Hey everyone, it’s Medicine Mondays again. This is “kind of” medicine related. Today I’m going to talk about “What is Tommy John Surgery?”

Stock Photo from: Pexels

What is “Tommy John Surgery”?

Just so we’re clear, that picture isn’t Tommy John, it’s just some left handed pitcher I found on Pexels. I also want to be clear that I’m not an orthopedic surgeon, but I am a doctor — so I’m going to try my best to explain what it is in my own terms, as simplistically as possible.

So first things first, Who is Tommy John?

Well, he was a professional baseball pitcher — quite good actually. However, what made his name famous was that in 1974 he permanently damaged his ulnar collateral ligament. Basically, it’s the ligament that attaches the distal humerus to the proximal ulna (across the elbow joint). This particular area undergoes extreme tension during overhead pitching, and as you would expect, is commonly injured in pitchers.

So then, back in 1974, Tommy John was the first to have this new surgery technique. A tendon is harvested from the opposite (non-dominant) forearm and then used to reconstruct the ulnar collateral ligament. A common tendon which is harvested is the palmaris longus tendon. Rehabilitation takes about 9 months.

At the time, the feeling was that he would be unlikely to come back to baseball at all. Also, even if he were to come back, people felt he wouldn’t be able to pitch anymore. Interestingly, not only did Tommy John come back to pitch, but he did reasonably well in his first season back – posting a 10-10 record. Not only that, he continued to pitch for 12 more years. 

Some say he was even better post-surgery than he was before the surgery.

That’s cool, but why are we talking about this today?

Well, a couple of reasons. One is that one of my Dodgers, Corey Seager, will undergo Tommy John surgery. This will, unfortunately, take him out for rest of the season. However, because of the history of Tommy John surgery, the likelihood is that he’ll come back next season and be better than ever.

The interesting thing is that this kind of injury is very rare for a non-pitcher. Corey is a shortstop, and while it makes sense that he does a lot of overhead throwing, it is kind of weird that he would get this kind of injury, especially so early in his career… right?

Well, you would think so… but…

Kids are getting Tommy John Surgery nowadays.

Tommy John for teens: Why kids get major league surgery

The reason for this occurrence isn’t well understood. However, people believe it may stem from kids “specializing” in one sport. For example, if they play baseball year-round as a pitcher and are basically doing overhead pitching everyday with high pitch counts. This kind of continuous stress, even at a young age, could cause the ulnar collateral ligament to break.

Examining the rapid rise of Tommy John surgery in youth baseball

To quote this article:

“One recent study showed that there is increased risk of injury in 9-12 year olds who throw more than 600 pitches in a season or more than 75 in one game. It follows that as kids play on multiple teams throughout the year, the chance of hitting that 600 pitch number gets much more likely.” (emphasis mine)

So what’s the take home point then?

Let kids be kids.

Specializing in one sport year round is probably not a good idea. Sure, the experience for them is great, however, it puts a lot of stress on whatever they are doing. While this is easiest to see in baseball because of pitching and Tommy John, it’s probably similar for specializing in any one sport.

Let your kid play whatever he/she wants. Having them play 2 or more sports is great. I think that sports are more interconnected than we think. Playing soccer may help your shortstop gain better finesse on the field. All in all, sports are designed to help kids gain better control over their bodies.

Any other reason for this post?

Yea.

Kylie is 5 years old now and Lucas is 2, turning 3 in September. They’ve developed an interest in playing some sports. Kylie isn’t very interested in baseball. Lucas wants to play baseball — or maybe just hit stuff with a bat — I’m not quite sure yet. However, both Kylie and Lucas are interested in soccer. Kylie may try tennis instead of baseball. We’ll see.

I’d like for them to play at least two different sports, if possible. However, for Kylie we may need to cut back on other activities which include piano, hula, and swimming. Also, she wants to add ballet into the mix too. We are kind of running out of time to this activities on the weekends. So, I’m hoping that eventually we can move swimming to a weekday event and then add in soccer for the both of them. Unfortunately, the way soccer is set up here, Kylie and Lucas wouldn’t be in the same group, so we may be at the park all of Saturday morning. We’ll see how things go.

TL;DR

Tommy John surgery was a revolution when it happened, giving pitchers longer careers.

However, when kids are having the surgery so early, I think we need to pause and reflect.

We should focus on trying to prevent it from happening in the first place.

I think it’s a good idea to let your kids play different sports, and not just specialize in one.

Lucas likes baseball. Kylie may try tennis. They both like soccer. Our days/weekends will be full for the foreseeable future.

I hope Corey Seager is able to come back better than ever after his Tommy John Surgery.

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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