How To Prevent Tommy John Surgery

Although there is no guaranteed method to prevent Tommy John Surgeryyou can greatly reduce your chances of ever having to undergo this procedure by learning the proper training and maintenance for pitching. Being educated about Tommy John Surgery and learning the proper training procedure is a far better alternative than going ‘under the knife’. Rehabilitation is a long and sometimes painful process and can take you out of the loop at a critical time in your career.

What Is Tommy John Surgery?

Tommy John Surgery or Ulnar Collateral Ligament Reconstruction as it is known in the medical world, was first performed in 1974 by Dr. Frank Kobe on Tommy John, a famous major league pitcher. It 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.” (wikipedia)


It is generally associated with throwing too often or an incorrect throwing motion. Symptoms can include pain, a feeling of looseness, numbness in the fingers or inability or decreased ability to throw. Although some people claim that it can be the result of throwing one incorrect pitch (Stephen Strasburg), the general sentiment is that an incorrect throwing motion over the course of time is the culprit. Simply put, the incorrect motion causes the bones in the elbow to move apart and the UCL keeps them together. The long term result is a tear in the UCL.

Tommy John Surgery

Tommy John Surgery

5 Myths About Tommy John Surgery

According to Mike Rienold, PT, DPT, SCS, ATC, CSCS, an expert in the field of sports medicine, rehabilitation, fitness, and sports performance, there are 5 common myths about Tommy John Surgery.

1) Everyone Returns From Tommy John Surgery

Wrong. About 83% of pitchers return to their previous level of better. Recovery is not guaranteed.

2) There Are No Complications From Tommy John Surgery

Wrong. There are some complications from almost every surgery. It seems that about 20% of Tommy John Surgery recipients experience some form of complication, although most of them are minor.

3) Recovery From Tommy John Surgery Is Quick And Easy

Wrong. It usually takes about a year of concentrated rehabilitative training before most players can return to their former level.

4) Velocity Improves After Tommy John Surgery

Wrong. There seems to be no significant increase or  decrease in velocity after Tommy John Surgery. Of the pitchers that do experience an increase in velocity, industry experts attribute it to the increased and specialized training the athletes undergo during rehab.

5) All Post Tommy John Surgery Rehabilitation Is The Same

Wrong. Every case is different. Some people rehab quicker than others but the bottom line is that no two people are the same and every case has to be treated on an individual basis. There is no blanket program and the gradual progression to a full throwing motion must be overseen by an expert.

Preventative Training – Be Proactive

As Dr. Chris Mckenzie explains, because of the fact that there’s such a focus on velocity at an early age, especially prior to puberty, the growth plates aren’t closed and we may be training beyond the physiological limits of our bodies. Add to that the sheer number of pitches that multiple season pitchers throw, that cumulative stress over the course of several years could easily result in the UCL tear. Preventative training, (the type that will strengthen and increase velocity safely) is critical.

Probable causes of UCL Tear

As mentioned earlier, there are several probable causes of the UCL tear; throwing too hard, throwing too often, an incorrect throwing motion or a combination of the above. The throwing motion needs to be a fluid motion initiated from the legs, through the hips and torso and then to the arm. At this point it’s critical not to put too much strain  on the elbow. All of the power generated from the legs, hips and torso is where velocity comes from. You may have heard the expression before “pitchers that are all arm” are the most likely to be Tommy John candidates later in their careers.

Tommy John Surgery

Will He Be The Next Tommy John Surgery Candidate

Parents Need To Get Involved

Everyone loves a winner and everyone loves to win, but when there’s too much emphasis on winning and not enough emphasis on the proper training procedures, it’s critical for parents to get involved and be proactive about your child’s safety. I have seen (thankfully) parents who wouldn’t let their son pitch even though it was a critical game and would have meant a state championship. I applaud this decision and the courage it took. This particular parent stepped up and made some enemies in the process – bravo. Not an easy thing to do, but what would you rather have; a twenty dollar trophy or a healthy child!


Preseason Preparation

Perhaps the best place to start is prior to the season. Developing a preseason throwing program and adhering to that program is the most important factor. In this day and age of multiple season athletes, it’s critical that kids and parents know exactly how to prepare for the stress that a young player’s arm will endure. And that means being informed about how often a player pitches and how many pitches they throw; not only in a game but through the course of the season.


Regular Season Training

During the regular season, it’s important for kids to warm up correctly and be training in a manner that will strengthen the arm and not injure it. Again, an incorrect throwing motion over the course of time is an invitation to Tommy John Surgery, or at least a rehabilitation program. Remember, preventing an injury makes more sense than treating one! Kids need to warm up, train and cool down properly.

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