There seems to be a myth perpetuated throughout the baseball community; the myth is that Tommy John surgery makes you throw harder and faster. I often hear players and their parents say “We knew this guy who started throwing harder after he had Tommy John surgery.”
I guess the logical conclusion is that Tommy John surgery leads to an increase in velocity. But that’s not true. Following Tommy John surgery, we often see pitchers have improved mechanics, increased upper extremity strength, and better muscular endurance which collectively leads to increased velocity from the mound. But it’s not the surgical repair of the torn ligament that did this.
It’s the rehabilitation the athlete must go through for nearly a year after surgery that leads to improved velocity on the mound.
Take a good look at these pictures.
Look at the position of those pitchers' arms…does your arm move like that?!
Most of ours don’t. But pitchers put their arms in this position while whipping it around at a rate of 2400 degrees per second (which equates to your arm revolving around in a circle seven times in one second for reference….AKA really, really fast!) At this ridiculously rapid rate, there is about 50 lbs of force going through your Ulnar Collateral Ligament which is a small ligament in charge of stabilizing your elbow during the extreme amount of force.
Now consider this…baseball players throw a baseball repeatedly, this fast and hard, hundreds if not thousands of times per week.
Almost every week.
From the time they’re 5 years old through high school, or if they’re lucky enough, beyond that.
And when you think about it like that there’s no wonder we see so many elbow injuries among high school baseball players.
The injury rate of this ligament has steadily increased the last several years and there are many hypothesized reasons for that. It has become so common that about one in four Major League Baseball pitchers has had Tommy John surgery to correct a tear of the UCL. Many of them have significant success following surgery. And it is because of the high-level performance-based rehabilitation they received post operatively.
The most important way to minimize injury to the UCL is by following pitch count protocols, rest between pitching appearances, and taking extended rest for several weeks each year. Following these protocols has shown to be the best way to prevent these types of injuries.
But I believe athletes, in this case, baseball players, also need to be proactive in taking care of their arms in effort to reduce risk for injury. In my experience working with these patients and getting them back to throwing, most of them tend to have similar restrictions or limitations that likely led to the development of trauma to the UCL overtime. Therefore, the right arm care program is paramount to staying healthy and on the field.