Tommy John surgery is most commonly associated with baseball players, specifically pitchers. If you have heard about this type of surgery, it is likely because you are a fan of baseball or pay attention to it a little bit. The name Tommy John comes from a baseball pitcher that had this type of surgery in 1974. He was the first person to undergo the procedure.

The surgery involves a reconstruction of an elbow ligament. After Tommy John underwent surgery, he was able to go on to enjoy playing baseball professionally until 1989.

What is Tommy John Surgery?

While the common name for the surgery might be Tommy John, it’s also known as an Ulnar Collateral Ligament (UCL) reconstruction. The UCL is found in the elbow and may become torn due to excessive throwing movements. This is precisely why it’s commonly a baseball injury.

Another tendon from a donor or another place in your body will be used during this reconstruction surgery. The tendon will be attached to repair the torn UCL. Recovery from Tommy John surgery can be rather lengthy. Most baseball players will be out for the season, even if this injury occurs early on.

When the UCL is torn, it is not common for it to heal on its own. This type of sprain comes in three different degrees:

  • First Degree Sprain – A painful injury, but one where the ligament has not been lengthened.
  • Second Degree Sprain – When the ligament still works, but it has been stretched.
  • Third Degree Sprain – This is the worst degree as the ligament will be torn and will not function.

It is relatively common to go through physical therapy or use an alternative treatment before surgery is recommended. Athletes may go directly to surgery simply to help get them back on the field. It’s more common for tears in athletes to be more severe than those not playing baseball or another sport.

The Tommy John Surgery Procedure

Tommy John surgery or UCL reconstruction is commonly an outpatient procedure. It will take about an hour or an hour and a half. Most patients will undergo rehabilitation exercises and other treatments before undergoing surgery.

Before the procedure, you will be given general anesthesia. This helps to ensure you don’t feel anything during the procedure.

After the ligament has pulled away from the bone, it will need to be replaced with a tendon. The tendon, also called a graft, will likely come from somewhere else in your body. Sometimes, it comes from a donor. A hamstring tendon or one from the forearm is used, most commonly.

An incision will be made, usually around three or four inches in length. It will be located on the outside of the elbow. Damaged tissues will be removed, and a new graft will be added. The doctor will need to drill holes in the upper and lower arm bones to connect the new tendons.

Tommy John surgery is a rather common and successful option for baseball players. The majority of patients undergoing the surgery are able to return to playing and most MLB pitchers resume their careers.