Friday, September 15, 2006

NIH: What is Tommy John?

When working the injury beat, it's kind of nice not to have anything to report about, especially with the injurific season that the Nationals have been having. However, it's been awhile since I've updated the NIH, so I thought I'd do the next in an on going series of articles where I get to the bottom of common injury terms.

Today, I'll be looking at Tommy John surgery.

The first important question that popped into my mind when I learned about this procedure is who, exactly, is Tommy John, and why does the surgery get named after him? It's a long medical tradition that diseases and procedures often get named after the person or group who go first. Thus it is that we have diseases named after the tragic Lou Gherig, a group of Legionaires who were having a convention in Philly, and who can forget Maxwell Necrotizing Fasciitis? In much this same tradition, Tommy John was the first pitcher who reaped the benefit of the surgery that has become almost a right of passage in modern badeball.

Tommy John, in short, is the winningest pitcher not in the Hall of Fame. His career ERA is under 4.00. He won 57 more games than he lost over his career. His career strikeout total is well north of 2000. But what he will always be famous for was when he told a surgeon to "make something up" in 1974 when he damaged his ulnar collateral ligament, an injury that, at the time, was viewed as career ending.

The surgeon he said this to was one Dr. Frank Jobe. Dr. Jobe was a graduate Loma Linda University Medical School and did his residency (and later specialized in) orthopaedics. And what he eventually made up was a revolutionary procedure that involved replacing the damanged ligament with a tendon from elsewhere in the body, usually in the forearm or the leg (in John's case it was the forearm, though an urban legend says it was from a cadaver).

Tommy John returned to the Dodgers 18 months later, pitched for 13 more years, and 164 of his 288 career wins came with a transplanted tendon in his arm. That surgery took four hours to perform. Now the process has been stramlined so that the surgery takes only about an hour, leaves nothing more lasting than a scar, and can get players back on the diamond sooner.

And, some claim, better than ever. It's always been one of those stories about Tommy John surgery that players come back better than ever, throwing harder and getting better motion on the ball. To the point that some people have even considered elective Tommy John. Of course, this is a bit of a myth. The surgery isn't magic, no medicine is. And there isn't a 100% recovery rate. Just because you get Tommy John doesn't mean you'll play again. Also, many believe that what is the real benefit is not the surgery itself but the long recovery process, and the work that is gone through on the arm after the stitches are put in, taken out, and only a scar is left behind.

It's not, to put it simply, the surgery, but the conditioning.

Still, it has meant that pitchers can have much longer careers than they once did. Heck, it even means that a diagnosis of a torn UCL can be a sigh of relief, since there is such a well established procedure for replacement of the ligament.

And there you have it. The $2 tour of the history and procedure of Tommy John Surgery.


At 4:39 PM, Blogger Sam said...

Cool -- I've heard folks argue that Jobe should be elected to the Hall of Fame.

At 5:06 PM, Blogger thurdl said...

I could totally get behind that.

At 11:10 AM, Anonymous Anonymous said...

There's another part of the story--after the surgery, Mike Marshall taught him a new breaking ball that didn't hurt his arm to throw.
Remember the wisdom of Dr. Krankheit--"Does it hurt when you do dat?"
"Then listen verrry carefully. Don't dooooo dat "


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