Young athletes alarmingly uninformed on Tommy John procedure

By Jacob Clemen

Many high school and collegiate athletes are dangerously uninformed about Tommy John surgery, according to a study on perceptions of the elbow surgery.

The study, published in Physician and Sportsmedicine and authored by Dr. Christopher S. Ahmad, showed that 51 percent of high school athletes and 30 percent of high school coaches believe that players without elbow injuries should receive Tommy John surgery to enhance their performance.

The list of professional baseball pitchers that return from their Tommy John surgeries throwing harder than they threw before the ulnar collateral ligament reconstruction surgery is lengthy. Kerry Wood and Stephen Strasburg are two of the most notable instances of their post-surgery velocity increasing or coming more easily.

The surgery, which involves replacing the UCL in the elbow with a ligament from elsewhere in the body, was developed by Dr. Frank Jobe for Dodgers pitcher Tommy John in 1974. The surgery is required when the ligament in the elbow becomes worn down from overuse or an isolated tear.

The risk of elective surgery

Athletic trainer Jessica Christensen cautions against performing the surgery if no prior injury exists.

“I would never recommend electively repairing your ligament when it’s not damaged,” Christensen said. “I don’t think the elbow surgeons that I know would voluntarily do this surgery.”

Ahmad’s study showed that patients are able to return to the previous level of pitching  between 80 and 90 percent of the time.  While the surgery has a very high success rate and recovery is likely, no surgery is without its risks.

Malcolm Kelner, sophomore outfielder for the Emerson Lions, agrees that the risks do not outweigh the potential gains of the surgery.

“I would not recommend (surgery) to anyone I know because there is no guarantee that the surgery will benefit your arm,” Kelner said. “Many major league players have undergone Tommy John  and have never been the same. So for those who surgery is not medically needed, why would you take that risk?”

Strength stems from recovery, not surgery

It is unclear what exactly leads to the increased strength in the arms of major league pitchers. It is possible that a ligament from another part of the body simply performs better than the original or worn-down UCL in the elbow.

Ken  Wainwright, certified athletic trainer for the University of Kansas baseball team, suggests that the surgery is not the cause of the increase in arm strength.

“When you talk about strength I don’t think it is the surgery that is doing that, I think it is the rehab,” Wainwright said. “You spend nine months making your shoulder, your core and everything stronger and more stable. That is going to make you perform better.”

Wainwright also doubts that strength increases rather than just returns after surgery.

“For the people saying that this surgery is making them stronger than before the surgery, it goes back to this type of injury taking a long time to occur,” Wainwright said. “Gradually over that process your performance wanes. Gradually you start to throw slower, you start to lose control but you find a way to get through it.

With such a drop in performance over time Wainwright explained it is likely that the improvement is an illusion.

“I’m not sure people are better. I think they’re back to where they would have been,” Wainwright said.

  • Click here for an audio piece on training techniques for high school pitchers

Ahmad’s study indicated that athletes believe surgery will bring more than just enhanced strength. The study said that every group studied believed that performance, control and speed were all improved post-surgery.

Ethics of elective surgery 

According to a report on FoxNews.com experts are concerned that players may even use Tommy John like a performance enhancing drug by altering the elbow through an unnatural and potentially dangerous procedure to increase their physical ability.

Kelner, however, believes the decision to have surgery should be left to the player.

“I would not liken it to performance enhancing drugs,” Kelner said. “While surgery can’t be considered a natural process, it involves correcting the body with itself. Drugs involve consuming foreign agents.”

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