What Is A Tommy John?
The Tommy John surgery is one of the most prevalent and famous in the baseball world. Most people know the name but few actually know what it is.
The Tommy John surgery is a repair of the ulnar collateral ligament of the elbow. This is a ligament on the inside (closest to your body) of your elbow that stabilizes the elbow against side to side movements. The surgery was first done in 1974 to MLB pitcher Tommy John, and the operation has bore his name ever since. The surgery consists of taking a tissue, usually a tendon from the opposite arm and using it to replace the damaged tissue.
There are a few rumors and myths surrounding the Tommy John surgery. The first is the success rate of it, it is not a 100% successful surgery. Only about 85% of athletes will actually return to throwing at the same level they did prior to the injury. The next is that it will actually make you better. This myth started with people watching MLB pitchers coming back and pitching better than they ever have. While some MLB pitchers do come back better, this usually has little to do with the surgery itself. It is often from one of two things. The first is that some pitchers have been battling elbow injuries since they were in college and still made it pro. They then had the surgery and were able to finally pitch unencumbered by injury. The second and most common cause is the pre and post surgical rehab. One of the biggest predictors of the success of any surgery is the condition you are in going into it. Therefore, many athletes will immediately start their rehab process the minute they are injured. Then there is the post surgical rehab. It takes a long time for a graft to fully heal and in the MLB pitchers often wait longer than high school or college athletes where they are try to rush back for the next season. This post surgical rehab is also often the longest time the athlete has gone without pitching. This allows them to strengthen any deficits they have, work on their mobility and improve their technique. Often this process is over a year long. It is very rare for a pitcher to be able to take a year off of throwing and solely dedicate their time to rehab and improving their technique. With this well rested body, improved technique and strength, some MLB pitchers will return better than they have been.
If you are looking to prevent an injury leading to a Tommy Johns surgery, the number one rule is load management. By respecting pitch counts, taking days off after outings and taking a legit off season, you can mitigate some of the damage that comes with throwing an object overhead. Addressing any biomechanical deficits you may have would also be pertinent, such as range of motion restriction in the shoulder, limited back mobility, weakness in the shoulder, poor timing of your kinematic sequence.
