Tommy John Surgery

Tommy John surgery, known in medical practice as ulnar collateral ligament (UCL) reconstruction, is a surgical procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, knee, or foot of the patient). The procedure is common among collegiate and professional athletes in several sports, most notably baseball.

The surgery is named after Tommy John, a pitcher for the Los Angeles Dodgers who was the first professional athlete to successfully undergo the operation in 1974. The procedure was performed by Dr. Frank Jobe, who also serves as a Special Advisor to Los Angeles Dodgers chairman Frank McCourt.

"Tommy John Surgery Recovery" In 2009, chances of a complete recovery after surgery are estimated at 85 to 92 percent. At the time of Tommy John's operation, Jobe put his chances at 1 in 100. After his surgery in 1974, John spent 18 months rehabilitating his arm, returned for the 1976 season, and went on to pitch in the major leagues until 1989 at age 46. The procedure can take about one hour. Full rehabilitation takes about one year for pitchers and about six months for position players. Usually, pitchers who have the surgery can get their full range of motion back after about two months and can start doing weight exercises. For the next four months, they can increase the weight that they use and start doing exercises that emphasize all parts of their arm.

The ulnar collateral ligament can become stretched, frayed, or torn through the repetitive stress of the throwing motion. The risk of injury to the throwing athlete's UCL of the elbow is thought to be extremely high as the amount of stress through this structure approaches its ultimate tensile strength during each and every hard throw.

While many authorities suggest that an individual's style of throwing or the type of pitches they throw are the most important determinant of their likelihood to sustain an injury, the results of a 2002 study suggest that the total number of pitches thrown is the greatest determinant. The 2002 study followed 426 pitchers aged 9 to 14 for one year, and studied their throwing volume, pitch type, and throwing mechanics. Compared to pitchers who threw 200 or fewer pitches in a season, players who threw 201–400, 401–600, 601–800, and 800+ pitches faced an increased risk of 63%, 181%, 234%, and 161% respectively.

The types of pitches thrown showed a smaller effect; throwing a slider was associated with an 86% increased chance of elbow injury, while throwing a curve ball was associated with an increase in shoulder pain. There was only a weak correlation between throwing mechanics perceived as bad and injury. Thus, although there is a large body of other evidence that suggests mistakes in throwing mechanics increase the likelihood of injury it seems that the greater risk lies in the volume of throwing in total. Research into the area of throwing injuries in young athletes has led to age-based recommendations for pitch limits for young athletes.

In younger athletes for whom the growth plate is still present, the "opening up" force at the inside of the elbow during throwing is more likely to fail at this region than at the Ulnar Collateral Ligament. This injury is often termed "Little League Elbow," and does not require reconstructing the Ulnar Collateral Ligament.

In some cases baseball pitchers throw harder after the procedure than they did beforehand. As a result, orthopedic surgeons like Dr. James Andrews have reported that increasing numbers of parents are coming to them and asking them to perform the procedure on their un-injured sons in the hope that this will increase their performance. However, many people—including Dr. Frank Jobe, the doctor who invented the procedure—believe any supposed post-surgical increase in performance is generally due to two factors. The first is pitchers' increased attention to conditioning. The second is that in many cases it can take several years for the UCL to degrade. Over these years the pitcher's velocity will gradually decrease. As a result, it is likely that the procedure simply allows the pitcher to throw at the velocity he could before his UCL started to degrade. There are also examples of pitchers, like Francisco Liriano of the Minnesota Twins, who could not throw as hard after having the surgery as they could beforehand.

List of baseball players having received the Tommy John surgery

All are pitchers unless otherwise noted.

    * Nick Adenhart
    * Brian Anderson
    * Rick Ankiel
    * Andy Ashby
    * Luis Ayala
    * Brandon Backe
    * Danys Baez
    * Rocco Baldelli
    * Rod Beck
    * Erik Bedard
    * Francis Beltran
    * Jeff Bennett
    * Kris Benson
    * Adam Bernero
    * Brent Billingsley
    * Joe Borchard (outfielder)
    * Dewon Brazelton
    * Doug Brocail
    * Taylor Buchholz
    * Ambiorix Burgos
    * A. J. Burnett
    * Paul Byrd
    * Jorge Campillo
    * José Canseco (outfielder; injured while pitching)
    * Chris Capuano (twice)
    * Chris Carpenter
    * Rocky Cherry
    * Shin-Soo Choo (outfielder)
    * Todd Coffey
    * Neal Cotts
    * Faustino De Los Santos (minor leaguer)
    * Ben Davis (catcher)
    * Manny Delcarmen
    * Ryan Dempster
    * Chris Denorfia (outfielder)
    * Jorge DePaula
    * Joey Devine
    * Brendan Donnelly
    * Octavio Dotel
    * Kyle Drabek (minor leaguer)
    * Darren Dreifort
    * Phil Dumatrait
    * Brian Duensing
    * Adam Eaton
    * Dave Eiland (twice)
    * Clint Everts (minor leaguer)
    * Willie Eyre
    * Scott Feldman
    * Jesse Foppert
    * Chad Fox (thrice)
    * John Franco
    * Frank Francisco
    * Éric Gagné
    * Luis Gonzalez (outfielder)
    * Mike González
    * Tom Gordon
    * Rusty Greer (outfielder)
    * Lee Gronkiewicz
    * Angel Guzman
    * Mike Hampton
    * Sean Henn
    * Pat Hentgen
    * Runelvys Hernández
    * Shawn Hill (twice)
    * Matt Holliday (outfielder)
    * Kris Honel (minor leaguer)
    * Norris Hopper (outfielder)
    * Tim Hudson
    * Philip Humber
    * Todd Hundley (catcher)
    * César Izturis (infielder)
    * Jason Isringhausen
    * Tommy John
    * Kelly Johnson (infielder)
    * Josh Johnson
    * Steve Karsay
    * Jimmy Key
    * Josh Kinney
    * Billy Koch
    * Bobby Korecky
    * Hong-Chih Kuo (twice)
    * Cory Lidle
    * Jon Lieber
    * Jesse Litsch
    * Mike Lincoln (twice)
    * Francisco Liriano
    * Rodrigo Lopez
    * Matt Mantei
    * Shaun Marcum
    * Scott Mathieson (twice)
    * Joe Mays
    * Seth McClung
    * Dustin McGowan
    * Sergio Mitre
    * Paul Molitor (infielder)
    * Matt Morris
    * Peter Moylan
    * Xavier Nady (twice; outfielder)
    * Tim Naehring (infielder)
    * Pat Neshek
    * John Odom
    * Russ Ortiz
    * Josh Outman
    * Juan Padilla
    * Jarrod Parker
    * John Parrish
    * Carl Pavano
    * Scott Proctor
    * Bill Pulsipher
    * Chris Ray
    * Carlos Quentin (outfielder)
    * Britt Reames
    * Al Reyes
    * Anthony Reyes
    * Arthur Rhodes
    * Jose Rijo (thrice)
    * Matt Riley (thrice)
    * Ricardo Rincón
    * Mariano Rivera
    * Fernando Rodney
    * Kenny Rogers
    * Francisco Rosario
    * B. J. Ryan
    * Ángel Sánchez (infielder)
    * Aníbal Sánchez
    * Humberto Sánchez
    * Scott Schoeneweis
    * Jae Seo
    * Alfredo Simon
    * John Smoltz
    * Kyle Snyder
    * Joakim Soria
    * Rafael Soriano
    * Tim Spooneybarger
    * Denny Stark (twice)
    * Clete Thomas (outfielder)
    * Brian Tollberg
    * Merkin Valdez
    * Rick van den Hurk
    * Edinson Volquez
    * Billy Wagner
    * Paul Wagner
    * Tyler Walker
    * David Wells
    * Jake Westbrook
    * Scott Williamson
    * Brian Wilson
    * Vance Wilson (twice; catcher)
    * Mark Wohlers
    * Randy Wolf
    * Kerry Wood
    * Mark Worrell
    * Jaret Wright
    * Tyler Yates (twice)
    * Matt Young
    * Mike Zagurski
    * Víctor Zambrano (twice)
    * Jeff Zimmerman (twice)
    * Jordan Zimmermann