Tommy John – Part 1 – What Is It? What Causes It?

What Is It?

Ulnar Collateral Ligament (UCL) reconstruction surgery; a surgical graft procedure where the UCL in the medial elbow is replaced with a tendon from somewhere else in body like the right or left elbow.  Now hearing just that, doesn’t that sound like a painful surgery? So does anyone out there even know what that surgery means? What if I were to tell you what it is infamously called? Does Tommy John ring any bells? Tommy John surgery is the name most often used when someone goes through UCL reconstructive surgery. The surgery is called Tommy John because Tommy John, a MLB pitcher from 1963-1989, was the first pitcher to have UCL reconstructive surgery.

Check out this video on Tommy John surgery by in their ESPN series 30 For 30 : Tommy And Frank


Up until 1974 Tommy John surgery had never been performed or even been developed yet.  Before 1974, when a pitcher had a UCL tear, their only option to try and fix it was rehab their harm and play through the pain. It was largely known though, that a pitcher’s career was over if he suffered the tear. In 1974 there was a doctor by the name of Frank Jobe, the LA Dodgers team physician, who came along and forever changed the landscape of pitching arm injuries in the MLB. Tommy John was the one that actually approached Frank Jobe and told him to fix his UCL tear, so that’s when Frank came up with Tommy John surgery.  When having the surgery done, Tommy was given the chance of making it back to the MLB of 1 in 100. Tommy John made a full recovery from the surgery and actually became a better pitcher because of it. It took Tommy one year from when he had the surgery to pitch in a game. Tommy John went on to win 288 games in the MLB with more than half of those wins coming after he had the surgery.

NCAA gymnastics: FEB 26

Photo Courtesy Cal State Fullerton Athletics

What Causes It?

A UCL tear is most commonly caused when the UCL ligament becomes stretched, frayed or torn from stress on ligament because of repetitive throwing motions. After years or even months of throwing hard and putting stress on elbow and the ligament, is when the tear begins and ultimately ruptures. After this pro longed stress on the ligament, is when the ligament ruptures while the pitcher is pitching and the pitcher hears a “pop” noise in their elbow. This noise is their UCL ligament rupturing and them now needing Tommy John Surgery.