Ligament Tears (Tommy- John surgery, etc.)

What is it: Tommy John surgery — the colloquial name for ulnar collateral ligament reconstruction — is a surgical procedure that aims to repair ligaments in the elbow. The procedure has become synonymous with sports medicine, particularly in baseball, because pitchers can cause damage to the ligament, which is located on the inside of the elbow joint.

The procedure was first performed in 1974 by Dr. Frank Jobe, who today serves as a Special Advisor to the Los Angeles Dodgers, and is named after former major league pitcher Tommy John whose 288 career victories ranks seventh all time among left-handed pitchers.

Statistics: In a three-year span from 1996-99, Andrews performed Tommy John surgery on 164 pitchers, 19 of whom were high school aged or younger. From 2004-07, that number had jumped to 588 pitchers, 146 of whom were high school or youth league players — a seven-fold increase.

When John’s surgery was completed in 1974, Jobe gave the player a 1 in 100 chance of making a successful return. Today the recovery rate is almost 85 percent. In 2003, USA Today reported that in the previous two seasons, 75 of the almost 700 major league pitchers had undergone Tommy John surgery — almost one in nine. With 288 career wins, Tommy John remains the pitcher with the most wins to have undergone the surgery that bears his name.

Important Facts: Tommy John surgery-technically an ulnar collateral ligament replacement procedure-has saved the careers of hundreds of major league players.

Jamie Moyer was far from a lock to make the roster this spring after missing the 2011 season because of Tommy John surgery, but now has thrown shutouts in four decades and has a lower ERA since turning 40 (4.40) than when he was in his 20s (4.56).

Treatment Duration: The initial rehabilitation time between Tommy John’s UCL surgery and his return to the majors was 18 months, or basically the end of the ’74 season to the beginning of the ’76 season (technically, from 9/25/74 to 4/16/76.

Do’s/Don’ts: Kremchek explains, “The crucial element is communication between the surgeon, therapist, trainer and pitching coach. When you diagnose a UCL injury you don’t want to waste a ton of time with the rehab. Go straight into surgery.” BP’s Injury Database concurs. Surgery produces a much higher success rate than just straight rehab.

Common Myths: A study conducted by St. Vincent’s and Richmond Orthopedics has recently found out that Major League pitchers see a significant decrease in performance after they have Tommy John surgery. Compared to pre-operation performances, Major League pitchers had a significantly higher earned run average and significantly lower strikeouts per nine innings after receiving Tommy John surgery.