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What is Tommy John surgery and how long does it take to recover?

Ohtani, who tore his UCL while pitching against the Reds, will not pitch again this season due to tightness in his right oblique, requiring complex surgery.

Shohei Ohtani #17 of the Los Angeles Angels

Tommy John surgery is seen as the cruellest procedure a pitcher can get to recover from an injury, but it is also the only option when they suffer from a previously unsolvable issue in the elbow. Pitching is a strenuous activity that puts immense stress on every part of the body involved in the throwing motion, which can lead to a number of different injuries that vary in severity and recovery time. This is what you need to know about the surgery that most of your favorite pitchers, such as Jacob deGrom recently, have had to undertake in order to continue their careers.

What injury does Tommy John surgery solve?

A torn ulnar collateral ligament is the condition under which pitchers decide to take the surgery option. The UCL runs up the inside of the elbow, keeping your elbow joint stable during the act of throwing or overhead arm movements. The elbow is one of the most fragile joints in the human body, which, when paired with a violent throwing motion which pitchers repeat thousands of time per season, can lead to constant injuries that are not easy to solve. Elbow injuries often show up initially as some discomfort in the forearm and some pitchers do try to make it through it, but it ends up getting worse until there is no other option but Tommy John surgery.

Its name comes from pitcher Tommy John, one of the first professional players to undergo the operation in 1974 as a way to continue his career in baseball after an injury that was previously understood as incapacitating. This injury can happen in other sports or even to hitters, but there is no doubt that pitchers are by far the most affected by it.

How does Tommy John surgery work?

The only option that injured players have after their ulnar collateral ligament is destroyed is to replace it with another tendon from somewhere else in the body. The main options for this are a hamstring tendon, the big toe extensor tendon and the palmaris longus tendon from the forearm, out of which the surgeon takes a “graft” to replace the torn tendon in the elbow. An incission is made in the elbow to attach the new tendon to the bones.

How long does it take to recover from Tommy John surgery?

When talking about pitching again, the elbow needs to be in tip-top shape, so after a UCL tear and consequent surgery, the road to recovery is long and hard for the player, almost always taking more than a year. Josh Johnson recovered in just 11 months, but he is an anomaly. Dustin May for the Dodgers took 16 months to come back. Perhaps the greatest pitcher to come back from Tommy John is Justin Verlander, who won the Cy Young and has impressively improved his arm strength and control since the surgery.

The Rangers have expressed hope that they will get deGrom back in late 2024, allowing just over a year to 16 months for his recovery, but GM Chris Young was quick to point out that there are “no guarantees.” The precision of the procedure nowadays allows for a total recovery for most pitchers, but the time they lose in recovery is long enough for it to be deemed one of the worst injuries they can suffer.


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