Tommy John was a legendary MLB pitcher whose career spanned from 1963 to 1989, during which he won an impressive 288 games – a feat unmatched by many.
Looking at his 27 years of statistics, there is a noticeable gap in 1975. This gap occurred because in the fall of 1974, John underwent a groundbreaking surgery for a ligament tear in his elbow, an injury that was once considered career-ending.
John was the first pitcher to successfully return to action after such an injury, and remarkably, he went on to win even more games post-surgery than before. The procedure that saved his career became known as “Tommy John surgery.”
Since John’s surgery 50 years ago, Tommy John elbow reconstruction surgery has revolutionized the game of baseball, benefiting players of all levels from Little Leaguers to professionals.
The Mechanics of Elbow Tears
The ulnar collateral ligament (UCL) is a crucial band of fibrous tissue that connects the upper arm’s humerus and the forearm’s ulna on the inside of the elbow. This ligament is essential for athletes who rely on throwing, such as baseball pitchers and football quarterbacks, as it facilitates the transfer of throwing force from the shoulder to the hand.
However, the high-velocity forces generated during pitching, particularly in today’s game with pitchers throwing faster than ever, often exceed the UCL’s strength, leading to stress and tears that require surgical intervention.
To repair a torn UCL, surgeons typically use tendons from less utilized areas like the forearm or hamstring to replace the damaged tissue.
Resurrecting Arms
Before the advent of Tommy John surgery, a UCL injury signaled the end of many pitching careers, as exemplified by Sandy Koufax, who retired prematurely due to severe elbow pain in 1966.
Today, the surgery boasts an 80% success rate in returning players to gameplay, although approximately 30% of pitchers who undergo the procedure require a second surgery.
The Rise of Tommy John Surgeries
Since Tommy John’s pioneering surgery, nearly 2,500 professional baseball players have undergone the procedure, with the number of surgeries rising about 9% annually.
About one-third of current Major League Baseball pitchers have undergone Tommy John surgery at some point, including stars like Shohei Ohtani, who had the procedure in 2023.
Several factors contribute to the increasing frequency of these surgeries, including higher pitch velocities, a rise in high-velocity breaking pitches, and changes in youth sports culture.
The Youth Epidemic
Much of the rise in Tommy John surgeries is seen in teenagers aged 15 to 19, who, due to changing youth sports dynamics, increasingly sustain UCL injuries. Over-scheduling, lack of cross-training, and a focus on early specialization contribute to excessive stress on young arms.
This alarming trend underscores the importance of Pitch Smart, a program designed to mitigate injury risks in young athletes through education and guidelines for pitch counts and rest periods.
While the surgery has become a standard procedure, Tommy John himself advocates for a return to a simpler time when sports were played for fun rather than driven by profit and ambition.
Ultimately, as the number of Tommy John surgeries for youth continues to rise, it may be time for parents and coaches to reassess their approach to developing young athletes.
Ted Spiker, Professor of Journalism, University of Florida and Kevin W. Farmer, Professor of Orthopaedics and Sports Medicine, University of Florida
This article is republished from The Conversation under a Creative Commons license. Read the original article.