Two of the most earth-shattering yet career-extending words in a pitcher’s life are – Tommy John. Since baseball’s advent, pitchers have been at higher risk of getting injured. The sheer pressure on their elbows and arms makes it almost certain that they will feel the pain one way or another. Until the 70s, any major elbow injury sounded like the death toll on most careers.

One could recover but they rarely matched their previous heights. That was the case until Tommy John and surgeon Frank Jobe did something that revolutionized sports. Tommy John became the first major sportsman to undergo that surgery. The pitching legend had been excelling before his injury.

But unlike others, he continued with the same momentum even after his surgery. Suddenly that opened a lot of doors and gradually that surgery became synonymous with Tommy John. Now a mainstay of sports in general and baseball in particular, Tommy John surgery has become a boon for many young players. With superstars extending their careers through it, it’s only natural to dive deep into who has undergone the knife and its impact on their careers.

What is Tommy John and why is it scary? 

In technical terms, Tommy John surgery is an Ulnar collateral ligament (UCL) reconstruction. UCL is a thick triangular ligament at the medial elbow. Repetitive throwing usually leads to stress which in turn leads to stretching, fraying, or at worst – getting torn. As a result, it’s one of the most important and at-risk parts of the elbow for a pitcher. 

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Through Tommy John surgery, the UCL is replaced by either a tendon from some other part of the patient’s body, or with one from a deceased donor. While it sounds quite simple, it is a very elaborate process. Later, it takes up to seven to nine months to begin throwing from that arm.

Yet, for pitchers, it takes around 10 to 18 months to make a full return. The success rate ranges from 85 to 92 percent. So even in the best case scenario – the Tommy John surgery takes at least 10 months of one’s career. In a highly competitive sport like baseball, that is a huge period. The scary part? Number of players going for this surgery has risen exponentially in the past few years.

How many players have encountered this so far?

Finding the exact number of players going for Tommy John surgery is quite tough. Most sources place the number of MLB players at around 580-600. On the other hand, the total number of baseball players to have had this surgery is over 2300. Since the turn of the century, Tommy John surgery has gradually become more accessible. Partly because of an increase in injuries, pitchers are now opting for this more regularly.

Case in point, between 2000-2010 – an average of 16 pitchers had this surgery every year. The number skyrocketed to 36 in 2012. While at that point, the 2012 number was seen as an anomaly, ever since then the 20s and 30s have been breached regularly. 2021 saw 32 MLB players go through the surgery. 2022 saw 28 and 2023 saw 31. Similarly overall in baseball, 2023 saw 92 Tommy John surgeries taking place. 

While that is a scary trend, it also shows how baseball is gradually taking a toll on its pitchers. With the pitchers overextending their arms and continuously overpitching, debates have been raised over the long-term impact of such overexertion. While one awaits feasible changes, players have no option but to undergo Tommy John surgery. Especially because it has extended the careers of many superstars.

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Shohei Ohtani and others made it back successfully after the Tommy John 

Any list is incomplete without mentioning how the surgery impacted “The Bionic Man” Tommy John. The legendary pitcher had been pitching for eleven seasons when his elbow gave up on him in 1974. Until then he had won 124 games. After recovering for the entire 1975, John returned in 1976 and had a miraculous 10-10 record. The surgery extended his career for 14 years and he ended up winning 164 games after the surgery. 

Similarly, Shohei Ohtani had to undergo Tommy John surgery in 2018. Ohtani ended up playing as a DH in 2019 and gradually returned to pitching by 2020. Doubts were high over whether he’d be back to his best or not. But Ohtani’s next three seasons proved those naysayers wrong as he won 2 AL MVPs in 3 years. His pitching had improved and he was leading his team’s lineup more prominently than ever before.

Nathan Eovaldi has undergone two Tommy John surgeries (2007 and 2016). His first one came before his draft and could’ve been a huge setback for the young man. Yet Eovaldi managed a successful stint of 134 games with a 4.21 ERA. In 2016, he was forced to undergo another procedure.

Once again his career was in jeopardy but Eovaldi ended up playing a crucial role in winning the World Series with the Boston Red Sox in 2018 and then the Texas Rangers in 2023. However, not every player has been as lucky as them. There have been many careers that have been cut short due to the Tommy John surgery. Here are the few names that couldn’t regain their lost vigor after their surgery.

Pitchers including Jarrod Parker whose career dipped after the Tommy John 

The former Arizona Diamondbacks and Oakland Atheltics’ pitcher Jarrod Parker’s career was completely derailed after his two Tommy John surgeries. Parker was able to script a good return from his 2009 surgery – he posted a 3.73 ERA in 2012-13. Things went south for him real fast after the 2014 surgery. The pitcher tried to return many times but every year his rehab faced major setbacks. With multiple elbow fractures delaying his return, Parker decided to retire from baseball in 2018.

Brandon Beachy – another pitcher whose potential was hampered due to multiple Tommy John surgeries. Beachy had the world in his hands for a brief point in time. With just a 2.00 ERA in 2012, he was on the way to an All-Star nod when his injury struck. Beachy underwent his first Tommy John surgery. In less than two years, he was back in the doctor’s room for another surgery in 2014. That was it for him, Beachy returned briefly in 2015 for the Dodgers and then never pitched in the major leagues again.

So as it stands, the Tommy John surgery may have been an important breakthrough for players. Yet one can’t deny the inherent risk involved with any medical procedures. While multiple players have staged a great comeback, many have seen their careers take a nosedive. However, with injuries rapidly rising in baseball – Tommy John’s importance will only increase.

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