50 years after the primary procedure, Tommy John surgery is more common than ever – especially amongst young athletes

Thomas John was a pitcher in the most important leagues from 1963 to 1989 and won 288 games. Only 25 MLB pitchers have won more.

But have a look at his 27 years of statisticsand you will note that one 12 months is empty: 1975. This is because John had an operation in the autumn of 1974 for a Torn ligaments within the elbowan injury that was once considered career-ending.

John was the first pitcher to return to motion after suffering such an injury. In fact, John won more games after the surgery than before – and the procedure that repaired his arm is now named after him.

John had his surgery 50 years ago. Since then, Tommy John's elbow reconstruction surgery has modified the sport and the individuals who play it, from Little Leaguers to the professionals.

How ligaments within the elbow tear

The ulnar collateral ligamentor UCL, is a band of connective tissue that connects two bones – the humerus within the upper arm and the ulna within the forearm on the inside the elbow. Without this ligament, there can be a spot between the 2 bones.

This band plays a vital role for athletes who throw, comparable to Football Quarterbacks and baseball pitchers since it serves as an anatomical bridge. The UCL transfers the force of the throw from the shoulder to the hand when the ball is released.

But here's the issue: The force exerted on the elbow when throwing a baseball, especially from today's high-velocity launchersexceeds the strength of the tape.

Poor mechanics and other aspects place a lot stress on the ligament that it could actually tear, requiring repair. To replace the torn tissue, the surgeon normally uses a comparatively unused tendon from the thrower’s forearm or thigh.

Weapons brought back to life

Before this surgery, a torn UCL ended the careers of many major league pitchers.

A typical example: Sandra Koufaxthe Los Angeles Dodgers pitcher and Hall of Famer, retired in 1966 as a consequence of severe elbow pain. Koufax was only 30 years old and at the height of his profession. Frank JobeThe doctor who performed the primary Tommy John operation and was the Dodgers’ team doctor on the time said the procedure had called Sandy Koufax Operation he would have developed the concept earlier.

Returning to play after Tommy John surgery is just not without its difficulties and recovery is long; it took John nearly two years to give you the chance to throw again. Although today's surgery is far less invasive, recovery takes a few 12 months.

About 80% of pitchers can play successfully again after surgery. But sometimes the repair doesn’t last endlessly, and about 30% The pitcher with the operated elbow will undergo a second operation.

An increase in operations

It is estimated that just about 2,500 skilled baseball players have undergone this surgery since Tommy John, and the whole variety of procedures increases by 9% annually.

A 3rd of current Major League Baseball pitchers have undergone Tommy John surgery sooner or later. Shohei Ohtani, the Dodgers' two-way superstar, had the procedure in 2023Although Ohtani will return to batting in 2024, he is just not expected to start out pitching until 2025.

There are several the reason why the variety of operations has increased. Firstly, the addition of a Pitch Clock in 2023which works like a shot clock in basketball – the pitchers must throw their next pitch inside a certain timeframe.

In addition, pitchers today throw harder than they did half a century ago; the common speed of throws has increased about 4 miles per hour within the last 20 yearsBut pitchers who throw at higher speeds – especially at speeds over 100 miles per hour – Are more prone to suffer this injury.

The rise of Libero playing field has also had an impact. This fast breaking ball was blamed for the strain on the UCL.

Young arms carry greater burdens

Today, greater than half of Tommy John operations are performed on Children aged 15 to 19 years – essentially teenagers who’re highschool or college athletes.

This is because youth sport has modified dramatically over the many years. Today it’s a 15 billion dollar dealBetween school leagues, travel balls, all-star teams and showcases, young athletes play more often; in warmer parts of the country they’re lively year-round. Since a lot of them play for various teams and different coaches, nobody monitors the whole variety of throws.

This and the tireless concentration on a sport at a young age result in excessive strain on the elbow. Studies show Athletes who practice a couple of sport have actually led to a discount in injury rates.

The Pitch Smart programsponsored by Major League Baseball And USA Baseballoffers coaches and oldsters resources to assist young athletes reduce the danger of injury. However, participation in this system is strictly voluntary. A 2021 study shows that 90% of the teams surveyed Failure to comply with Pitch Smart guidelinesMany young players throw too many balls per day and don't get enough rest between games. Parents and coaches are either unaware of the Pitch Smart recommendations or just ignore them.

In fact, there are parents who wish to have their children operated on before a possible injury because they imagine that the procedure as a preventative measure will make the elbow stronger and more immune to future tears. However, that is is a myth.

Tommy John, now 81, regrets that the operation that saved his profession has turn into a routine procedure for kids whose bodies are still developingWith nearly all of these operations now being carried out by teenagers, John is asking for a return to the youth sports of the past, a time when kids played not a lot for the prospect of fame, fortune or scholarships, but simply for fun.

Admittedly, that doesn't help much. But as increasingly children must go under the knife, parents and coaches may finally be listening.