Tommy John Surgery Doesn't Mean the End

The phrase "Tommy John surgery" tends to have a chilling effect on pitchers and fans.

The recovery time is long - 12 to 18 months, on average - and it used to be that Major League Baseball pitchers returned to the mound a shell of their former selves, lacking the power and control they once had.

Not the case, anymore.

In fact, some pitchers have even found they were throwing harder after the surgery.

A quick look at the list of pitchers who have undergone Tommy John surgery shows a handful of success stories - Chris Carpenter, Josh Johnson, John Smoltz, Tim Hudson, Ryan Dempster and Eric Gagne, to name a few.

Washington Nationals phenom Stephen Strasburg injured his throwing elbow halfway through his rookie campaign in 2010, requiring Tommy John surgery. Strasburg went down just as teammate Jordan Zimmermann was returning from his rehabilitation from the same procedure.

The fact so many players have undergone the surgery helps explain why it's no longer the career-threatening move it used to be.

Ulnar Collateral Ligament Reconstruction, or UCLR, is the medical name for Tommy John surgery, so called because Los Angeles Dodgers pitcher Tommy John was, in 1974, the first to undergo the procedure.

A damaged ligament in the elbow is replaced with a tendon from somewhere else in the body, usually from the forearm. The long recovery time is necessary while the tendon learns to become a ligament.

Among the reasons pitchers are recovering at a higher rate than ever before is, for starters, because the procedure is less invasive than it used to be. For another thing, teams have figured out how to successfully rehabilitate their pitchers, giving them a better chance than ever at returning to form.

And "form" is a huge part of the equation.

Team trainers and doctors place a big emphasis on a pitcher's form, or delivery, during the rehab process.

The mechanics of the pitching motion have been studied from every possible angle, and teams take advantage of their pitcher's long recovery time to dissect his motion and begin tweaking his delivery, to avoid future issues and to maximize what's left of his arm.

The result is often a cleaner delivery and, in some cases - such as that of Florida Marlins ace Josh Johnson - a pitcher who throws harder post-surgery than he did before the injury.

Tommy John surgery isn't a success story for all, however; far from it.

Jesse Foppert, who was Baseball America's No. 5 pitching prospect in 2003, injured his throwing elbow during his rookie season with the San Francisco Giants, spent three years toiling in the minor leagues and was eventually released in 2009, never realizing his potential.

Fewer cases than ever before are that extreme these days.

Kerry Wood and Joakim Soria are among the pitchers who underwent UCLR and found success upon returning by switching to new roles - as closers. Others, such as Francisco Liriano, struggle to adjust to new mechanics but end up being productive once again.

Then there's St. Louis Cardinals ace Chris Carpenter, who went 17-4 with a 2.24 ERA in 2009 after undergoing Tommy John surgery in 2007, finishing second in the Cy Young Award voting.

See? Piece of cake.

Sources:
Ulnar Collateral Ligament Reconstruction (Tommy John Surgery), eOrthoPod
Tommy John surgery losing its stigma, The Examiner
Jesse Foppert, The Baseball Cube