Tommy John – Part 2 – Career Maker? Or Career Breaker?

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?

Career Maker

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.

Career Breaker

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.

Conclusion

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.

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.

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.