Health & Safety Resources

"TOMMIE JOHN" SURGERY

You may not have seen L.A. Dodgers Tommy John pitch in the 70’s, but most people recognize his name.  Not so much for his accomplishments in baseball, but more so for being the first professional athlete to successfully undergo a revolutionary surgery by Dr. Frank Jobe known to physicians at ulnar collateral ligament reconstruction, or “Tommy John” surgery to you an I.  This is a surgical procedure where the ligament on the medial side (inside) of the elbow is replaced with a tendon from another part of the body.  Recovery time from this surgery ranges from 6 months for position players to 1 year for pitchers, and includes intensive physical therapy.  Full recovery to pre-injury function is usually 18 -24 months, and success rate is now around 85%.

The ulnar collateral ligament (UCL) is the main ligament on the inside of the elbow that holds the lower part of the arm (radius and ulna) to the upper part (humerus) and prevents them from moving abnormally from side to side.  It can become stretched, frayed, or torn through the stress of the throwing motion.  This injury is usually not painful and is often misdiagnosed.  This injury will rob a pitcher of both velocity and control, as the arm can shift during throwing.  It has been referred to as “Dead Arm”.  If a thrower continues to participate before the injury is treated a full rupture may occur.  When the ligament ruptures, the joint of the elbow becomes unstable and may require surgery.

While an athlete’s style of throwing or the type of pitches they throw can contribute to injuries to the UCL, the greatest determinant actually seems to be the volume of throwing in total.  And since injury, and eventually surgery, is becoming more and more common in children ages 10-18, age-based recommendations for pitch limits in young athletes have been developed.  Little League baseball moved to adopt pitch count rules voluntarily at first in 2004, then mandatory in 2007.  The National Youth Sports Organization then refined the pitching rules for the 2008 season.

In addition to pitch count limitations, pitchers ages 16 and younger will be required to comply with mandatory rest requirements:

Some of the other contributing factors for the increased injury rates seen in young throwers include increased season length, participation in travel teams, playing on more than one team at a time, and throwing more breaking pitches at a younger age.  But the volume of throwing still appears to be the major factor in these injuries.  By monitoring these factors and adhering to the guidelines for pitch count and rest, the number of injuries to the UCL, as well as surgeries in young throwers, will decrease.  And “Tommy John” will be known more for his success on the field, rather than for the surgery named for him.

For more information on this article or for priority appointments for sports injuries please contact Henry Ford Center for Athletic Medicine at 313 972-4216.

Henry Ford Health System’s Center for Athletic Medicine offers a comprehensive approach to sports medicine, including surgical and non-surgical care, sports rehabilitation, injury prevention, and performance enhancement programs.  The HFHS treatment team includes sports medicine fellowship trained orthopedic surgeons, sports medicine fellowship trained primary care physicians, as well as certified athletic trainers and physical therapists.  These health care professionals are supported by the HFHS nationally recognized bone and joint research facility, including the prestigious Herrick Davis Motion Analysis Lab.  HFHS is proud to be health care providers to the Detroit area’s premier sports programs including professional, collegiate, and high school athletes.