The Great Baseball Advancement

An ulnar collateral ligament replacement procedure. What is it? Probably just some fancy medical term to describe some little known experimental medical surgery that a doctor might be toying with. But what you may not know, is an ulnar collateral ligament replacement procedure is possibly the greatest advancement in baseball in the past 30 years. What is it? Well, baseball fans know it as ‘Tommy John surgery'.

Throughout the first two-thirds of the century, many, many baseball pitchers saw their careers come to an end prematurely. No one knew why exactly, but for whatever reason, the pitchers simply couldn't pull back and fire the way they once used to. What was the term given to those pitchers of the era that could no longer fire like they used to? "Dead arm".

But there was one pitcher who when he came under the problem, he didn't want to accept that his career was actually over. So, Tommy John visited Frank Jobe back in 1974 about an experimental medical procedure that would potentially get him back on the mound, as opposed to relegating him to coaching duty for the rest of his life.

What exactly does the procedure involve?

Well, when a pitcher throws a baseball, his elbow is kept stabilized by his ulnar collateral ligament. This is a rare injury, because the average person doesn't create such extreme tension on the elbow (tension that might come from firing a baseball at 90-plus MPH).

When this ligament becomes damaged, the pitcher can no longer throw with the same velocity or control that they did before the injury. Possibly the most difficult part of it all is diagnosing the injury, simply because it's not extremely painful and is very difficult for medical specialists to find (and nearly impossible pre-MRI).

So, to complete the surgery, a doctor will take a tendon from another part of the body (typically a tendon from the forearm – but it's so unimportant that 15% of people don't have it, in which case a tendon is taken from the hamstring or the ankle) and use it as the replacement ligament. This ligament is woven through tunnels in the elbow and, Presto! You have a new ligament.

Now, the surgery isn't full-proof; they estimate that 85%-90% of the surgeries are classified as successful. The full recovery time for those that it is successful for is about two years, and doctor's now believe this is the ideal amount of time that is necessary for the elbow to properly heal.

The entire first year is simply rehabilitation, teaching the tendon to perform the duties of a ligament, while not pushing it too hard and taking plenty of time.

Once the elbow is ready to go once again, doctors and players estimate that it takes around another full year for the arm to be ready to pitch at full strength once again. The long recovery time is largely due to the simple fact that the pitcher needs to train his entire arm how to throw all over again.

Tigers' minor leaguer Rob Henkel owes his career to modern medicine. Henkel, who is hopeful of being ready to go by Opening Day, is currently recovering from a torn labrum. But back in college at UCLA, Henkel also underwent Tommy John surgery.

When asked about his injury struggles, Henkel stated "The shoulder had been bothering me for awhile, much like my elbow was back in college, but I was relieved to find out that there was actually something wrong, and the doctors today are just amazing, were able to go in and fix it, and now I should be ready to go."

Henkel isn't the only Tiger pitcher benefiting from this surgery. In fact, recent estimates show that about 75 pitchers in Major League Baseball in 2004 had undergone the ligament replacement surgery (or approximately one in nine of all big league hurlers).

A pair of relievers competing in camp this spring; Chris Spurling and Fernando Rodney, just underwent the operation last spring and are now working on coming back from the injury and hope to get a chance to grab one of the remaining available bullpen jobs.

It's certain that both Spurling and Rodney will go through their share of struggles this upcoming season, regardless of where they pitch. But what won't be in question is the incredible advancements that have been made, and how much they benefit big league clubs (and especially many of their players) today.

So, the next time you see Spurling, or Rodney, or Kris Benson, or Kerry Wood or any of the other well-known star pitchers that have undergone the procedure, take a look at their arm. That 4-inch scar by the elbow may look like just any other surgery that a big leaguer may go under, but that one little scar is the reason those guys are back on the mound, pitching in the big leagues. They're getting the opportunity that the dead-arm'ers of the previous generation didn't.


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