July 13th, 2012

Health N' Sports: Tommy John Surgery

Staff Report

Health N' Sports: Tommy John Surgery
photo from ubethecritic.com

Facts about Tommy John Surgery

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation. 

On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to editor@catholicsportsnet.com. 

Tommy John Surgery: Misconceptions & Guidelines

Baseball is in full swing and millions of fans just enjoyed the All Star game.  The league’s best hitters and pitchers gathered in Kansas City.  National League pitching and hitting dominated the game as they beat the American League 8-0.  Quality pitching is always in high demand and top free agents receive millions of dollars in new contracts.  Some of the top pitchers might not be where they are today if it were not for the Tommy John procedure.

In 1974, Dr. Frank Jobe first performed this procedure on a major league pitcher named Tommy John.  The procedure is designed to reconstruct the UCL or ulnar collateral ligament, which is located on the inside of the elbow joint.  The repetitive stress of pitching puts enormous amounts of stress on the UCL ligament.  Before advancements in sports medicine, UCL injuries were considered career ending.  Even after the first procedures in 1974, Dr. Jobe gave the player a 1 in 100 chance of making a successful return.  Today, the success rate is over 85%.  In 2003, USA Today found that almost one in nine major league pitchers underwent the procedure.  The rate is probably even higher today.

Although the procedure has become very successful, this is still a major surgery for an athlete.  The procedure removes the damaged UCL and replaces it with either an autograft or allograft.  An autograft is a piece of tissue taken from the patient and an allograft comes from a donor.  Full range of motion usually occurs after two months and throwing can resume after six.  Total recovery and rehabilitation from the procedure usually takes 12-18 months for pitchers.

There are many misconceptions about the Tommy John surgery.  First of all, UCL injuries are preventable.  According to Christopher Ahmad, MD, “growing evidence indicates that overuse and fatigue related to increased game time and practice time – including participation on multiple teams and playing baseball year-round – are responsible for UCL injury.”  Dr. Ahmad, who is the orthopaedic surgeon for the New York Yankees, also finds that many young throwers visit his office desiring to have the procedure done even though they don’t have a significant elbow injury.  They believe the procedure improves their performance.

In a study conducted by Dr. Ahmad, they “concluded that players, coaches, and parents should be better educated on the causes of elbow injury, the true indications for the Tommy John surgery, and the required rehabilitation.”  Groups like USA Baseball and the American Orthopaedic Society for Sports Medicine have developed guidelines for parents and players to follow in order to prevent these overuse injuries.  Recommendations for maximum pitch count and the age at which players can begin throwing certain pitches (tables 1 & 2) can be found on the web at www.stopsportsinjuries.org.


Mike Mehring, ATC

Louisville Orthopaedic Clinic & Sports Rehab Center

Main Office: 502-897-1794

Physical Therapy: 502-897-1790

Website: louortho.com

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