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What Is Your “Tommy John” Ligament?

You’ve probably heard of a few odd or unusual terms that refer to various medical conditions, body parts, or specific injuries. One of the most common of these terms, particularly heard in sports circles, is used to describe the Ulnar Collateral Ligament (UCL) of the elbow, also known as the “Tommy John Ligament.”

The UCL, or Tommy John ligament, is the main ligament stabilizing the inner part of the elbow. It attaches the end of the arm bone to one of the forearm bones. The UCL is often torn or stretched by activities causing repetitive strain on the ligament – particularly throwing or tennis. Stretching of the ligament can cause subtle instability in the elbow leading to pain with repetitive throwing. Often the ligament needs to be reconstructed with a tendon graft to restore its strength and allow return to pain-free throwing or overhead sports, a procedure that has become common in baseball pitchers.

Where Did The Name Tommy John Come From?

Tommy John was major league baseball pitcher for the L.A. Dodgers and New York Yankees over a twenty-year career and was the first person to undergo the procedure that now carries his name. John began to experience some serious ligament discomfort and pitching problems around 1974. Dr. Frank Jobe, a noted orthopaedic surgeon who was team physician for the L.A. Dodgers at that time diagnosed John with tearing of the UCL as the cause of his pitching problems and devised a new surgical procedure to reconstruct the ligament – a radical and controversial treatment at the time. Back then, it was believed that a major league pitcher could never return to pitching in the big leagues after having surgery. Faced with few options and the prospect of having to retire from baseball, John placed his trust in Dr. Jobe and underwent the procedure. He then went on to return to the major leagues and had a successful Hall of Fame carreer. Based on his success, the procedure became known as the “Tommy John” procedure and is now commonly performed on baseball pitchers with painful elbows.

Misconceptions About the “Tommy John” Procedure

Based on John’s experience and the success of others who have had the procedure over the years there has become a misconception that undergoing the procedure can actually improve pitching performance over that of having a normal elbow. Many players and coaches came to believe that the procedure increased pitching velocity and accuracy and that players were actually “better” after undergoing the procedure. There is no medical or biomechanical evidence to support this. However, most sports medicine and athletic trainers believe that the post-operative rehab and strengthening that players undergo after the surgery is what often times can lead to their improved performance. This has lead to more research and focus on prevent exercises and training regimens to improve performance in throwing and to help prevent the need for a thrower to undergo a “Tommy John” procedure.

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