Tommy John surgery for baseball elbow injuries – is it always necessary?

For all the baseball fans, or players, out there, I hope everybody enjoyed the World Series.

Today, I would like to talk about one of the most common baseball injuries. This is an elbow injury, called ulnar collateral ligament tear. These days, as young players tend to specialize earlier and earlier and only play one sport, overuse injuries seem to be more and more common and seem to happen earlier in life.

Ulnar collateral ligament injury is the result of repetitive use of the elbow during baseball throwing motion. This injury has been historically treated with ulnar collateral ligament reconstruction. During this surgery, the ligament in the medial (inside) elbow is replaced with a tendon from somewhere else in the body, be it from the forearm, hamstring, or foot. This surgery was first performed in 1974 by Dr. Frank Jobe, on Tommy John, a pitcher who ironically started his career in 1963 with the Cleveland Indians (for all of you Cleveland World Series fans).

While this surgery is successful, there are still some unknowns or lesser knowns about it. The rehabilitation is long, up to 12 months, and not every player recovers well from it. Invariably, osteoarthritis can settle in faster after surgery

More recently, we have heard from a few high level pitchers, including San Diego Padres’ Colin Rea, who have forgone the Tommy John surgery in favor of trying to repair their torn elbow ligaments using either platelet-rich plasma or stem cells. The news are good so far.

I don’t know about Major League pitchers: those players might opt for surgery right away. After all, their multi-million dollar careers are on the line. But what about the high schoolers out there who tear their ulnar collateral ligament? If the choice is between surgery followed by one year of rehabilitation, and a couple of stem cell injections in that area, followed by a shorter period of rehabilitation and no early-onset osteoarthritis, what would you opt for? If the UCL tear is partial, why not take some time to try to heal it naturally? If that does not work, surgery is always available.

So, to all you pitchers out there, or parents of pitchers: I think we live pretty during exciting times in musculo-skeletal medicine. There are more options out there these days, at relatively low cost with few to no complications.

If you have any further questions, or would like to make an appointment, please give us a call.

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