BASEBALL ‘Saved so many careers’

50 years later, Tommy John surgery still a game-changer

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 past his playing days.

Tommy John surgery.

“I wouldn’t still be standing here if it weren’t for a surgery like this,” White Sox pitcher Michael Kopech said. “It’s doubled the length of 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 physician for the Reds.

“It (has) just prolonged and saved so many careers,” he said. “Not just in baseball, but now for some other sports that we’re doing it for so many other athletes, especially overhead athletes. But in terms of baseball, I think it’s allowed us to see some of the greatest players in the world continue to play for a long period of time.”

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 just applied to 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 proper tension.

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 the Phillies’ lineup in May.

Then, of course, there’s Ohtani, who received a $700 million contract from the 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 Rams.

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 rehab process.

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 the 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 returns to 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 thrown before . ... Then I threw couple days later and it felt much better.”

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

“I think the evolution of the surgery and just the sheer medical breakthrough from it allows to extend people’s careers,” he said. “It gives everybody a second opportunity.”

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 elbow pain.

“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.

The Crimson Tide can win a scoring contest against anybody. The question is whether they can play enough defense to win a game if the pace becomes grinding, as often happens in the tournament. Alabama is 342nd out of 351 teams in scoring defense.

Duke

The Blue Devils are among the teams capable of reaching the Final Four. They went into the ACC Tournament 8-2 in their last 10 games, and most of those wins weren’t close. But there’s been a drop in rim protection since Derek Lively II left after last season. There’s also been a late-season injury to freshman guard Caleb Foster that has left him wearing a protective boot on his right foot. A team with quick guards who can get to the basket could be trouble.

Iowa State

The Cyclones have been fabulous defensively in three seasons under T.J. Otzelberger, and they beat Houston, Kansas and BYU while going 18-0 at Hilton Coliseum this season. Thing is, almost half of those home wins came against weak nonconference opponents. The concern is if the Cyclones get a matchup against a team that takes care of the ball and has a big, physical guard.

Kansas

Big 12 scoring leader Kevin McCullar, big man Hunter Dickinson and freshman Johnny Furphy headline a strong starting five. But McCullar tweaked a bone bruise in his knee and Dickinson dislocated a shoulder, and both will miss the Big 12 Tournament. That puts pressure on a bench short of depth. The Jayhawks’ eight losses in conference play are their most since 1988-89, and a program that won it all just two seasons ago went 3-7 on the road.

Marquette

Marquette is another example of how a late-season injury to a key player could be ruinous. Tyler Kolek has missed the last three games with a strained oblique. The Golden Eagles are potentially great when he is fully healthy. They aren’t nearly the same otherwise. The best point guard in America is capable of scoring 30 points with double-digit assists any given night.

Purdue

The Boilermakers seem likely to land another No. 1 seed and are on this list only because of their recent history: first-round loss to No. 16 seed Fairleigh Dickinson in 2023, Sweet 16 loss to No. 15 Saint Peter’s in ’22 and a first-round loss to No. 13 North Texas in ’21. Still, this team is better than a year ago with Zach Edey again leading the way. Maybe this is the year Matt Painter makes it to his first Final Four.