WASHINGTON — Some people accomplish enough in life to have something named after them — anything from a street or a middle school to a mountain or even a continent. Former Major League pitcher Tommy John got a surgery.
Once a radical, rare procedure, Tommy John surgery has become not only commonplace, but almost an expected rite of passage of top pitchers. On Wednesday afternoon, news came down that Texas Rangers ace Yu Darvish was likely headed for the procedure, which will cost him at least the entire 2015 season, if not some of 2016 as well.
For those unfamiliar with the procedure, Tommy John (or TJ, for short) surgery is the reconstruction of the ulnar collateral ligament along the underside of the elbow. Another ligament is used to replace it, and woven through two drilled holes in the bone. Despite its prevalence, the procedure itself is a major one, and the rehabilitation process to return to baseball often takes roughly a year for pitchers.
When John himself first underwent the surgery in 1974, he was essentially Dr. Frank Jobe’s patient zero, having exhausted all other options. John had won 124 Major League games to that point in his career, then returned after missing the 1975 season to win 146 more from his age 31 season on, including a trio of 20-win seasons. He finished in the top 10 in Cy Young voting four straight years and finished his career with the seventh-most wins of any left-hander in big league history.
If none of that had happened, the procedure may never have caught on. It’s an odd legacy to have, but one John embraces.
“I’m proud that Dr. Jobe named it after me,” he said recently while in town to lobby Congress to help reduce healthcare costs through support for exercise programs. “I’d rather have it called that then Stephen Strasburg surgery.”
Speaking of the devil, the now infamous Strasburg shutdown late in the 2012 season, following his own TJ surgery, remains the topic of much debate when it comes to how to handle pitchers following such surgeries. Rushing them back too quickly, too hard can cause complications and require a second procedure. Aside from another lost year, the success rate of the second surgery is closer to 20 percent than the 80-plus percent recovery rate from an initial ligament replacement.
“The reason you have to have it done the second time is you started doing too much, too soon the first time, and it couldn’t take it,” says John.
But why such a rash of injuries in the first place? A total of 31 big leaguers had Tommy John surgeries last year, with hundreds more amateur pitchers undergoing the procedure. Considering the lower recovering rate from younger players, Dr. James Andrews — the leader in this field — considers it an epidemic.
Everyone has their theories on how to help prevent the damage, from lower pitch counts to innings limits. But John doesn’t believe any of that is the real culprit.
“The injury is an overuse injury, but it has nothing to do with 100 pitches, 125 pitches,” he says. “It has to do with pitching year-round baseball at 7, 8, 9, and going 10 years.”
The lack of recovery time in the offseason is what John believes is contributing to the rapid spike in injury. Between club teams and travel leagues, most kids playing at a competitive level no longer have an offseason.
“The players that are having this done now, they are the first wave of kids who have been pitching 12 months a year,” he says. “We didn’t have that. If you ask Jim Andrews, six months on, six months on. You play baseball for six months, then you’re off for six months. Major League players don’t pitch 12 months a year, so why should some 7-year-old, 8-year-old.”
John has seen the rise first-hand. He managed the independent Bridgeport Bluefish from 2007-09, where he discovered that seven of his players — six of them pitchers — had undergone Tommy John surgery. Ownership asked him if he had recruited them on purpose because he felt sorry for them.
“I didn’t even know they had (the surgeries) until they told me,” he says.
John is vehement about making sure parents understand kids should not have the surgery preemptively, as some are inclined to do. The myth that one actually throws harder after the procedure is a dangerous one, he warns.
“That’s the farthest thing from the truth,” he says. “The surgery does not make you throw harder. The surgery corrects a flaw in your arm. It corrects a tear. You have the surgery, you rehab.”
The rehab itself is what makes the pitcher throw harder, as he has corrected the tear and further strengthened the area around it in a way that hadn’t been done before.
His views aside, John doesn’t spend his time preaching about how he believes the game should be governed. He has his well-formed opinions, due to his unique insight, but seems to recognize his place in all of this.
“If I were the grand mullah of baseball, I would say we play baseball during baseball season and other sports the rest of the time,” he says. “But I’m not. I’m just an old man who played baseball and had a surgery named after him.”
