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Ashway: Tommy John surgery changed baseball forever
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Forsyth County News

Brandon Beachy returned to the Braves’ rotation Monday night, 13 months removed from Tommy John surgery.

Ironically, he took the rotation spot of Tim Hudson, who suffered a gruesome ankle fracture last week.  Hudson himself underwent Tommy John surgery back in 2008. Between his elbow, ankle, and back, Hudson could sponsor a medical school course dissecting his many surgeries.

Irony No. 2: Beachy followed Kris Medlen to the mound. Medlen also underwent Tommy John surgery, back in 2010. 

Earlier this season, the Braves suffered what was then thought to be a devastating double-blow. Eric O’Flaherty and Jonny Venters, who presided over the seventh and eighth innings, both needed season-ending Tommy John surgery.

And are you aware that bullpen members Anthony Varvaro (2004) and Luis Ayala (2006) have also undergone Tommy John surgery?

That’s seven current Braves who have encountered the procedure. That’s how commonplace the surgery has become.

In fact, recent research by Will Carroll of The Bleacher Report found that 124 of the 360 pitchers who began this season on major league rosters have had Tommy John surgery. That’s over one-third. 46 players had the surgery in 2012 alone, and 17 more this year.

Staggering.

How can this be happening today, in an era when pitchers on the professional level are babied as never before?  Twenty win seasons, complete games, 250-innings-pitched seasons and 150-pitch games have all gone the way of the dinosaurs. When Tim Lincecum threw a 148-pitch no-hitter a few weeks ago, people were stunned that his arm didn’t shrivel up and fall off right there on the mound.

According to Carroll’s research, the problem is overuse at a young age. Carroll noted that Dr. Tim Kremchek recently performed Tommy John surgery on two 14-year-olds who pitched in the Little League World Series.

Gone are the days when kids played whatever sport was in season. Now it’s one sport year-round, and young arms have no time to rest and recuperate.

Never has the pioneering work of Dr. Frank Jobe, who performed that very first operation on Tommy John, been more necessary. That made it appropriate that he was honored Saturday at the Baseball Hall of Fame with a special recognition award.

Which was nice. But Dr. Jobe and Tommy John deserve plaques in Cooperstown by virtue of their outstanding contributions to the game.

John was 31 and in his 12th big league season on July 17, 1974, when he threw a pitch to Hal Breeden of the Montreal Expos. He felt searing heat and pain unlike any he had ever experienced. 

Despite having no MRI available back then, Dr. Jobe, the Dodgers team physician, diagnosed the torn ulnar collateral ligament in John’s left elbow. After a few months in a cast, Dr. Jobe realized that the ligament wouldn’t heal on its own.

After consulting with two surgeons who had performed ligament transfers, Dr. Jobe hit upon an idea:  why not replace the ruptured ulnar collateral ligament with the palmaris longus tendon, which extends from the base of the hand down the inside of the wrist, and has no specific purpose?

There were myriad questions, Dr. Jobe recalled for Doug Miller of mlb.com. "Would it stay there? Would it receive blood vessels? Would it become part of his elbow? We didn’t know. That’s why I told him he had about a 1-in-100 chance. And he said, ‘Well, if I don’t do anything, I’ve got zero chance.’"

On September 25, 1974, Dr. Jobe performed the three and one-half hour surgery.  Dr. Jobe drilled holes in the ulna and humerus, grafted the new tendon in a basic figure eight, and anchored it in place. Today, the basic procedure remains the same, but the surgery lasts only 45 minutes.

The rest was up to John. With the help of Dodger trainer Bill Buhler, they established a rehab regimen that, like the surgery, remains the basic blueprint today.

"We did a little bit of surgery for him," Dr. Jobe said Saturday at Cooperstown, "but the man himself did the hard work. He developed a rehabilitation program that stood the test of time."

It took almost 17 months, but on April 16, 1976 at Atlanta-Fulton County Stadium, Tommy John made it all the way back. Quite rusty, as you might imagine, he lasted only five innings, allowed three runs, and took the loss. But by the All-Star break, John began feeling comfortable again.

"In the second half, I was able to get hitters out when I didn’t have good stuff," he told Dave Anderson of the New York Times. "My arm was like I never had surgery."

John would go on the pitch 13 more seasons, and win 164 more games. He pitched until 1989, when he was 46 years old.

In all that time, his new elbow, courtesy of Dr. Frank Jobe, never caused him to miss a start.