Before 1974 when a pitcher had a UCL tear his career was effectively over. When Tommy John had surgery in 1974 to repair his UCL tear he was give a 1 in 100 chance of returning to the MLB and pitching effectively. Tommy John returned from the surgery better than he was before. Now, in 2013, the chances of a pitcher coming back from Tommy John surgery are 85-92 percent. That recovery rate and return to form percentage is great, but what is alarming is the number of current pitchers who have had Tommy John surgery. On MLB opening day 2013 there were about 360 pitchers on opening rosters. Of those 360 pitchers, 124 of them, nearly one third, all had Tommy John surgery done at some point during their career. That brings us to the question of, does a pitcher need to have Tommy John surgery at some point during their career to be successful or if they have surgery will it end their career?
Tommy John was just the first of a long line of pitchers to have UCL surgery and make a full recovery. In 2007 Josh Johnson of the Miami Marlins underwent Tommy John surgery and returned in 2008 and pitched a phenomenal season earning 15 wins and 191 strikeouts. Four years later, 22-year-old Washington Nationals, pitching prodigy Stephen Strasburg underwent Tommy John surgery. Strasburg returned in 2012 with similar dominant numbers compared to Johnson, earing 15 wins and striking out 197 batters.
For every Stephen Strasburg type success story, there is another story where one does not return to form. A name that comes to mind for all Toronto Blue Jays fan’s is B.J. Ryan. Ryan underwent surgery in 2007 and came back to baseball in 2008. He had a good 2008 season, but after that it all went down hill. Ryan pitched in 2009, but his command was all over the place and was being hit on by anyone who stepped into the batters box. Ryan never pitched in another MLB game after 2009.
What is interesting about the list of MLB pitchers who have had Tommy John surgery is that there are two distinct groups of players that have had it. There is Tim Hudson, Billy Wagner and John Smoltz who were at the end of their prime and careers when they had it and then there is Stephen Strasburg and Josh Johnson who had it at the beginning of their young careers.
In the end Tommy John surgery is just re-adding life to a pitchers arm. The surgery is strengthening and re-doing what had been worn down over all of those years of pitching and almost essentially giving a pitchers arm a reboot for the remainder of their pitching career.