‘Tommy John’ The surgery that continues to shape the game

GLENDALE, Ariz. — There is a bridge that runs from Tommy John and Dr. Frank Jobe in 1974, all the way to Shohei Ohtani, Justin Verlander and Bryce Harper. A thread that connects an increasing number of baseball’s biggest stars. Mostly on the mound, but at the plate, too.

An operation that changed everything.

Almost 50 years ago, on Sept. 25, 1974, Jobe reconstructed a torn ulnar collateral ligament in John’s left arm. It was a pioneering achievement for Jobe and a lifeline for John, who went from a career-ending injury to 14 more years in the majors — and an eponymous connection to sports medicine that would live on long pasthis playing days. TommyJohn surgery. “I wouldn’t still be standing here if it weren’t for a surgery like this,” Chicago White Sox pitcher Michael Kopech said. “It’s doubled the lengthof my career.”

Alongside arthroscopic surgery and ACL reconstruction, Tommy John is one of the biggest advancements in sports medicine in the last 50 years, according to Dr. Tim Kremchek, a longtime physicianfor the Cincinnati Reds.

“It(has) just prolonged and saved so many careers,” he said.

The roots of the surgery can be found in Jobe’s work at Rancho Los Amigos, a Southern California hospital, where doctors used tendon transfers to help people with polio.

Jobe applied the same concept to John’s elbow. He removed the palmaris longus tendon from John’s right arm, drilled four holes in his left elbow and then used the tendon to replace the torn ligament.

“It wasn’t a new idea,” Jobe said in July 2013, about seven months before he died. “It was just new for the elbow.”

The actual surgery largely remains the same as the one Jobe performed in 1974. But doctors have made improvements in terms of protecting the ulnar nerve, along with avoiding excessive scarring, putting the ligament in the right place and creating the propertension.

The evolution of the procedure — along with the physical evolution of the players themselves — is seen in the results on the field.

Verlander won the AL Cy Young Award in 2022, two years after he had Tommy

John surgery. Kopech had the operation in 2018, and he averaged 95.2 mph on his fastball last season. Dodgers pitcher Tyler Glasnow had Tommy John in 2021, and he struck out 162 batters in a career-high 120 innings last year. Harper, who had the procedure in November 2022, returned to Philadelphia’s lineupin May.

Then, of course, there’s Ohtani, who received a record-breaking $700 million contract from the Los Angeles Dodgers within months of his second major elbow operation.

“If you put it in dollars and cents, I think there’s no question that Tommy John is the most valuable reconstructive procedure there is,” said Dr. Neal ElAttrache, the head team physician for the Dodgers and the NFL’s Los AngelesRams.

Following thousands of successful Tommy John surgeries — everyone from middle schoolers to major leaguers — the biggest challenge for players just might be the monotony of the lengthy rehabprocess.

The arm that had the surgery is in a cast at an approximately 90-degree angle for about 10 days following the operation. After it comes off and the stitches are removed, it takes months to recover full range of motion. That’s all before the player starts throwing again on flat ground.

It typically takes at least a year before a big leaguer returnsto the majors.

“I remember the very first day of throwing,” said Dodgers pitcher Tony Gonsolin,

who had surgery on Sept. 1. “It was like 30 throws, nice and easy, and just felt super foreign, like I’d never thrownbefore.”

As Gonsolin makes his way through the process, he isgrateful for the opportunity presentedby Tommy John — one he knows wasn’t available to big leaguers before 1974.

The operation was a source of pride for Jobe later in life. ElAttrache recalled being at a dinner with his wife after the Baseball Hall of Fame honored Jobe and his work.He was seated at a table with Jobe, John and Hall of Fame pitcher Sandy Koufax — whose illustrious career ended at age 30 due to chronic elbowpain.

“Frank said, ‘Sandy, the only bittersweet part of this, I wish I would have been smart enough to think of this a few years earlier. You would have been pitching a lot longer,’” ElAttrache said.