Baseball's 'Tommy John' Epidemic and What it Can Teach Us About Elbow Injuries

In baseball, the elbow joint is key; it’s necessary for throwing, catching and swinging the bat.  With baseball season fully underway, the sports page headlines have become rife with news of big league players suffering elbow injuries. One of the most prevalent such baseball injuries stems from issues with the ulnar collateral ligament, or UCL, located at the elbow joint.

When a person twists or bends the elbow, specifically a repetitive throwing motion, the UCL, is placed under extreme stress.  The motion can cause the ligament to fray, stretch, and even tear.  Over time, the UCL can develop tiny or large tears, causing elbow pain and instability.  The tears cause the ligament to stretch and lengthen so much so that it cannot hold the upper arm bone (humerus) and forearm bone (ulna) tightly enough. Baseball players, specifically pitchers, are at risk for this type of injury because of the repetitive throwing motion they do on a daily basis.  Symptoms of an UCL injury include: instability of the elbow, pain, tingling or numbness in the small or ring finger, decreased throwing ability, and a sense of looseness in the elbow.

Although sometimes difficult to identify, UCL injuries can be diagnosed through a patient history, X-rays, and MRIs of the elbow.  Once diagnosed, the patient can begin conservative therapy, including rest, ice and non-steroidal anti-inflammatory drugs (NSAIDS).  With the non-surgical route, strengthening surrounding muscles around the UCL is important.  This can be done through physical therapy.  Athletes and patients who don’t respond to the conservative treatment can consider Tommy John surgery, also known as UCL reconstruction.

“The Tommy John surgery is one that is done more commonly in baseball players due to overuse syndrome and repetitive motion with throwing, causing damage to the ulnar collateral ligament,” local orthopedic surgeon Dr. Jeffrey Colbert explained. “During the procedure, a ligament is harvested and used to reconstruct the ulnar collateral ligament.  It is a rather lengthy recovery process that can take up to a year to recover with much therapy thereafter.” 

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