How “Tommy John surgery” changed our national pastime

With a fastball clocked at 95 mph, Quincy Bright was on a track for the major leagues. He was just 13 when he was recruited by Mississippi State University. But at 17, the Connecticut high school star pitcher learned he had a torn ligament in his elbow. “I broke down in tears; I cried like a baby,” he said. “I love the game so much, so me not being able to play, it just really hurt me. I just felt like I was letting people down.”
Including his family, who had nurtured his talent. “He always rotated very quick,” said Omari Bright, “so every time he threw a ball, I was worried. So, I’d always try to limit what he was doing.”
Why did he think the injury occurred? “I think it happened when I was throwing too hard,” Quincy replied, “especially at a young age, and my body not being able to handle it.”
Like thousands of other athletes, Bright was thrown a lifeline called “Tommy John surgery.”
In 1974, Los Angeles Dodgers pitcher Tommy John was having a dream season, until he tore his ulnar collateral ligament, or UCL, the ligament that supports a pitcher’s arm while throwing. At the time it was a career-ending injury, that is until Frank Jobe, the Dodgers’ team physician, invented a procedure to fix John’s arm, changing baseball forever.
“I just said, ‘You do what you have to do to get me back playing baseball again,'” John recalled.
And how does it feel to have a surgery named after him? “Well, it’s better to have an orthopedic surgery than a proctological surgery!” John quipped.
Quincy Bright’s surgeon, Dr. Chris Ahmad, chief of sports medicine at NewYork-Presbyterian/Columbia, is also head team physician for the New York Yankees. “What Tommy John surgery involves is taking tissue from your forearm, a tendon, and replacing a ligament in your elbow, tighten it up, secure it, and that recreates a brand-new ligament that replaces the injured ligament,” he said.
“Baseball is America’s pastime, and throwing hard is part of this pastime. And therefore, Tommy John surgery is now part of America’s pastime,” Ahmad said.
Among active MLB pitchers, an astonishing 35% have had the surgery, up from 27% in 2016.
Asked why these injuries keep occurring, Ahmad replied, “The harder you throw, the higher your velocity, the more force on your ligament. And every year fastball velocity increases.”
Today, the average major league fastball is 93.8 mph – a full 2 mph faster than it was 15 years ago. “And when that’s happening at the major league level, it’s also happening at the amateur level,” said Ahmad. “In addition, the volume of throwing’s going way up, meaning it used to be that you would play baseball during baseball season. Now you play year-round. It’s a time bomb and an explosion about to happen in the elbow.”
Those explosions keep Ahmad in scrubs. He said that 20 years ago he performed the procedure about 10 times a year. “This first half of the year, I’ve done 150 Tommy John surgeries,” he said, most of them on athletes under the age of 18. 
Today, about 60% of Tommy John surgery recipients are under 19. 
Baseball Hall of Famer, MLB commentator, and Tommy John surgery recipient John Smoltz is an advocate for a cultural shift. He calls the rise in pitcher injuries an “epidemic.”
“Don’t buy into thinking that this is normal for your 12-year-old, yet alone a 25-year-old,” Smoltz said. “We just act like, ‘No big deal, have a Tommy John.'”
But he does understand the pressure young athletes are under: “I also don’t blame them for chasing their reward system, because that’s how they’re getting paid. At some point, this industry will have to self-correct. And the way it self-corrects is by rule changes and philosophical changes.”
Smoltz thinks change could begin with Little Leagues discouraging uncontrolled pitching velocity, and encouraging kids to take seasonal breaks from baseball. Smoltz said, “When I see a young man just throwing everything he has at 13, he’s not giving himself the best chance to pitch in high school.”
Or, for that matter, the major leagues.
For better or worse, the legacy of 50 years of Tommy John surgeries means players like Quincy Bright have a chance of strong-arming themselves toward major league dreams.
Asked what would happened if he did not play in the majors, Bright laughed: “That’s not gonna happen! I will be in the major leagues.”
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      Story produced by Amol Mhatre. Editor: Emanuele Secci.