As a San Diego orthopedic surgeon who treats kids alongside adults, I spend a lot of time talking to athletes about how to extend their active careers.
Baseball is an evergreen topic when it comes to sports medicine, especially the various burdens that pitchers place on their shoulders and elbows. Many of these conversations focus on the pros and cons of a common elbow surgery procedure known as Tommy John surgery. At one end of the spectrum I see rising pitchers who wonder when they might require a Tommy John procedure, while at the other I field questions from seasoned pitchers who have had the procedure and wonder what to expect as they ease out of their competitive years.
The answers to such questions typically depend on each patient’s individual history, genetics and lifestyle, but they all start with an understanding of the process. This article covers the basics of Tommy John surgery in simple language, including this key passage about a wrist tendon known as the palmaris:
Once the tendon is harvested, the doctor will have the tendon cleaned and cut to size while he goes back into the elbow. Holes are drilled through the bones of the upper and lower arm, angled to allow the tendon to loop through and be placed in as near an identical position as the damaged ligament. In some cases the doctor will leave the damaged tendon in place, but most dissect it away.
The donor tendon is then looped through two or three times and locked into place. The doctor will then check that the ulnar nerve (“funny bone”), which runs through the same area, is not entrapped. Some doctors will move (transpose) the nerve as a matter of course, while others leave it in place. Nerve entrapment is one of the most common complications of the surgery. Tommy John himself suffered from the issue.
Recovery is often rapid, and research shows that this kind of elbow surgery is surprisingly durable and resilient. It’s not a magic bullet, however, and pitchers should be disabused of the notion that it will result in superhuman improvement. Like anything else, the mechanics of Tommy John surgery don’t hold up forever, and revision or followup appointments may be required.
Bottom line: if you’re experiencing elbow pain already, it’s wise to speak with an orthopedic surgeon about your options for surgery, recovery, and aftercare. To learn more, contact the San Diego elbow surgery experts here today.