?
Tommy John Jr.
The call came into my office in the dead of winter, at a time of year when baseball should only be looked forward to—not forced upon.
It had been the mom of a high school junior named Jared, a kid who not only loved playing as a catcher but stood a shot at having a future in baseball, something very few do. The only thing standing in his way? A torn ulnar collateral ligament in his elbow he was told required surgery—a surgery that also meant the inevitable possibility of ending Jared’s future before it began.
“Please… can you save my son’s arm?”
It wasn’t the first time a parent asked me that question, desperate to avoid what every doctor spoken to previously had claimed was unavoidable. But after looking at Jared’s arm to find the ligament partially torn but intact, I told him he had nothing to worry about and that his body could mend this. I described the process and what needed to happen—and how the road ahead wouldn’t be easy. I told him that what I would ask him to do would seem unconventional at times, but it’s what his body needed to heal itself from within.
Jared committed himself to doing exactly what was asked of him. (In fact, he remains to this very day one of the most compliant patients I’ve ever turned around.) And in one month, about the time he would have been scheduled for surgery, Jared was back throwing again, making the playoffs at his high school just a few months later.
I attended his first game back and could hear the whispers behind me.
“That’s the guy. That’s the one who worked with Jared.”
But to be honest, I was too busy watching a young athlete who was one of the best high school catchers I had ever seen. A young athlete who went on to be signed by the University of South Carolina and had a healthy college career. A young athlete whose body had been pushed to the point of needing surgery, but who had avoided it by listening to what his body was trying to tell him.
Jared wasn’t the first kid I saved from going under the knife—and he won’t be the last. But he was the one that reminded me that I couldn’t save all of them and that the best way to try the impossible was to educate parents about what is possible. Something needed to be written—that contained everything necessary in one easy-to-understand package. That a solution was needed to share with all young athletes in America—no matter what their age, sport, or gender—and not just the one I was lucky enough to repair and root for from the stands.
Being the son of a Major League Baseball (MLB) pitcher, I grew up as you may have expected, immersed in the sport and playing it for as long as I can remember. But as a training and rehabilitation expert specializing in soft tissue injuries for over fifteen years, I’ve also witnessed firsthand the outcomes of injury, innovation, and principled healing. So, imagine my surprise when I discovered how the young athletes playing sports today had become a major portion of the rising tide of the injured we’re now seeing flood into doctor’s offices nationwide.
Like my dad, I am also a former ball player, even though I never reached his heights in the sport. After playing college ball and receiving my bachelor’s and master’s degrees in health and exercise science from Furman University, I played two seasons of pro ball as a pitcher with the Schaumburg Flyers, the Tyler Roughnecks, then went on to sign a free agent contract with the Los Angeles Dodgers and was invited to their spring training.
Only to have my MLB dream stripped away before it began—due to injury.
Upon retiring, I created (along with the help of others) a training and rehabilitation system and began working with adult and geriatric clients dealing with a multitude of injuries and chronic conditions, such as torn ACLs, UCLs, plantar fasciitis, and herniated disks. But because of my love of sport, I simultaneously opened up a baseball performance company where I logged more than eleven thousand baseball lessons to players ranging from six to thirty years of age. But with each passing year, I began to see an uncanny connection between my older injured patients and the kids that were coming to see me for baseball tips.
The young athletes I was teaching were suffering from the same ligament and tendon damage as the older adults I was treating.
Every season, more and more young athletes began to step through my door with injuries and imbalances—issues I had only previously seen in older patients in their fifties or sixties that had decades of mileage on their bodies. I also began to notice how these young athletes were missing key performance traits that should be present in kids today, including nervous system development, fundamental movement patterns, and even the simple act of being able to breathe properly.
More often than not, I found myself offering rehab advice instead of instruction about the game, explaining to parents that although they paid for a lesson, their children had wear-and-tear throughout the body that shouldn’t be there. I showed them how despite being great athletes, children were not even capable of balancing on one leg or closing their eyes without falling over. I even explained to a few parents how their children didn’t have ADD just because they always squirmed when seated—it’s that the children had never lost the Galant’s reflex, a primitive reaction that causes the abdominal muscles to contract when the skin over a child’s spine is touched.
I helped many open their eyes to what sport and society were doing to the development of their child—and how they could reverse it. But I soon came to realize I could only help the kids that came through my door and the parents willing to listen. That’s when I decided to close the doors of my baseball school for good to spend four years earning my doctorate in chiropractic—a decision made, ironically, when I was the same age my dad was when he had his famous groundbreaking surgery.
For him, that day had been a moment where he looked at his injury not as an end, but an obstacle.
For me, it was the day I knew I had to push away the obstacles preventing parents from recognizing what was behind the injuries plaguing our youth—to put an end to them once and for all.
Dr. Tommy John
The Unspoken Epidemic
No matter how much we love the game… we’re just human beings who choose to play a sport for a short period of time.
Right now, more than 36 million kids1 play organized sports each year in the United States. It’s a number that comes out to roughly two out of every three boys and more than half of girls between the ages of five and eighteen years old. As a parent, it should be inspiring to see how those numbers break down, since that must mean kids today are more active and healthy than ever before.
But it’s because of how kids are more active than ever—and what’s not being done in tandem—that’s causing their bodies to fall apart.
As a lifelong athlete and former baseball coach, in addition to being a training/rehab specialist and doctor of chiropractic care, I’m aware of the positive impact a structured, well-organized youth sports program can have on a young athlete’s life. I’ve both personally experienced and witnessed in the thousands of young athletes that I’ve worked with over the years how sports builds self-esteem and self-discipline,2 develops social skills and leadership qualities, and can improve their overall health and well-being.
New data continue to prove how extracurricular sports help young athletes evolve into better human beings off the field, from reducing their risk of preadolescent smoking and drinking3 to improving their cognitive skills,4 making them more able to follow instruction and focus. There’s even plenty of evidence that being a young athlete increases your odds of landing a better job5 as an adult to having healthier muscles at a cellular level decades after you retire.6
But that’s when it’s done the right way.
When it’s done the wrong way—the way in which many coaches and sports parents innocently believe is the right approach—current research is revealing that being involved in youth sports may be doing more harm than good.
According to the National Safe Kids Campaign,7 more than 2.6 million children aged nineteen and under are treated in emergency rooms for sports and recreation each year. Furthermore, Nationwide Children’s Hospital, one of America’s largest pediatric health care and research centers, reports that in addition to ER care, another 5 million kids8 are seen by their primary care physician (or a sports medicine clinic) for injuries.
So, why do I care about your child? After all, as a training/rehab specialist and doctor of chiropractic care, shouldn’t every doctor be happy when business is booming?
Not this doctor—and it’s because of a little thing called legacy.
You see, there was a time when my dad’s name (Tommy John) meant something different than it does today. As a former Major League Baseball (MLB) pitcher, whose 288 career victories rank as the seventh-highest total among left-handers in major league history, he was not only an accomplished baseball player but the very first to both have (and fully recover from) a procedure where a damaged ulnar collateral ligament in the elbow is surgically reconstructed, using a tendon from another part of the body.
Not only did he come back midway through his twenty-six-year career in the pros after going under the knife, but my dad went on to play professional baseball better than he had ever played before. But while it’s true he was the first to have Tommy John surgery—a procedure now named after him—my dad was far from the last, and the number of athletes having it done now is growing exponentially.
The number of pitchers that had Tommy John surgery in 2014 alone surpassed those operated on from 1990 to 2000 combined. In fact, many doctors have noticed a ten times average increase in athletes needing the surgery since 2000. And although my dad fully recovered, only 20 percent of those who have it ever make it back to their previous level of performance. Worse yet, between 25 and 30 percent of athletes that undergo Tommy John surgery find themselves no longer able to play baseball two years afterward.
Why should these statistics be so alarming? Because even though a staggering 25 percent of all active MLB players (and 15% of current minor leaguers) have had Tommy John surgery, the statistics I just shared with you aren’t attached to professional ball players.
It’s what’s happening to our young athletes.
In 2010 alone, 31 percent of all Tommy John procedures were on young athletes, but by 2016, that number had nearly doubled. The truth is, Tommy John surgery is a procedure that shouldn’t be happening in anybody under nineteen years of age. Yet as it stands, 57 percent9 of all Tommy John surgeries are being performed on young athletes between fifteen and nineteen years old. But the injuries occurring today aren’t just related to baseball and damaged elbows—what we’re seeing now is an across-the-board injury epidemic.
Every week, my practice handles a surge of young athletes injured from every sport imaginable, especially football, basketball, softball, volleyball, baseball, and soccer. In fact, a new study10 from the Center for Research and Policy at Nationwide Children’s Hospital in Ohio found that between 1990 and 2014, the number of soccer-related injuries treated in emergency rooms in the United States annually increased by 78 percent—and the yearly rate of injuries increased by 111 percent—among kids seven to seventeen years of age.
The injuries range from the common to the severe, from rotator cuff tendinitis, muscle strain, stress fractures, growth plate injuries, and sprained or torn ligaments, particularly ACLs (anterior cruciate ligaments). One 2017 study11 discovered that the number of injuries to the ACL—one of the major ligaments that provide stability to the knee joint—has risen dramatically among six- to eighteen-year-old patients over the past twenty years. Researchers found the overall incidence of ACL tears increased by 2.3 percent per year, and the rate of ACL tears surgically reconstructed has risen steadily by 3 percent per year as well.
So, what’s changed since we were kids, why are our children suffering as a result, and—most important—is it even possible to put a stop to it? The truth is this:
What has changed over the past twenty years is plenty. Why our kids are suffering more today than ever before isn’t due to one thing—it’s because of three. And can you put a stop to it? Can you prevent your son or daughter from becoming a statistic, so his or her future isn’t met with an invasive surgery or much worse? In other words, can you not only injury-proof your young athlete but help him or her perform at their highest level?
You can now, and it starts by understanding how the odds turned against kids in the first place.
The Causes That Compound
No matter what their injury may be, and regardless of what sport they might play, almost every single time I begin my evaluation of young athletes to figure out how to help them, their parents typically blame their injury on the same cause: “I guess they just didn’t warm up correctly.”
If only it were as simple as that.
When it comes to youth sports, we’ve placed so much emphasis on warming up that most parents never allow themselves to step back and see the big picture. No warm-up in existence will ever prevent injury. It’s what their child does within a sport—and away from that sport—that decides whether he or she falls on the injured list or the A-list.
It may all boil down to three specific causes behind this injury epidemic: the business of youth sports (from the coaches to the corporations), the American Dream, and regrettably, the choices parents truly believe are helping their children—but actually harming them instead.
IT’S MORE OFTEN LESS ABOUT THE KIDS—AND MORE ABOUT THE CASH
But that shouldn’t surprise you, right? After all, youth sports is estimated to be a 9 to 15 billion-dollar industry (depending on who you ask) that continues to skyrocket. But how it’s reached those heights isn’t due to more kids participating in youth sports. In fact, according to Project Play,1 participation in team sports among children aged six to twelve is lower now than it was a decade ago. It’s because the business of youth sports has made a year-long training schedule the new norm.
Behind the scenes—and in most cases, right in front of our very eyes—our children are being put through a gauntlet of coaches, camps, and countless lessons unnecessarily. What was once meant to be played for a season is now pushed 24/7, 365 days a year. All courtesy of new “select teams” that extend a child’s time playing the game, coaches and parents who believe “more is better” when it comes to practice, as well as indoor facilities and elite showcases that encourage kids to train during the off-season and even year-round.
Today, there is no off-season for our youth athletes. Because if their uniform ever found its way back into their closet, the money would stop rolling in.
This situation is developing young athletes in desperate need of medical intervention at younger and younger ages when inflammation, surgery, and rehabilitation shouldn’t even be words in their vocabulary. These surgical and rehabilitation procedures go beyond jumper’s knee, Little League elbow, or any of the common aches and pains active kids sometimes experience. It’s about significant damage to ligaments, tendons, and joints that require serious care—injuries from which many never come back.
Even worse, at a critical phase of developmental growth when children should be naturally developing balance, coordination, agility, and spatial awareness (among other important functional skills), they are being forced instead to overtrain and perform specialized movements that are creating muscular imbalances and deficiencies within their body. Because the human body is so adaptive, many kids can keep up and persist for a period of time. The problem is, their body eventually can’t maintain the pace and demands it is being put under.
It’s why the bodies of many of today’s young athletes aren’t keeping up—they’re giving up.
WELCOME TO THE AMERICAN DE-EVOLUTION
America may be the land of the brave and home of the free, but when it comes to being fit, our kids are failing miserably compared to other countries. In a recent landmark study2 of the fittest children and youth that collected data from 1.14 million children between nine and seventeen years old in fifty countries around the world, America came in close to dead last (47th place) despite the US passion for youth sports. The highest-ranking countries were in Africa and central-northern Europe, whereas the United States and countries in South America were consistently on the bottom regarding performance.
Youth sports may be leaving our kids overtrained and less developed, but the culture of America also plays a role in contributing to the health issues persistent among young athletes. The American diet is leaving kids malnourished, overfed, and improperly hydrated. In addition, the American lifestyle is not only affecting its youth’s activity level and posture, but causing kids to be less aware, overstimulated, and disconnected from certain vital physiological and neurological responses that promote healing.
THE TOUGHEST SPORT OF ALL—RACING TO KEEP UP WITH THE JONESES
Finally, both the business of youth sports and the American dream have caused parents to believe that any child can become a superstar athlete. That all it takes to make their sons’ or daughters’ athletic dreams come true is to push hard enough—and the youngsters will succeed.
"Too much organized sports at a young age is bad for nearly all American tweens and teens. Dr. Tommy John's Minimize Injury Maximize Performance is an invaluable guide to reducing young people's orthopedic problems associated with contemporary sports mania.'
—Gregg Easterbrook, author, The Game's Not Over
- "Tommy John was one of the fiercest competitors I've ever managed in my career. He never quit--and his son has that same spirit when it comes to protecting kids from what's wrong in youth sports today."—Tommy Lasorda, two-time World Series champion manager of the Los Angeles Dodgers
- "Parents are worried about their children being cut from the team, when they should be concerned about needless surgery and an epidemic of injury due to overuse. This book serves as a wakeup call for us all!"—Randy Cross, three-time Super Bowl Champion and football analyst
- On Sale
- Jul 23, 2019
- Hachette Audio