Graft reconstruction of the ulnar collateral ligament of the elbow is better known in baseball, simply, as
Tommy John surgery. Which should really be Frank Jobe surgery, after the surgeon who devised this career-saving medical procedure.
This documentary by ESPN tells a wonderful story of patient and physician. Jobe reluctantly agreed to do a procedure that sounded more experimental than established, and John, perhaps desperate to resume his baseball career, wanted to have it done.
The things was, Jobe could do the procedure, and John would just an unlikely to ever pitch again. He added that,
if he didn't do it, then for sure John would never pitch again. The odds of success apparently were 1 in 100, based on Jobe's scant experience and knowledge about the experience. With the known and unknown risks laid out duly on the table, they went forward.
Sports is a thrill to perform, and it's a thrill to watch. But it puts extraordinary stress on particular parts of the body, depending on the athlete's specialty: the feet, from dancing en pointe; the elbow, from playing tennis; and the head, from the pounding of boxing. So medical research and procedure have had to evolve along side sports, in order for these athletes to have any hope of plying their trade.
John had surgery on September 25, 1974, and spent the 1975 season in rehabilitation. In 12 seasons prior to it, he won 124 games. But he won 164 games, in the 14-season second-half of his career. So this wasn't just a resumption of his pitching, but also an improvement of his career.
There is another key figure in the Tommy John story, whom we don't often hear about - Mike Marshall. He was Dodger teammate of John, and won the Cy Young in 1974 as a relief pitcher and was an All-Star in 1974 and 1975.
Here is a bit on him from Wikipedia:
Marshall teaches and advocates a pitching method he developed that he "believes could completely eradicate pitching-arm injuries." He wants pitchers to have a smooth transition. To pitch[,] the arm has to externally rotate (hand lays back) before the ball accelerates. With traditional pitchers[,] the thrower often lifts his elbow before his hand (also called scapula loading); this leads to the ball coming up late and the arm to externally rotate late. The elbow will be accelerated forward while the hand still goes backward, which creates enormous stress on the arm.
Marshall instead wants pitchers to externally rotate early as they swing their arm up. That means the will lift the hand before the elbow, so that the wrist faces away from the body and up, the hand is above the elbow when the front foot touches the ground, which leads to a smooth transition without a "forearm bounce," as Marshall calls it (Marshall believes this causes UCL injuries, which require Tommy John surgery). He wants to first lay back the forearm and then accelerate by rotating the body instead of bending over, in order to protect the elbow against injury.
John worked with Marshall, as part of his rehabilitation in 1975, before coming back to MLB pitching in 1976.
About 500 pitchers have had Tommy John surgery, in the nearly 40 years since Jobe's pioneering. Presumably they all returned to the mound with solid, if not resounding, effectiveness.
Thank you for reading, and let me know what you think!
Ron Villejo, PhD
