A special feature by permission of Primal Pictures

QWhat is Tommy John surgery? And why does it seem to be done so frequently or routinely in MLB pitchers? And is it being done at earlier ages?

A

Officially it's called Ulnar Collateral Ligament replacement or reconstruction surgery and it happens in the elbow. The basic procedure is to replace the failed ligament with a tendon taken from elsewhere in the body... the other arm or the hamstring of the leg are common sources. The tendon must change its behavior and function as a ligament. There are actually a number of UCL segments around the elbow (the animation highlights each of them in turn). Assuming you aren't asking because you plan on being the surgeon, we'll spare the technical details which involve cutting and drilling.

By the way, it was named for an LA Dodgers pitcher (Tommy John) who was the first to receive it rather than the doctors who performed it. Timing is everything: the second pitcher to receive it was Brent Strom (a WebBall contributor) who actually had it twice. But it is forever known as Tommy John and not a Stromie.

The tougher question is why is it so frequent and why is it being done on teenagers now and not just pros? Well, the good news part of this is that the surgery has become routine and with a high success rate (some say 85% or better) and so that makes it safer to perform. The ligament damage is no longer career ending for pro pitchers and scouts and coaches no longer view players who've had it as a liability.

That said, the real objective needs to be avoidance, which means proper training and conditioning, and players who are willing to pay attention to soreness and twinges before they develop into full-blown problems that can only be fixed with surgery.