Tommy John surgery is when the doctor has to replace the ulnar collateral ligament (UCL) in the elbow with a tendon taken from another part of the body. Some surgeons have used tendons from cadavers to perform the surgery.
The surgery was first performed in 1974 when Dr. Frank Jobe operated on Los Angeles Dodgers’ pitcher Tommy John. John took the 1975 season off and was able to return in 1976 with great success as he pitched until 1989, when he decided to retire at the age of 46. At the time John had the revolutionary surgery, his chance of returning to action was estimated at a mere one percent. The estimated success rate now has been reported to be around 85 percent on the professional level and has helped extend careers in all levels of baseball.
For many baseball players, especially pitchers, recovery time can average anywhere between 6-12 months. Some players recover quicker while other players take more time to recover depending on their position.
Recently, Garrett Pickens, who was a relief pitcher for DSU from 2011-13, missed the entire 2012 season due to Tommy John surgery. He came back this past year and concluded his career at DSU with a 3-2 record and a 0.47 ERA with four saves in 17 relief appearances. He is currently pitching for the Gulf Coast League Blue Jays.
Gerald Jordan, Delta State University’s Assistant Athletic Director for Health and Sports Performance, said each player has to be monitored differently.
“The throwing program pitchers have to go through just takes a lot longer and is a lot more detailed oriented than say your second baseman,” Jordan said. “When you breakdown your pitchers, you have another subset that you have to deal with. You look at if they’re a starter or are they a reliever or a middle inning guy that eats up a lot of innings? Are they your closer who is going to throw an inning or two at the maximum? Do they throw all out? You look at starters and relievers a little differently.”
Although there have been high success rates for recovery in recent years, the surgery is a major reconstructive surgery and it’s not a guaranteed cure. Normally when the surgery has to take place, the ligament in the elbow has been damaged from stress due to overwork in many cases.
Jordan said the rehabilitation that a pitcher goes through after surgery is key to success.
“It’s not like there is this magic ligament and it’s doing all the work,” Jordan said. “You’re taking time to focus on the whole body and really rehab everything from the ground up more so than just the elbow. You’re doing lower body things, core exercises, back and shoulder exercises.”
One alarming thing about the surgery is that it has become fairly common among youth and high school pitchers. According to www.asmi.org, the website for the American Sports Medicine Institute, approximately 17 percent of the Tommy John surgeries that were performed in 2002 were performed on youth and high school pitchers. The next year in 2003, that number shot up to 26 percent and went up to 32 percent in 2008. In 2011, that percentage declined to 23 percent.
Richey Woods, a trainer for Mississippi Sports Medicine, said young pitchers need to take good care of themselves to protect their arms and prevent reconstructive surgeries like Tommy John.
“To prevent it, the main thing is to have conditioning and proper mechanics,” Woods said. “That’s not just conditioning your arm, it’s also conditioning your legs, your core, everything and proper mechanics fall in along with that.”
One thing that concerns Woods when it comes to young pitchers is what kind of pitches they throw. Pitchers that are well in their teen and young adult years are throwing more curveballs, sliders and other off speed pitches. Pitchers that haven’t reached their teen years are in a crucial stage where their body is still developing and throwing those breaking pitches might not be safe.
Woods said the pitch selection for pitchers in youth league should be very basic.
“Your pitches should be a fastball and a change up,” Woods said. “You shouldn’t be throwing a slider or a curveball. That’s just stressing your elbow even more. Any kind of breaking pitch shouldn’t be done until your growth plates are closed and you’ve done the conditioning part of it and learned how to throw it.
“There’s nothing worse for me to go out and watch some little league baseball with a pitcher 8-15-years-old out there trying to throw a curveball. That’s leading to disaster right there.”
Woods also said monitoring the pitch counts per game and resting players with injuries can help prevent Tommy John surgery.