Originally posted on The Sports Post  |  Last updated 6/8/13
Why is Tommy John surgery so common? (Credit)  The very first Tommy John Surgery was performed by Dr. Frank Jobe in 1974. At the time, it was a revolutionary surgery that revitalized the career of a pitcher on the Los Angeles Dodgers named Tommy John. Most, if not all baseball fans now know of Tommy John Surgery. One of the most famous reconstructive surgeries in sports history, Tommy John Surgery has saved the careers of many baseball players. But, while baseball fans throughout the world know of Tommy John Surgery, few know how it is performed and the necessary risks that arise after the surgery. Tommy John Surgery is also known as ulnar collateral ligament (UCL) reconstruction of the elbow. When athletes, most notably baseball pitchers due to the violent movement of the elbow when throwing a baseball, have a tear in their UCL, Tommy John Surgery is almost always necessary. The procedure, simply put, is the replacement of the UCL in the elbow with a tendon from another place in the body. After preserving the new tendon, holes are drilled into the ulna and humerus bones of the elbow and the tendon is woven into the bones. The rehabilitation process after Tommy John Surgery is no easy task for players. Rehab takes about 12 to 15 months for pitchers and, due to the level of difficulty of the rehab, it is not surprising if the velocities on a pitcher’s pitches are down from what they once were. A breakdown of Tommy John surgery. (Credit) Although studies have shown that pitchers come back with an 85-93% success rate as of 2009, many risks are involved after the surgery is performed. When performing the surgery, the surgeon must move the ulnar nerve out of the way to properly replace the UCL. The ulnar nerve is the largest nerve in the body that is not protected by a muscle or bone, making it fairly easy to damage. For instance, when you hit your elbow firmly on a surface, the numbness is from the ulnar nerve being somewhat trapped in between the ulna and your skin. For pitchers, after Tommy John Surgery is performed, the ulnar nerve can be severly damaged. Risks to the ulnar nerve after a pitcher receives Tommy John Surgery could be anywhere from nerve damage to nerve irritation or infections. Despite the revolutionary surgery making headlines and saving the career of Tommy John, the surgery itself wasn’t used very much until the 2000 season. Since the very first surgery was conducted in 1974, there have been a total of 541 Tommy John Surgeries that have been performed, with 484 of them coming after 2000 (30 surgeries were to players that were not pitchers). That is roughly 89.5% of all the Tommy John Surgeries in history. The increased number of Tommy John Surgeries since 2000 may be related to the way in which pitchers are brought up in the Minor Leagues and how they adjust to Major Leagues. Up and coming players will play longer and tougher games in the Major Leagues. Pitchers are throwing harder, and starters tend to throw around 80-100 pitches per game The wear and tear damage that the violent nature of the pitching motion and release of the ball creates on the UCL in the elbow is something that is bound to happen for a pitcher. But, the proper care and development by coaches and managers to the pitchers as they mature is vital to keep the player’s career alive. By: Neil Shelat Twitter: @NeilShelat6 Tommy John statistics can be found at: http://www.baseballheatmaps.com/disabled-list-data/
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