The phrase “Tommy John” refers to injury sustained to the athlete’s elbow, specifically the ulnar collateral ligament or UCL. Surgical treatment of this injury is known as Tommy John reconstructive surgery, whereby a new ligament is recreated to replace the function of the injured one.
Tommy John himself was a successful baseball player in the 1970s and 80s for the Los Angeles Dodgers and the New York Yankees. His fame truly derives from the fact that his career appeared to be in jeopardy when he sustained an injury to his inner elbow at the UCL. At that time, no professional major-league baseball pitcher had ever returned to play after having sustained this significant injury.
Behind the treatment and pioneering work of Dr Frank Jobe, John had surgery and ultimately returned to continue playing baseball – and had several more exceptional years. From here, other players also began to have this surgery and henceforth the procedure known as “Tommy John” refers to elbow ligament reconstruction in athletes.
The incidence of Tommy John injuries is rising. Of even greater concern is the fact that injuries are happening not only more frequently but to younger athletes. It is estimated that more than 55% of all pictures in the major and minor leagues have had Tommy John surgery.
Research has provided insight into the mechanism of injury. These include some of the following: year-round throwing, failure to adhere to established pitch counts and pitch limits, initiating curveballs at an early age or before mastery of fastballs and breaking balls, poor throwing mechanics, and others.
Throwing athletes of all ages should see a sports medicine elbow specialist if they are having elbow pain or a decrease in velocity when throwing. An experienced physician can help sort out the diagnosis as well as provide next steps for treatments or rehabilitation.
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