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Tommy John surgery, known by doctors as ulnar collateral ligament reconstruction (or UCL), is a surgical procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, knee, or foot of the patient). The ulnar collateral ligament ( internal lateral ligament) is a thick triangular band consisting of two portions an anterior and posterior united by a thinner intermediate portion The elbow is the region surrounding the elbow-joint&mdashthe ginglymus or Hinge joint in the middle of the Arm. The forearm is the structure on the Upper limb, between the elbow and the Wrist. In Human anatomy, a hamstring refers to one of the Tendons that make up the borders of the space behind the knee The knee is the lower extremity Joint connecting the Femur, Patella, and the Tibia. The foot is an Anatomical structure found in many Animals It is the terminal portion of a limb which bears weight and allows Locomotion. The procedure is common among collegiate and professional baseball players.

The surgery is named after Tommy John, a pitcher for the Los Angeles Dodgers who was the first professional athlete to successfully undergo the operation in 1974. Thomas Edward John Jr (born May 22 1943 in Terre Haute Indiana) is a former left-handed Pitcher in Major League Baseball whose 288 The Los Angeles Dodgers are a Major League Baseball team based in Los Angeles California, USA The procedure was performed by Dr. Frank Jobe. Tommy John surgery known by doctors as ulnar collateral ligament reconstruction (or UCL) is a surgical procedure in which a Ligament in the

Contents

Process

After the tendon from the forearm of the opposite elbow or below the knee is harvested it is then woven in a figure-eight pattern through tunnels that have been drilled in the ulna and humerous bone that are part of the elbow joint.

There is a risk of damage to the ulnar nerve. In Human anatomy, the ulnar nerve is a nerve which runs near the Ulna bone [1]

Recovery

Chances of a complete recovery after surgery are estimated today at 85 to 90 percent. At the time of Tommy John's operation, Jobe put his chances at 1 in 100. After his surgery in 1974, John spent 18 months rehabilitating his arm, returned for the 1976 season, and went on to pitch in the major leagues until 1989 at age 46. Today, the procedure takes about an hour. Full rehabilitation takes about a year for pitchers and about six months for position players. Physical medicine and rehabilitation (PM&R or physiatry, is a branch of Medicine dealing with functional restoration of a person affected by physical disability Usually, pitchers who have the surgery can get their full range of motion back after about two months and can start doing weight exercises. For the next four months, they can increase the weight that they use and start doing exercises that emphasize all parts of their arm.

Risk of injury

The collateral ligament can become stretched, frayed or torn through the stress of the throwing motion.

The risk of injury to the throwing athlete's UCL of the elbow is thought to be extremely high as the amount of stress through this structure approaches its ultimate tensile strength during each and every hard throw[2]. In some cases, pitchers will seem to throw harder after the surgery than they did before the injury that caused the surgery to be necessary. However, many people -- including Dr. Frank Jobe, the doctor who invented the procedure -- believe this is generally due to two factors. The first is pitchers' increased attention to conditioning. The second is that in many cases it can take several years for the UCL to degrade. Over these years the pitcher's velocity will gradually decrease. As a result, the surgery simply allows the pitcher to throw at the velocity that they could before their UCL started to degrade[3].

Today, the injury and eventual surgery are becoming more common in children ranging from 10-18 years of age due to increased season length, the rise of travel teams (and tournament play), and the more frequent use of breaking pitches by young pitchers. In Baseball, a breaking ball is a pitch that does not travel straight like a Fastball as it approaches the batter. Children have an additional risk factor because of the open growth plates in young bones. In younger athletes in whom the growth plate (the medial epicondylar physis) is still present the 'opening up' force at the inside of the elbow during throwing is more likely to sustain failure at this region (the growth plate) than at the Ulnar Collateral Ligament. This injury is often termed "Little League Elbow" and in these athletes therefore reconstruction of the Ulnar Collateral Ligament is not indicated. Little League Elbow is a condition that is caused by repetitive throwing motions especially in children who play sports that involve an overhead throwing motion

While many authorities suggest that an individual's style of throwing or the type of pitches they throw are the most important aspects of their likelihood to sustain an injury, the greatest determinant seems to be the volume of throwing in total. In 2002 the results of a large study of young pitchers was published[4]. In this work, 426 pitchers aged 9 to 14 were followed for a year and questioned as to their throwing volume, pitch type, and their throwing mechanics were examined. Using throwing 200 or less pitches in a season as a reference, those players who threw 201-400, 401-600, 601-800, and 800+ pitches were at an increased risk of 63%, 181%, 234%, and 161% respectively. Considering the types of pitches thrown showed a smaller effect: throwing a slider was associated with an 86% increased chance of elbow injury while throwing a curve ball was associated with an increase in shoulder pain. In Baseball, a slider is a pitch halfway between a Curveball and a Fastball. The curveball is a breaking pitch in Baseball thrown with a grip and hand movement that imparts down and/or sideways spin to the ball. There was only a weak correlation between throwing mechanics perceived as bad and injury, although there is a large body of evidence that suggests that mistakes in throwing mechanics will increase the likelihood of injury[5] it seems that the greater risk lies in the volume of throwing in total. Research into the area of throwing injuries in young athletes has led to the development of age-based recommendations for pitch limits to young athletes[6].

List of baseball players receiving the surgery

All are pitchers unless otherwise noted. In Baseball, the pitcher is the player who throwsthe baseball from the Pitcher's mound toward the Catcher to begin each play with the goal of

List of football players receiving the surgery

References

  1. ^ Purcell DB, Matava MJ, Wright RW (2007). Brian James Anderson (born April 26, 1972 in Ashtabula Ohio) is a former Major League Baseball Pitcher. Richard Alexander Ankiel (born July 19, 1979, in Fort Pierce Florida) is an Outfielder for the St Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Andrew Jason Ashby (born July 11, 1967 in Kansas City, Missouri) is a former Major League Baseball Starting pitcher who Luis Ignacio Ayala (born January 12, 1978 in Los Mochis, Sinaloa, Mexico) is a professional Baseball Pitcher Brandon Allen Backe (born April 5, 1978 in Galveston Texas) is a Starting pitcher in Major League Baseball for the Houston Danys Báez González (born September 10, 1977 in Pinar del Río Cuba) is a Major League Relief pitcher for the Baltimore Rocco Daniel Baldelli (born September 25, 1981 in Woonsocket Rhode Island) is a Major League Baseball Outfielder for the Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Rodney Roy Beck ( August 3 1968 – June 23 2007) was an American Relief pitcher in Major League Baseball who Érik Joseph Bédard (eʁik beˈdɑʁ baydar) (born March 6, 1979 in the Ottawa suburb of Navan Ontario, Canada) Francis LeBron Beltrán (born November 29, 1979 in Santo Domingo, Dominican Republic) is a Major League Baseball Relief pitcher David Jeffrey "Jeff" Bennett (born on June 10, 1980 in Donelson, Tennessee) is a Pitcher who plays for the Atlanta Kristopher James Benson (born November 7, 1974 in Superior Wisconsin) is a Major League Baseball Right-handed Starting Adam Gino Bernero (born November 28 1976 in Los Gatos, California) is a Major League Baseball Pitcher in the Joseph Edward Borchard (born November 25, 1978, in Panorama City California) is a Major League Baseball player with the Atlanta Braves Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Dewon Cortez Brazelton (born June 6, 1980 in Tullahoma Tennessee) is a major league pitcher currently a Free agent. Ambiorix Burgos (born April 19, 1984 in Nagua, Dominican Republic) is a Right-handed Pitcher in Major League Allan James "AJ" Burnett (born January 3 1977 in North Little Rock Arkansas) is a Right-handed Starting pitcher in Major League Baseball Paul Gregory Byrd (born December 3, 1970 in Louisville, Kentucky) is a Major League Baseball Right-handed Starting Jorge Campillo Hidalgo (born on August 10, 1978 in Tijuana, Baja California, Mexico) is a Right-handed Pitcher José Canseco y Capas Jr (born July 2, 1964 in Havana, Cuba) is a former Outfielder and Designated hitter in Major Christopher Frank Capuano (born August 19, 1978 in West Springfield, Massachusetts) is a Major League Baseball Starting Christopher John Carpenter (born April 27, 1975 in Exeter, New Hampshire) is a starting pitcher in Major League Baseball who has Rocky Ty Cherry (born August 19, 1979 in Dallas Texas) is a current Pitcher in Major League Baseball who plays for the Shin-Soo Choo ( born July 13, 1982 in Busan, South Korea) is a Major League Baseball Outfielder for the Cleveland Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Justin Todd Coffey (born September 9, 1980 in Forest City, North Carolina) is a Major League Baseball Relief pitcher Manuel "Manny" Delcarmen (born February 16, 1982 in Boston Massachusetts, United States) (from Dominican decent is a Relief Ryan Scott Dempster (born May 3, 1977 in Sechelt British Columbia) is astarting Pitcher for the Chicago Cubs in Major League Christopher Anthony Denorfia (born July 15, 1980 in Bristol Connecticut) is a Major League Baseball Outfielder for the Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Jorge A DePaula (born November 10, 1978 in Sabana Grande, Dominican Republic) is a Right-handed Baseball Pitcher Brendan Kevin Donnelly (born July 4, 1971 in Washington DC) is a Major League Baseball Relief pitcher for the Cleveland Octavio Eduardo Dotel (born November 25, 1973 in Santo Domingo, Dominican Republic) is a Pitcher for the Chicago White Adam Thomas Eaton (born November 23, 1977 in Seattle Washington) is a Major League Baseball Pitcher for the Philadelphia Phillies William Mays Eyre (born July 21, 1978 in Fountain Valley California) is a Relief pitcher for the Texas Rangers. Jesse William Foppert (pronounced /ˈfɑˌpɚt/) (born July 10, 1980 in Reading PA) is a professional Baseball player who plays Chad Douglas Fox (born September 3, 1970 in) is a Major League Baseball Pitcher for the Chicago Cubs. Franklin Francisco (born September 11, 1979 in Santo Domingo Dominican Republic) is a Major League Baseball Relief pitcher for Éric Serge Gagné ( IPA:) (born January 7 1976 in Montreal, Quebec, Canada) is a Relief pitcher for the Milwaukee Brewers Thurman Clyde "Rusty" Greer III (born January 21, 1969 in Fort Rucker Alabama) is a former Major League Baseball Outfielder Luis Emilio Gonzalez (born September 3, 1967 in Tampa Florida) nicknamed " Gonzo ", is a Major League Baseball Outfielder Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Ángel Moisés Guzmán (born December 14, 1981 in Caracas Venezuela) is a Pitcher in Major League Baseball who plays for the Michael William Hampton (born September 9, 1972 in Brooksville Florida) is a Major League Baseball Starting pitcher who plays Patrick George Hentgen (born November 13, 1968 in Detroit, Michigan) is a former Major League Baseball player Runelvys Antonio Hernandez (born April 27, 1978 in Santo Domingo, Dominican Republic) is a Right-handed Major League Baseball Shawn Hill (born April 28, 1981 in Mississauga Ontario) is a Canadian Baseball Pitcher who plays for the Washington Matthew Thomas "Matt" Holliday (born January 15, 1980, in) nicknamed "Big Daddy" is the starting Left fielder for the Colorado Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Philip Gregory Humber (born December 21, in) is a Major League baseball Pitcher for the Minnesota Twins. César David Izturis (ɪsˈtʊərɪs (born February 10, 1980 in Barquisimeto, Venezuela) is Baseball teams take turns one "out" in the field and one "in" at bat Jason Derik Isringhausen (born September 7, 1972 in Brighton Illinois) is a Closing pitcher in Major League Baseball for the Thomas Edward John Jr (born May 22 1943 in Terre Haute Indiana) is a former left-handed Pitcher in Major League Baseball whose 288 Kelly Andrew Johnson (born February 22, 1982 in Austin Texas) is a Major League Baseball Second baseman with the Atlanta Outfielder is a generic term applied to each of the people playing in the three defensive positions in Baseball farthest from the batter Baseball teams take turns one "out" in the field and one "in" at bat Stefan Andrew Karsay (born March 24, 1972 in Flushing New York) was a right-handed Major League Baseball pitcher for the Oakland Athletics James Edward "Jimmy" Key (born April 22, 1961 in Huntsville Alabama) is a former left-handed starting Pitcher in Major League Hong-Chih Kuo ( Traditional Chinese: 郭泓志 Pinyin: Guō Hóngzhì (born July 23 1981 in Tainan City, Taiwan) is a Major League Cory Fulton Lidle ( March 22, 1972 – October 11, 2006) was an American right-handed baseball Pitcher who spend nine seasons Jonathan Ray Lieber (born April 2, 1970 in) is a Pitcher for the Chicago Cubs. Francisco Casillas Liriano (born October 26, 1983 in Juan Barón San Cristóbal Dominican Republic) is a Left handed Major League Matthew Bruce Mantei (born July 7, 1973 in Tampa Florida) is a retired Major League Baseball Relief pitcher. Scott William Mathieson (born February 27, 1984 in Vancouver British Columbia, Canada) is a Philadelphia Phillies pitching Joeseph Emerson Mays (born December 10, 1975 in Flint Michigan USA) is a Free agent Major League Baseball right-handed Pitcher Michael Seth McClung (born February 7, 1981 in Lewisburg West Virginia) is a Relief pitcher for the Milwaukee Brewers. Dustin Michael McGowan aka "D-Mac" (b March 24 1982, Savannah, Georgia) isa Baseball player currently a Pitcher Peter Michael Moylan (born December 2, 1978 in Attadale, Australia) is a Relief pitcher for the Atlanta Braves in Xavier Clifford Nady VI (ɛksˈeɪːvɪər 'neɪdiː born November 14, 1978 in) is a Major League Baseball Outfielder for the New Russell Reid Ortiz (born June 5, 1974 in Encino, California) is a Major League baseball Free agent Pitcher. Juan Miguel Padilla (born February 17, 1977 in Rio Piedras, Puerto Rico) is a Major League Baseball Relief pitcher Carl Anthony Pavano (born January 8, 1976 in New Britain Connecticut) is a Pitcher for the New York Yankees. Christopher Thomas Ray (born January 12, 1982 in Tampa, Florida) is a Major League Relief pitcher for the Baltimore Britt William Reames (born August 19, 1973 in Seneca South Carolina) is a Pitcher for the Pittsburgh Pirates. Arthur Lee Rhodes Jr (born October 24, 1969 in Waco Texas) is a Left-handed Major League Baseball Relief pitcher for Matthew Paul Riley (born August 2, 1979 in Antioch California) is a Free agent Major League Baseball Pitcher. Ricardo Rincón Espinoza (born April 13, 1970 in Cuitláhuac, Veracruz, Mexico) is a Relief pitcher for the New York Mariano Rivera (born November 29, 1969 in Panama City, Panama) is a Professional baseball player Fernando Rodney (born March 18 1977 in Samana, Dominican Republic) is a Relief pitcher who currently plays for the Detroit Tigers. Kenneth Scott Rogers (born November 10 1964 in Savannah Georgia) is a Left-handed American Major League Baseball Pitcher for Francisco Alberto Rosario Division (born September 28, 1980 in San Rafael del Yuma, Dominican Republic) is a Right-handed Relief Robert Victor Ryan Jr, more commonly known as B J Ryan, (born on December 28, 1975 in Bossier City Louisiana) is a closer in José Antonio Rijo Abreu (born May 13 1965 in San Cristóbal, Dominican Republic) is a former right-handed Pitcher in Major League Humberto A Sánchez (born May 28, 1983 in Santo Domingo, Dominican Republic) is a Right-handed Major League Baseball Scott David Schoeneweis (born October 2, 1973 in Long Branch New Jersey) is an American Left-handed Relief pitcher Jae Weong Seo (born May 24, 1977 in Gwangju, South Korea) usually referred to as simply Jae Seo and pronounced "Jay So" John Andrew Smoltz (born May 15, 1967 in) is a Major League Baseball Pitcher for the Atlanta Braves. Kyle Ehren Snyder (born September 9, 1977 in Houston, Texas) is a Major League Baseball Relief pitcher in the Rafael Soriano (born December 19, 1979 in San José, Dominican Republic) is a Major League Baseball Relief pitcher Merkin R Valdéz (born November 10, 1981 in) is a Pitcher in Major League Baseball. Tyler Lanier Walker (born May 15, 1976 in San Francisco California) is a Major League Baseball Pitcher who currently plays for Jacob Cauthen Westbrook (born September 29, 1977 in Athens, Georgia) is a Right-handed Starting pitcher for the Scott Ryan Williamson (born February 17, 1976 in Fort Polk North Louisiana) is a Right-handed Relief pitcher in Major Vance Allen Wilson (born March 17, 1973 in Mesa Arizona) is a Major League Baseball Catcher for the Detroit Tigers Mark Edward Wohlers (born January 23, 1970 in Holyoke Massachusetts) is a former Right-handed Relief pitcher in Major League Randall Christopher Wolf (born August 22, 1976 in Canoga Park, California) is a left handed Pitcher who plays for the Kerry Lee Wood (born June 16, 1977 in Irving, Texas) is an American Baseball player Jaret Samuel Wright (born December 29, 1975 in Anaheim California) is a Starting pitcher in Major League Baseball who is currently Tyler Kali Yates (born August 7, 1977 in Lihue Hawaii) is a Right-handed Pitcher in Major League Baseball for the Matthew John Young (born August 9, 1958) is a former American Major League Baseball player Víctor Manuel Zambrano (born August 6, 1975 in Los Teques, Venezuela) is a Major League Baseball Pitcher who is currently Jeff Zimmerman (born August 9, 1972 in Kelowna, British Columbia, Canada) was a Pitcher for the Texas Rangers Jake Christopher Delhomme (Duh-LOAM (born January 10, 1975 in Breaux Bridge Louisiana) is an American football Quarterback Craig Neil Erickson (born May 17, 1969 in Boynton Beach Florida) is a former professional American football player who was selected by the Chris Hunter may refer to Chris Hunter (hockey player, (b 1972 a Canadian hockey player Chris Hunter (author, Sebastian Janikowski (born March 3, 1978 in Wałbrzych, Poland) is an American football Placekicker who currently plays Rob Garland Johnson (born March 18, 1973 in Newport Beach, California) is a former professional American football "Ulnar collateral ligament reconstruction: a systematic review". Clin. Orthop. Relat. Res. 455: 72–7. doi:10.1097/BLO.0b013e31802eb447. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17279038.  
  2. ^ Fleisig, G. S. , The biomechanics of baseball pitching, in Biomechanical Engineering. 1994, University of Alabama: Birmingham. p. 163.
  3. ^ Keri, Jonah, Interview With Frank Jobe. http://espn.go.com/mlb/columns/bp/1431308.html
  4. ^ Lyman, S. , et al. , Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. In Baseball statistics, pitch count is the number of pitches thrown by a Pitcher in a game Am J Sports Med, 2002. 30(4): p. 463-8.
  5. ^ Whiteley, R. , Baseball throwing mechanics as they relate to pathology and performance - a review. Journal of Sports Science & Medicine, 2007. 6(1): p. 1-20.
  6. ^ Lyman, S. , et al. , Longitudinal study of elbow and shoulder pain in youth baseball pitchers. Med Sci Sports Exerc, 2001. 33(11): p. 1803-10.

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