Tommy John surgery has become an increasingly common procedure in Major League Baseball (MLB), particularly among pitchers. Named after former MLB pitcher Tommy John, who was the first to undergo the operation in 1974, the surgery—officially known as ulnar collateral ligament (UCL) reconstruction—has become a routine solution for elbow injuries that were once considered career-ending.
The Growing Numbers
By 2023, it was estimated that approximately 35% of active MLB pitchers had undergone Tommy John surgery at some point in their careers. To put the rise in perspective, more professional pitchers underwent the procedure in 2023 alone than in the entire decade of the 1990s. This dramatic increase underscores just how common UCL injuries have become at the highest levels of baseball.
Why So Many Surgeries?
Several factors have contributed to the rise in Tommy John surgeries:
- Increased Pitch Velocity: Modern pitchers are throwing harder than ever before. The higher velocity puts added strain on the elbow’s UCL, making it more susceptible to tears.
- Year-Round Competition: Many pitchers begin playing competitively at a young age and continue through multiple seasons without enough rest, leading to overuse injuries.
- Early Specialization: Focusing solely on pitching from a young age can lead to repetitive stress on the same parts of the arm, increasing the risk of ligament damage.
The Recovery and Success Rate
One of the reasons Tommy John surgery has become so common is its high success rate. Roughly 80% of pitchers are able to return to their previous level of performance after the procedure. However, recovery can be lengthy, often taking 12 to 18 months. In some cases, pitchers may even require a second surgery later in their careers if the ligament becomes compromised again.
Ongoing Efforts to Prevent Injury
With the continued rise in UCL injuries, MLB teams, coaches, and medical professionals have placed a greater emphasis on injury prevention. These efforts include:
- Monitoring pitch counts carefully
- Focusing on proper pitching mechanics
- Ensuring adequate rest and recovery periods throughout the year
Despite these measures, the physical demands of modern baseball make Tommy John surgery an ever-present reality in the sport.
Conclusion
Fifty years after Tommy John first underwent the pioneering procedure, UCL reconstruction has become one of the most common surgeries in professional baseball. While the surgery offers hope for recovery and continued success, its growing prevalence also serves as a cautionary tale about the physical toll of modern pitching.
