Tommy John surgery has come a long way
MINNEAPOLIS – On a pitcher-perfect June night in the Twin Cities, Francisco Liriano and Tim Hudson dueled for eight dazzling innings, making every hit look like pure accident and every run scored feel like a minor miracle.
Liriano struck out 11 and allowed one run in eight innings for the Twins. Hudson went the distance for the Braves, losing 2-1 after giving up five of his seven hits and both runs in the seventh inning.
Even more impressive, both have reasserted themselves as top-shelf starters this season after having Tommy John surgery, the elbow-ligament-replacement procedure that once spelled the beginning of the end for a pitcher’s career.
“That’s the modern miracle of what doctors can do to put people back together,” Twins manager Ron Gardenhire said after the game. “We all know the arm takes a beating. Goodness gracious, we saw two guys who were both throwing the ball 90-plus mph with sliders and stuff. That’s because some doctors did some really good jobs.”
As the pennant races heat up, more and more pitchers are showing that there is life after Tommy John. Hudson, Liriano, Florida’s Josh Johnson, Atlanta’s Billy Wagner and St. Louis Cardinals ace Chris Carpenter are among the many coming back from the surgery almost as good as they’ve ever been, a development that surprises even the physician who pioneered the technique more than 30 years ago.
“I had no idea it would do this,” Dr. Frank Jobe told The Associated Press by phone from his California offices. “It startles me even today that it has done that. The doctors are recognizing the condition early enough to fix it and they are learning how to do the surgery so well. They rehab it so not just the arm, but the whole body gets better.”
It’s even working for power pitchers. Rays closer Rafael Soriano’s fastball is still in the mid-90s, Johnson is hitting 96 regularly and Liriano’s superb slider is biting again.
“I feel great,” said Hudson, who had the surgery in 2008. “I can’t feel any better. My arm’s as good as it’s ever been. I wish they had similar procedures for the rest of your body.”
When Jobe told Dodgers pitcher Tommy John he wanted to take a tendon from John’s right forearm and use it to replace the torn ulnar collateral ligament in his left elbow, John wasn’t the only one in that room who was unsure how the whole thing was going to turn out.
“I told him I wasn’t sure and that he didn’t have much of a chance coming back, but it was probably the only chance,” Jobe recalled of their 1974 meeting.
After 18 months of rehab, John returned in 1976 and remarkably pitched for 13 more years, proving the surgery was a viable option to treat an injury that otherwise would have ended a pitcher’s career. Still, Jobe wasn’t totally convinced in the early going.
“When he did come back, I thought maybe we could do it on somebody else,” he said. “I waited two years to try it on somebody else, but we had no idea we could do it again.”
But there were many others, including some earlier this decade, who never returned to their previous form. Minnesota’s Joe Mays, Atlanta’s Mike Hampton and former Mets prodigy Bill Pulsipher are among the long list who struggled to make it back, with some developing shoulder problems or other injuries in the process.
In the last five years or so, team physicians have been perfecting the delicate rehabilitation process, and skilled surgeons like Dr. James Andrews and Dr. Lewis Yocum have helped reduce what was a four-hour procedure into a one-hour deal.
“It seems like the whole thing is turning out better,” Jobe said.
Liriano had the surgery in 2006 after dominating the American League in a superb rookie season. It took him four long years to work his way back, but now he appears close to being the ace he once was. Liriano had a 21-inning scoreless streak end last week and has said his arm has felt stronger and stronger after each start.
Hudson and Johnson each made much quicker recoveries. Hudson returned from surgery in 2008 to pitch late in 2009, performing well enough to earn a three-year, $28 million contract to stay in Atlanta.
Hudson has rewarded the Braves’ faith, going 13-5 with a 2.24 ERA this season to lead the team to first place in the NL East.
“I think gradually everything gets a little bit better,” Hudson said. “I’m not saying there’s going to be crazy leaps and strides from one week to another. The more you get out there, the stronger you’re going to be.”
It’s seemingly been even easier for Johnson, who returned from the surgery in July 2008. He is 32-10 since coming back and has been better than ever this season, going 10-4 with a 1.97 ERA and a career-best 4.33 strikeout-to-walk ratio.
“You go back to Tommy John and how it’s evolved over the course of time, it’s definitely at the point where it’s not a negative anymore,” Rays manager Joe Maddon said. “You do believe that if it happens to a young guy, you know you’re going to have him back and possibly even better. It’s the world we live in, man.”
An entirely new world where the procedure is starting to be viewed as routine maintenance, Rockies manager Jim Tracy said.
“It’s like taking your car to Jiffy Lube,” he said. “Does your car run better when you get an oil change? Same thing here.”
Ligament-replacement surgery is even starting to creep into the NFL now. Quarterback Jake Delhomme had Tommy John surgery while with Carolina and is now likely to start for the Cleveland Browns this season.
Jobe said the key is taking an entire year to rehabilitate, being patient as arm strength is restored, and not rushing back, which exponentially increases the risk of re-injury.
So will the advancements continue?
“I’m sure they can,” Jobe said. “You never want to say in medicine this is the end. You’re always coming up with something a little bit different. Even with Tommy John, there’s people doing things slightly different. In their minds they’re getting better.”
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