The Athletic interviews Joshua S. Dines, MD,  sports medicine surgeon at HSS about Tommy John Surgery and what it looks like today.

In baseball, the words “Tommy John surgery” are uttered every day. And with a rash of injuries sidelining stars around the league, we are hearing the phrase more than ever. The number of injuries to pitchers’ ulnar collateral ligaments keeps rising, an epidemic swallowing the sport and leading to changes in the surgical landscape. But it’s no longer as simple as a pitcher tearing his ligament, going under the knife, and returning a little over a year later. Now there are many pitchers undergoing second, or even third, surgeries, known as revisions, with slightly different techniques and recovery times at play. And many players are gravitating towards a newer option, the internal brace procedure, which is adding a dimension to a seemingly familiar landscape. One thing is clear: Tommy John surgery, in its various forms, is going to continue to be an important part of baseball for the foreseeable future. 

Once viewed as a last-chance operation, Tommy John in the 21st century no longer has such a negative stigma. But the idea that all pitchers return from Tommy John as harder-throwing superhumans comes with misconceptions.

“In the first four or five months after Tommy John surgery, we’re really not even throwing a baseball,” Dr. Dines said. “You’re working on core strength and shoulder rotation and all these other things that when you’re playing baseball often get neglected. But because you have nothing else to do, you’re focusing on them. I think if anything that’s what makes these baseball players better and throw harder.” 

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