Tommy John Injuries – Part 1

As winter gives way to spring and the smell of fresh cut grass fills the air, people will emerge from their winter hibernation and begin the trek to baseball and softball parks.  The crack of a bat, the pop of a ball hitting a mitt, and the chant of “here, batter, batter” will increasingly be heard as people of all ages turn their focus towards America’s pastime.

Most people who have spent much time around baseball have inevitably heard the words Tommy John injury.  When we refer to a Tommy John injury, we are actually referring to the Ulnar Collateral Ligament or UCL.  Prior to 1974, a torn UCL was a career ending injury to any high level baseball player.  Tommy John was a professional baseball player who began his career in the early 1960s and played in the majors until the early 1980s.  His career did hit a bump in 1974 when he was diagnosed with a UCL tear.  Up until that time, there were not any good options to repair or reconstruct this ligament.  Mr. John was evaluated by a Sports Medicine physician by the name of Dr. Frank Jobe in California.  Dr. Jobe ultimately reconstructed Mr. John’s UCL with a new surgical technique, and thus the Tommy John surgery was born.  Following the surgery, Mr. John was able to return to a high level of competition and resume his professional baseball career.

Today, over 40 years after the first UCL Reconstruction (Tommy John Surgery), there is almost an epidemic of UCL injuries in Major League Baseball pitchers. compiles the MLB’s injury data on their website.  According to that information, there were 17 UCL reconstruction operations in 2012, 28 operations in 2013, and 19 operations in 2014. The American Sports Medicine Institute’s position paper on Tommy John injuires states, this rise in professional UCL injuries corresponds to the sharp rise in adolescent UCL injuries that was seen in the late 90s and early 2000s.  It is believed by many that a torn UCL in a professional pitcher is often the result of accumulated stress that has worn the ligament out over time.  The injuries that are being seen now on a Major League level are likely related to the stresses these athletes underwent when they were in adolescence.

From time to time, baseball or softball players may notice some pain on the inside (medial side) of their elbow.  This may be a sign of ulnar collateral ligament or UCL injury.  The following may also be symptoms of a UCL or Tommy John injury:

•    pain with throwing
•    decreased velocity
•    numbness or tingling in the pinky and ring finger
•    tenderness on the inside of the elbow

Some athletes may hear or feel a “pop” during a specific throw, but not every athlete will describe this “Uh oh, I just hurt my elbow” moment.

If you are concerned that you or your young athlete may have an injury to their UCL, theyshould be evaluated by a Sports Medicine Physician who commonly evaluates the elbow of throwing athletes.  Often the use of Magnetic Resonance Imaging (MRI) is used to evaluate the integrity of the UCL and rule out any other causes of the elbow pain.

Having a torn UCL is no longer career ending to a professional or aspiring baseball player.  Our physicians at Elite Sports Medicine and Orthopaedic Center have vast experience with this athletic injury and the treatment options.  We would be happy to evaluate any athlete’s elbow pain and provide the corresponding treatment to enable them to return to activity as quickly and safely as possible.
Please call us at 615-324-1600 for an appointment.

Coming Soon—
One of our goals at Elite is to help individuals prevent injury while competing in athletics or pursing an active and healthy lifestyle.  New research has shown ways that throwing athletes, particularly baseball players, can reduce the risk of UCL injury.  Stayed tuned for more blogs exploring ways to reduce injury risk and address some common myths associated with UCL or Tommy John Injures.  In the meantime, enjoy the ball park!

Stephen Hasselbring, PA-C, MSM, ATC
Physician Assistant for Dr. Burton Elrod, MD
Elite Sports Medicine and Orthopaedic Center

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