Tommy John Surgery

It’s the season for Tommy John surgery.


Former LA Dodgers pitcher, Tommy John, whose name will forever be linked with the successful elbow surgery he had.

Major League Baseball (MLB) began its season earlier this month…….Wait!  In truth, it began its season last month:  the Opening Series of the season took place in Australia on March 22! I thought it was a nice, antipodean, cross-cultural touch that MLB played the first game of 2014 at the Sydney Cricket Grounds (the LA Dodgers faced the Arizona Diamondbacks)…..

With the return of baseball comes an all too common injury:  UCL tears, partial and complete.  This season, it seems there is a veritable epidemic:  14 pitchers scheduled to have this surgery already (in comparison, from 2000 to 2011 there was an average of 16 MLB pitchers per year undergoing the procedure).

What was once a career-ending injury has been transformed into a season-ending one because of one man, Dr. Frank Jobe.  Dr. Jobe, as readers will know, passed away earlier this year.  Many in the sports world noted his incomparable legacy as the ‘savior of pitchers elbows’  He was a great doctor, and a decent man.

He devised the surgical approach to ‘ulnar collateral ligament reconstruction,’ and his first patient was the pitcher Tommy John, who went on to pitch 164 games in his career after the surgery (such success is arguably a major reason his name has ‘branded’ the procedure).

I’m not the only one thinking of Tommy John, Dr. Frank Jobe, and pitching-related elbow pain.  Sue Basile, a reader of this blog, reached out to me and asked if she could write a guest post on the topic.  Sue received her BS in  Biomedical Engineering from Columbia University, her MS in Biomedical Engineering/Biomechanics from the University of Tennessee, and is working on her PhD in Kinesiology/Biomechanics at Georgia State University.  Here are her thoughts on prevention of the injury that can lead to Tommy John surgery:


Stemming the Tommy John Tide begins in Little League – Sue Basile
Ivan Nova may soon find himself on a list that no pitcher wants to be on – the one of those undergoing Tommy John surgery.   Despite it still being the first month of the season, the elbow count is already high, with the Yankee pitcher potentially joining promising players like the Mets’ Matt Moore and the Braves’ Cory Gearrin  in having their season cut entirely too short. 
Over on Tom Verducci has written a tremendous article that touches on a number of issues surrounding the increase in UCL injuries in recent years.   One observation Verducci makes that years ago it was more common than not that a pro baseball player had played at least one other sport through high school.   Now, instead of playing basketball or hockey when it starts snowing, year-round baseball players are throwing in gyms and travelling to warmer climates to perform in showcases.   Now add to that the fact that young pitchers are being encouraged to throw harder than ever.
Notice that the conversation revolves around not the major or even minor leagues, but young athletes.  As has been discussed on the CJSM blog before, early specialization in athletes can be detrimental on a number of levels.  If arms have been overworked by the time they get to college or the minor leagues, let alone the majors, how much can even the best doctors and athletic trainers do to reverse years of accumulated damage?  Over the years, parents and coaches have been warned repeatedly to enforce pitch counts, and to wait to teach kids how to throw specialized pitches,  but what about throwing too hard?
The question is, what can be done?  Since baseball players are allowed to be drafted after high school, it places increased pressure on them, especially pitchers, to show promise at a relatively young age in order to get attention from scouts and colleges.  They therefor exist in a sort of middle ground between sports like tennis and swimming where slightly early specialization may be necessary and team sports like soccer and football where there is more time to develop skills, and where athletes may actually benefit from playing other sports.   If we do set limits, what are they?  Is limiting fast ball speeds necessary?  And how would we enforce these new rules?  How do you prevent kids from throwing too hard with private trainers?  One thing is for sure – increased communication among parents, kids, physicians, various travel and high school  league coaches, and training staff is a vital first step to start reversing this alarming trend.


I want to thank Sue for reaching out to us and writing this post.  I would like to encourage other readers to consider writing such posts:  check out the guidelines and send it our way for an editorial look.

If you want one more peek at a recent event in the baseball world relating to this surgery, check out the social media kerfuffle over Matt Harvey’s post surgical photo.  Wish you were still on twitter Matt…….and good luck with your recovery!


About sportingjim
I work at Nationwide Children's Hospital in Columbus, Ohio USA, where I am a specialist in pediatric sports medicine. My academic appointment as an Associate Professor of Pediatrics is through Ohio State University. I am a public health advocate for kids' health and safety. I am also the Deputy Editor for the Clinical Journal of Sport Medicine.

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