Nowadays we hear about pitchers undergoing Tommy John surgery more often than we hear about a prolific power hitter clubbing two home runs in the same game. It is a pandemic sweeping the game like we've never seen before.
Tommy John surgery is required when a the ulnar collateral ligament in the throwing elbow is torn. It is a thick triangular shaped band comprised of three components:
- Anterior oblique: the sturdiest against valgus stress, or joint twisting during elbow flexion and extension.
- Posterior oblique: the posterior oblique ligament functions the same as the anterior oblique ligament except that it helps against valgus stress only when the elbow is flexed.
- Transverse ligaments: these ligaments are what connect the end of the humerus (upper arm bone) to the ulna (forearm bone).
More often then not, the player will show signs of a forearm or elbow strain with pain, discomfort, swelling, and difficulty moving the muscle until MRI's show a tear and Tommy John surgery is recommended. Damage to the UCL in the pitching elbow isn't a normal kind of sports injury such as a sprained ankle; it takes, for lack of a better term, a lot of…work.
There are two types of UCL injuries. Slow deterioration, the slow tearing of the UCL over a long period of time, or an acute rupture creating a complete tear of the ligament. When focusing on the issue with baseball pitchers, the overhead motion of cocking the shoulder and elbow before firing the pitch toward the plate applies a great deal of stress to the UCL just after one pitch. Multiply that by the dreaded pitch count in a given amount of time and the stress placed on the UCL is staggering.
After Tommy John surgery, rehab for the player can take around nine to 12 months to fully recover. Most pitchers are placed onto an accelerated rehab program that allow for light tossing to begin sixteen weeks after the surgery is completed.
The 2014 MLB season is a mere nine weeks old, and already 18 pitchers have been forced to go under the knife. Notable pitchers to have the procedure done include Jose Fernandez, Kris Medlen, Matt Harvey, Patrick Corbin, and Ivan Nova. Baseball is suffering this incredible increase in torn UCL's because pitchers are pushed to the limit far too quickly with high pitch counts and the need to throw harder and harder.
The human body can only withstand a certain amount before it starts to crumble. Pitchers should focus on long term stability rather than one season of domination to maintain healthy and successful careers. That means limiting throwing in the off season and becoming more economical with pitch counts. Once pitchers and managers realize this, then the number of Tommy John surgeries will decrease.
For a breakdown of how Tommy John surgeries are performed, click here.