Baseball Injuries: What is “Tommy John” surgery?

Find out what "Tommy John" surgery is and how it can help baseball players.

Dr. Keith Meister, Medical Director of Sports Medicine at Medical Center Arlington and Team Physician for the Texas Rangers, shares more tips for baseball players on our blog today. Find out what "Tommy John" surgery is and how it can benefit baseball players

Question: What is “Tommy John” surgery?

Answer: “Tommy John” surgery, or a “TJ” as the players like to commonly refer to it, is a reconstructive procedure of the ulnar collateral ligament on the inner side of the throwing elbow.

When throwing a baseball, the inner (or medial) side of the elbow sees a tremendous degree of stress. The highest stresses are seen on the inner elbow during the throwing motion prior to ball release referred to as the late cocking /acceleration phases. Every time a baseball is thrown, even at the earliest ages, wear to this ligament begins to occur very much like the tire tread on a new car. Factors that can affect the speed with which the ligament wears out are related to pitch types, pitch counts, throwing mechanics, athlete’s conditioning and genetics (i.e. regardless of how well we monitor our training, rarely do we find someone with healthy professional careers for 25 years like Nolan Ryan).

When the ligament fails, the player may either feel a sudden pop or pain in the inner elbow or a gradual onset of pain which eventually leads to an inability to throw. Some injuries to the ligament are mild and require only rest and rehabilitation to return the athlete to their normal level of function. Other injuries result in more complete tearing of the ligament that requires reconstruction.

In 1974, Dr. Frank Jobe performed the first successful reconstruction of this ligament on a pitcher named Tommy John, who at that time was playing for the Los Angeles Dodgers. After 18 months of rehabilitation, Tommy returned to the major leagues to double his career win total. The now common procedure where most often a tendon from the forearm is taken and transferred to the inner side of the elbow now bears his name.

Although many baseball players, predominantly pitchers, are successfully reconstructed and resume their careers following this procedure, it is not a procedure for all individuals and ultimately prevention is a far easier solution to the problem than surgery.  

Dr. Keith Meister is the Director of Sports Medicine at Medical Center Arlington and is in his sixth season as the team physician for the Texas Rangers. To learn more about Sports Medicine at MCA, please visit us online. Please call 1-855-868-6262 for a physician referral.

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