Tommy John Surgery and the Facts

In 2014, a total of 29 pitchers in Major League Baseball (MLB) underwent Tommy John surgery (TJS); also known as ulnar collateral ligament (UCL) reconstruction, is a surgical graft procedure in which the ulnar collateral ligament in the medial elbow is replaced with a tendon from elsewhere in the body.

Tommy John Surgery

Off-season is coming to a close and with Spring Training 2015 less than two weeks away, you have to wonder how baseball players are handling their recovery, like Matt Harvey for the Mets, who underwent TJS and did not play for the entire season last year and catcher, Matt Weiters for the Baltimore Orioles who also underwent surgery.

History of the Tommy John Surgery

TJS was first performed in 1974 by orthopedic surgeon Dr. Frank Jobe, then a Los Angeles Dodgers team physician who served as a special advisor to the team until his death in 2014.

It is named after the first baseball player to undergo the surgery, major league pitcher Tommy John, whose 288 career victories ranks seventh all time among left-handed pitchers.

What is the procedure?

During Tommy John surgery, a surgeon replaces the injured UCL with a tendon taken from somewhere else in the patient’s body. The procedure is about 60-90 minutes; that general timeframe is from skin to skin and includes the harvesting of the palmaris longus — the forearm tendon you need to weave through the tunnels drilled into the ulna and humerus bones.

During Tommy John surgery, a tendon is taken from someplace in the patient’s body, such as his or her:

  • Wrist
  • Forearm
  • Toe
  • Hamstring (thigh)
  • Hip
  • Knee
  • Foot (Achilles tendon)

How does a UCL injury develop?

Anyone can get a UCL injury from repetitive stress to the elbow or from trauma. But throwers have the highest risk. That’s because throwing motions that twist and bend the elbow put extreme stress on the ligament.

Over time, the UCL can develop tiny or large tears. The ligament stretches and lengthens to the point where it can’t hold the bones tightly enough during throwing activities.

Most UCL injuries occur in baseball players. But other sports are sometimes linked to UCL injuries. These sports include:

  • Javelin throw
  • Tennis
  • Gymnastics
  • Soccer
  • Softball
  • Football
  • Wrestling
  • Cheerleading

Tommy John Surgery Rehabilitation

Rehabilitation from Tommy John surgery usually takes about a year. In some cases, up to 2 years are needed for athletes to return to their previous level of ability. Other types of UCL surgery may not need this much rehabilitation.

Dr. Weil was featured on KIRO Eyewitness News discussing the possibility of the Tommy John surgery about Richard Sherman, cornerback for the Seattle Seahawks. According to Dr. Weil, “… six months may be enough time to recover, though Sherman certainly could miss a game or two early on next year.”

If you believe you are suffering from UCL injury and need Tommy John surgery or specialized orthopedic care, the surgeons at Orthopedic Specialists of Seattle provide excellent treatment options available for you. Please feel free to contact OSS at (206) 633-8100 to schedule an appointment.


About Wayne Weil

Wayne Weil, MD Dr. Weil is a board-certified orthopedic surgeon who is well known in the community for his expertise in hand surgery. He sees patients with a wide variety of hand ailments, including carpal tunnel syndrome, cubital tunnel syndrome, dupuytren’s syndrome, thumb arthritis, wrist fractures, and more.