Tim Sussman 11 - 22 - 09 Composition II Prof. Anne Corbitt Words: 2020 Does Tommy John Surgery Give Pitchers an Advantage?

Tommy John surgery, formally known as ulnar collateral transplant surgery, is a medical procedure invented by Dr. Frank Jobe in 1974 that is usually performed on baseball players and other athletes who injure the ulnar collateral ligament in their elbows. It was named after Los Angeles Dodgers pitcher Tommy John, who was the first person to undergo the procedure. For baseball players, this damage is mainly caused by the wearing down of the ligament through constant throwing or pitching of the baseball. Over time, the ligament can wear down so badly that without the surgery, the players career can presumably be declared over. During the surgery, a donor tendon from another area of the patients body, usually the non-throwing arm, is removed and put in the place of the damaged elbow ligament (Shamus). The tendon is surgically attached in a manner similar to a figure-eight pattern like the shoelaces on a tennis shoe (Cohn). The donor tendon must then learn to function as a ligament and generally requires about twelve to sixteen months of rehabilitation before the athlete can return to action. If the healing process is successful, the

athlete will typically pick up where he left off, at a state near to what he was before becoming injured. However, there have been several cases of players coming back from the surgery who say they feel better than ever or throw harder and stronger than they had previously. These rumors have led some people who are not even injured to go through with this procedure in an attempt to give them an advantage over their opponents. Some parents have even asked their doctors to perform the surgery on their own children in hopes that they will eventually develop a stronger arm in the future (Smith). Is the rumor true? Does Tommy John surgery actually give its patients the upper hand once they have fully healed? There are many players who have claimed to feel much stronger and throw harder after their surgery than before they became injured. I hit my top speed after the surgery. Im throwing harder, consistently, claims Chicago Cubs starting pitcher Kerry Wood (Dodd). Tommy John himself pitched fourteen more seasons and won 164 games after undergoing the first ulnar collateral transplant surgery, forty more wins than he won before the procedure, and giving him a total of 288 wins in his career. Chicago White Sox relief pitcher Billy Koch says, "It felt so good when I came back, I said I recommend it to everybody ... regardless what your ligament looks like (Dodd). More recently, St. Louis Cardinals starting pitcher and 2005 Cy Young Award winner, Chris Carpenter, returned to the game after rehabbing from

Tommy John surgery in 2007 as well as a recovering from nerve problem in his right shoulder. He came back strong enough to compete for another Cy Young Award, the highest honor a pitcher can win, in 2009. He won seventeen games and achieved a 2.24 earned run average, helping his team make it to the playoffs (Grathoff). Early during the 2008 season, Atlanta Braves relief pitcher Peter Moylan also endured the fate of Tommy John surgery when a bone spur began to press against the ligament in his right elbow (ESPN). Moylan was ready to come back to the game for Opening Day 2009, less than one year after the surgery. He proceeded to appear in eighty-seven games, the second most in the National League, and went the entire year without giving up a homerun to an opponent. These results are intriguing, but are not completely due to Tommy John surgery itself. The creator of Tommy John surgery, Dr. Frank Jobe, believes these rumors about Tommy John surgery are all just misconceptions. Dr. Jobe says: When a pitcher comes in with elbow problems, you often see that their ligaments were already wearing out well before. Maybe

four or five years ago they could throw a 95 mile an hour fastball, but they've had that ability diminished as the ligament's been stretched. What the surgery does is restore the ligament's stability to where pitcher might say the operation did contributing to better

it was four or five years ago. A

it, but it's just more stability in the arm

mechanics (OLeary). This is simply stating that a players ligament gets broken down over time, making him throw slower. Since the surgery allows him to pitch as if he was given his original ligament back, he may be overwhelmed by the speed increase although it is just a return to his normal self, and thus begins the misconception that the surgery had actually increased his arm strength. When Dr. Jobe was asked if a player should get Tommy John surgery just in hopes of increasing his fastballs speed, he replied, It wouldnt help if you didnt have it before. All the surgery does is get you back to your normal elbow (OLeary). The degree of conditioning and strict rehabilitation exercises may also contribute much to the arms strength after the surgery compared to before it. Another prominent doctor who performs Tommy John surgery on star athletes, Dr. James Andrews says, For the ones that [have increased velocity], the reason is all the hard work, all the throwing exercises and the development from all the exercises they'd probably never done before (Dodd). Orthopedic surgeon Dr. Joshua Dines believes that the parents who want their baseball playing kids operated on solely for the elective purpose to increase arm strength are being ridiculous (Smith). Another belief about Tommy John surgery that is completely false is the confidence that the surgery will work 100% of the time. The first thought that goes through the heads of players and fans when

they hear their favorite player or teammate has to undergo Tommy John surgery is most likely along the lines of, Oh no, he will miss a season, but at least he will be back strong and healthy by spring training. Lewis Yocum, Dr. Frank Jobes partner and ulnar collateral ligament specialist says, "Everybody expects it to be 100%. Sorry, guys go into the operation hoping for a cure. We're able to help the vast majority of them, but it's not 100%" (Dodd). A more accurate expectation of success would be between 80 and 85% (Longman). One of the best examples of this would be Francisco Liriano of the Minnesota Twins. As a rookie in 2006, Liriano was considered the most impressive new pitcher in the American League. He won twelve games with only three losses together with a 2.16 earned run average and 144 strikeouts through just 121 innings pitched. At the end of the season, he began to feel pain in his pitching elbow. He soon learned that he required Tommy John surgery and would miss the entire 2007 season. He eagerly awaited the 2008 season and underwent a strict rehabilitation process for his chance to pitch again. Lirianos doctor, Dr. John Steubs, believed the operation to be a success, "The ligament was thinned and stretched and not completely torn. It really didn't appear to be as strong as we hoped. I'm pretty confident, based on what we saw, that he will do well," said Steubs (Neal). Unfortunately, in 2008 he was only able to win six games while nearly doubling his earned run average to 3.91. In 2009, he had an even more stressful time, only

winning five games and losing thirteen while ballooning his earned run average all the way to 5.80. Most fans attribute these struggles to a botched Tommy John surgery because before the operation, Francisco Liriano was able to hit 95 or 96 miles per hour on the radar gun. Now, three years later, he is only capable of reaching speeds around 92 miles per hour (Campbell). Kansas City Royals pitcher Brian Anderson experienced a much worse fate in 2005. Anderson blew out his elbow after twelve years of pitching and found it necessary to undergo Tommy John surgery to have any chance at a come back. He was very excited and hopeful after the procedure, posting an optimistic outlook on his personal blog: Just knowing that the situation is fixed, I can look forward to rehabbing and getting strong again. Its encouraging when the that I have a lot of innings ahead... encouragement to my the

doctor says there is no doubt Now Im going to try and be an

teammates and help out in any way that I can help on

field, all the while, making sure Im going to be ready to pitch in the Major Leagues for whoever will have me. Maybe that can be Kansas City and I can make right for these past two expensive of a player, have some

years. I dont think I would be too

and hopefully I can put up some good numbers and good years (Anderson).

He was never able to pitch in the Major Leagues again. He re-injured

his pitching elbow in spring training and decided to retire, adding to the nearly 15% of occurrences in which the surgery is unsuccessful (McLennan). It is safe to say that one can look at a few examples as well as take the doctors opinions and expertise in saying that ulnar collateral ligament transplant surgery, Tommy John surgery, does not in fact increase the patients arm strength, at least on its own. There are several factors that may bring about this velocity and power increase in addition to the surgery, but the surgery by itself will not increase arm strength. The main reason for the increased velocity seems to be the additional conditioning and exercise plans during rehabilitation that most athletes never do on a regular basis. The mind can influence the patients as well. For instance, if the patient strongly believes the surgery will help increase his power, he may accept any feeling of increase as being contributed solely by the surgery. A players strength and velocity will decline over time even before the injury that requires Tommy John surgery. Since the surgery is essentially setting a new ligament in place of an older one, the patient will be able to throw with the strength he had before the weakening he had experienced over the previous years. Simply put, all the surgery does is get the patient back to the strength he was before, but not anything extra than he ever was.

Works Cited All Major League Baseball season and career statistics acquired from <http://mlb.com>. Anderson, Brian. "Confessions of a Left-Hander: Inside my Tommy John surgery." Web log post. MLB Pro Blog. MLBlogs Network, 24

July 2005. Web. 3 Dec. 2009.<http://briananderson.mlblogs.com/archives/2005/07/inside_my_ to mmy.h tml>.

Campbell, Dave. "Liriano still trying to succeed with slower stuff." Bleacher Report. Web. 21 Oct. 2009. still-trying-to-

<http://bleacherreport.com/articles/186748-lirianosucceed-with-slower-stuff>.

Cohn, Lowell. "Let the kids play, out of harm's way." The Press Democrat. Dec. 2009. <http://www.pressdemocrat.com/article/20090418/NEWS/904189939? Tit le=Let-the-kids-play-out-of-harm-s-way>. PressDemocrat.com, 18 Apr. 2009. Web. 03

Dodd, Mike. Tommy John surgery: Pitchers best friend. USA Today 28 Jul. 2003. Print.

Grathoff, Pete. "Thirty-fifth anniversary of Tommy John surgery." Kansas City Star. 18 Oct. 2009. Web. 3 Dec. 2009.

<http://www.kansascity.com/sports/royals/story/1515414.html>. Longman, Jere. "Fit Young Pitchers See Elbow Surgery as Cure-All." New York Times. 20 July 2007. Web. 3 Dec. 2009.

<http://www.nytimes.com/2007/07/20/sports/baseball/20surgery.html >. McLennan, Jim. "Everything you wanted to know about Tommy John Surgery (but were afraid to ask)." AZ Snakepit. 28 Oct.

2009. Web. 03 Dec. 2009. <http://www.azsnakepit.com/2009/10/28/1099055/everything-youwanted-to-know>. "Moylan trying rehab to avoid season-ending surgery." ESPN: The Worldwide Leader 2009. In Sports. 18 Apr. 2008. Web. 03 Dec.

<http://sports.espn.go.com/mlb/news/story?id=3352558>.

Neal, La Velle E. "Liriano's Surgery Goes Well." Minneapolis Star Tribune. Star Tribune, 7 Nov. 2006. Web. 3 Dec. 2009.

<http://www.startribune.com/sports/twins/11693796.html>. O'Leary, Chris. "The Truth About Tommy John Surgery." ChrisOLeary.com. 20 Oct. 2007. Web. 27 Nov. 2009.

<http://www.chrisoleary.com/projects/Baseball/Pitching/RethinkingPitc hi ng/Ess ays/TruthAboutTommyJohnSurgery.html>.

Shamus, Eric, and Jennifer Shamus. Sports Injury Prevention & Rehabilitation. New York: McGraw-Hill, 2001. Print.

Smith, Michael D. "Parents Want Kids to Have Tommy John Surgery for Stronger 02 Dec. 2009. <http://backporch.fanhouse.com/2009/11/09/parents-want-kidsto-havetommy-john-surgery-for-stronger-arms/>. Arms." Back Porch Fan House. 09 Nov. 2009. Web.