Tommy John Surgery – Three Words No MLB Pitcher Wants to Hear

First appeared on Blogcritics.

Back in 1974 when Los Angeles pitcher Tommy John had a 13-3 record before hurting his elbow, who could have guessed that the surgery Dr. Frank Jobe performed on him would save his career? More importantly, this surgery, which repairs the ulnar collateral ligament in the medial elbow by replacing it with a tendon from another part of the patient’s body, has gone on to be performed on numerous college and professional athletes and has saved many careers.

With the down time after the surgery usually taking at least a year, Tommy John surgery has become a thing that pitchers wish they never have to consider. Those words alone send shivers through the spines of fans, managers, and team owners, especially when connected to key pitchers upon whom a team has invested many dollars and hopes of success in that season.

According to MLB.com, 15-20 MLB pitchers undergo the procedure each year; however, a survey suggested that numbers are even higher – with “25% of MLB pitchers and 15% of minor league pitchers” undergoing Tommy John surgery during their careers. Recently it was announced that Yu Darvish of the Texas Rangers would undergo the procedure, effectively ending his season. New York Mets pitcher Josh Edgin is reportedly deciding whether to take time off or have the surgery, and Masahiro Tanaka of the New York Yankees, who has a slight tear in his elbow, has decided to move forward and pitch anyway after resting and nurturing the elbow all winter.

Just yesterday another Mets pitcher, Zack Wheeler complained of “tendinitis” in his elbow, but the team is downplaying it by saying Wheeler has experienced this condition throughout his career and that it is nothing of concern to them. Believe that one and I’d like to show you several bridges over the East River for sale. The overriding question is not whether or not a pitcher should get this surgery, but rather why have so many pitchers reached the point where they even have to consider it? MLB provides an answer of sorts on its website:

There are a number of factors that contribute to the likelihood of having Tommy John surgery or another arm injury. The single most important factor is daily, weekly and annual overuse. Other factors include lack of rest, pitching while fatigued, poor mechanics, playing catcher when not pitching and playing on multiple teams at the same time. There are also certain behaviors which may increase your likelihood of an arm injury, including throwing curveballs and sliders, pitching multiple days in a row and throwing at maximum effort.

Back when an injury cut Tommy John's 1974 season short, pitchers worked differently than they do today. Many starters were in a four-man rotation, which would mean approximately 40 starts per year. In those days pitchers were being charted (as to pitches thrown, etc.), but no one was pulling John or Tom Seaver or Steve Carlton out of a game because he reached a 100-pitch-count. Relief pitchers may have been called upon every day, and perhaps both games of a doubleheader if necessary, and in general less pitchers seemed to be getting hurt in those days.

Today managers are quickly out to the mound once a pitcher reaches 100 pitches. With a guy like recently returned from Tommy John surgery Matt Harvey of the New York Mets, his manager Terry Collins has been watching each pitch and no doubt saying a novena. On the other side of town, Yankees manager Joe Girardi is probably praying too and holding his breath each time Tanaka lets the ball go. So in this world of more coddled pitchers – pitch counts, innings limits for a season, and five-man rotations – why does it seem like more pitchers are getting hurt?

Can we believe the MLB explanation, or is it the coddling itself that may be part of the problem? An old friend (who is an even older Brooklyn Dodger fan and now a Mets fan) lays blame not only on the coddling but the type of pitches the pitchers are throwing. He notes that the split-finger fastball is the worst thing that a pitcher could ever throw.

He and I are no experts, but an article in USA Today lays the blame on velocity; too many pitchers are throwing as hard as they can on every pitch or almost every pitch. Perhaps the radar gun is the worst thing that has happened to baseball in the last twenty years. In Matt Harvey’s second start of spring training, people voiced concern because his pitches were around 93 mph, when in his first start they were closer to 99. Trying to hit the highest number is probably the best way to blow out an arm.

Dr. James Andrew and Dr. Glenn Feisig of American Sports Medicine Institute (who perform the Tommy John surgery) basically agree and give this advice to pitchers for avoiding the procedure:

Do not always pitch with 100% effort. The best professional pitchers pitch with a range of ball velocity, good ball movement, good control, and consistent mechanics among their pitches. The professional pitcher’s objectives are to prevent baserunners and runs, not to light up the radar gun.

Seems like a sound approach, yet apparently pitchers are not listening as they try to make their mark, get their teams wins, and perhaps achieve personal goals in strikeouts and victories. Whatever the case, pitchers are getting hurt at an alarming rate. One might hesitate to call it an epidemic, but the news each day seems to involve some pitcher coming up with a sore elbow or arm.

Hall of Fame pitcher Tom Seaver has an idea of how pitchers can avoid injuries – pitch more. He notes that back in his day three hundred innings a season were not unusual and no one was counting his pitches. The way they conditioned their arms back then was the old fashioned way – they pitched.

Whatever your feelings about the situation, pitchers are going down for the count now and it is alarming. We will have to wait to see how many pitchers will get hurt this season even though they are under the watchful eyes of managers and pitching coaches. As fans we want to see healthy pitchers, and while strikeouts and velocity are exciting, there has to be a balance that provides an opportunity for that pitcher to get back out there for the next start.

No pitcher wants to hear the words “Tommy John surgery” and the long recovery time it entails. It may have saved hundreds of players’ careers over the years, but it is also something that maybe can be avoided if things change. My feeling is let’s get rid of the radar gun, pitch counts, and innings limits and find a way to get pitchers healthy and doing what they do best – pitching!


  Photo credits: nydailynews, getty images, flickr.com