Opinion: Tommy John surgery should occur less frequently in athletes

Complications associated with surgery make it increasingly detrimental

By Jenny Mosley
Sports Editor


Tommy John scar – Photo: Kelley L. Cox of USA Today

Properly known as ulnar collateral ligament reconstruction, Tommy John surgery stems from the over-use of a pitcher’s elbow. In previous years, elbow reconstruction wasn’t a common occurrence among baseball players, but recently those numbers have begun to raise. According to baseball-reference, “in the spring of 2014, it was reported that a third of major league pitchers had the surgery.”

Tommy John surgery is a procedure in which the medial elbow is replaced with a new tendon from either the patient’s body or a cadaver.

According to USA Today, famed orthopedic surgeon James Andrews said that he performed 41 Tommy John surgeries on kids in the year 2010 “The largest number of all those different groups, believe it or not, is high school kids,” Andrews told USA Today Sports. “They outnumber the professionals. There was a tenfold increase in Tommy John at the high school/youth level in my practice since 2000. I’m doing way more of these procedures than I want to.”

Despite the belief that getting Tommy John surgery as early as possible will help pitchers throw harder, most athletes never perform the same. According to, an analysis of MLB pitchers post-surgery “demonstrated performance declines in ERA, strike-zone accuracy, batting average against, walks plus hits per inning, innings pitched, percentage of fastballs thrown and average fastball velocity.”

Since recovery time is around 12-15 months plus another year or so of rehab, it’s hard to gage whether or not surgery was completely successful. Especially since 25 percent of pitchers end up having additional surgeries to fix other complications, according to

For young pitchers, returning from Tommy John is an even harder feat. In the pros, rehabilitation is much easier. Organizations are much more invested, not to mention they have more money in their athletes, meaning they get the best trainers, therapists and care. For high school athletes, paying for physical therapy can cost parents tons of money that they don’t have.

One way athletes can prevent surgery is to just take a break. In the past, baseball players were only active during the spring season, but now, with fall and summer leagues, winter camps and indoor training facilities; baseball has become a year-round game. Dr. Christopher C. Dodson also notes that kids and teens are playing for multiple teams. All of this additional throwing causes excessive stress on the elbow, which, for an underdeveloped body, causes injuries more frequently.

Another way parents and players can prevent Tommy John is to be more aware of tension in the elbow.

In many cases, young athletes play through pain or soreness not thinking much of it. In turn, parents and coaches are less likely to notice when something is bothering their children and players. Sports Illustrated advises that monitoring the amount of pitches per month/week will prevent over-usage. They also encourage participation in different sports, which will not only give their arms a rest, but will make them better athletes as well.

The most important thing to remember as a baseball parent, coach or player is that Tommy John surgery should be a last resort.