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What is Tommy John Surgery?  Is it necessary?

by Chris Daino

If you are a sports fan, youíve probably heard of this procedure. The surgery is named after former Los Angeles Dodgers pitcher Tommy John. In 1974, he was the first to undergo this type of surgery.

Tommy John surgery is also called UCL reconstruction. UCL is short for ulnar collateral ligament. Ligament is a short band of tough, flexible, fibrous connective tissue that connects two bones or cartilages or holds together a joint.  Often you hear of athletes getting Tommy John Surgery due to torn tendons. 

"Tommy John" is a surgical procedure in which a healthy tendon is extracted from an arm (or sometimes a leg) and is used to replace an arm's torn ligament. Surgeons drill tunnels in the ulna and humerus. The tendon (called a "graft") is passed through the tunnels. It is then woven into a figure-eight pattern to reconstruct the ligament. To give the graft added strength, the original ligament is also attached

Recently, many people have noticed that there is more and more of these procedures being dong. You hear about the successful one, but the baseball players that donít come back are somehow forgotten. This procedure is so common now, that there are even some who propose the idea those young players should proactively seek Tommy John surgery to "prevent" a future problem and "enhance" performance.

Following that train of thought, maybe we should all get bypass surgery in case an artery in our heart gets clogged? (Or is there something else that can be done for heart heath so that arteries donít get clogged with cholesterol?)

But I digress. Back to tendons.

So many players are getting Tommy John surgery that it has now sounded an alarm in baseball that maybe this injury is spiraling out of control. The injury (tearing of the ulnar collateral ligament), the surgery (using a tendon graft to reconstruct the UCL) and the rehabilitation process are now familiar. Yet the problem persists.

Most UCL injuries occur in baseball players. But other sports are sometimes linked to UCL injuries. These sports include javelin throw, tennis, gymnastics, soccer, softball, football, wrestling and yes, even cheerleading.

Complications can occur in anywhere from 5% to 20% of patients, depending on the technique that is used. The most common complication is damage to the ulnar nerve. Other complications can include infection or hematoma (a solid swelling of clotted blood within the tissues)

What else can be done?

Training

If you read about the pitchers in the past they didnít need Tommy John. Perhaps, a change in training would help eliminate these injuries. Pitching mechanics need to be looked at so that all the stress is not put on the elbow.

The key treatment of most elbow injuries is prevention.

But, faster and faster speeds are being asked for and problems due to competition for placement on the ball teamís roster. Perhaps, we need to teach the budding athletes better care of the body both nutritionally (no soda during or after the game. etc.) and better body use technology.

Why doesnít the body repair these tendons?

Mostly this is due to the body not being able to repair the injured cells due to the type of nutrition (or lack of good nutrition) that the person gets, and again perhaps the "steroid" drugs injected into the body when there is any sort of injury or inflammation in the area.

Arenít you suspicious of what these drugs do to the often injured athlete body? Steroids suppress the immune system.

It is well known that those athletes who use PEDs (Performance Enhancing Drugs) that it creates a breakdown of the body. You just have to read the coverage of those athletes who were suspected or who confessed to using PEDs to see the type of breakdown that occurs.

If you check the Mayo Clinic website some of the problems with using these steroid drugs PEDs are severe acne, increased risk of tendonitis, and tendon rupture, along with a long list of other possible side effects.

But what about the cortisone steroid shot for inflammation after an injury and not the PEDs?

Well, again check the Mayo Clinic Website

Death of nearby bone (osteonecrosis)
Thinning of nearby bone (osteoporosis)
Joint infection
Nerve damage
Thinning of skin and soft tissue around the injection site
Temporary flare of pain and inflammation in the joint
Tendon weakening or rupture

Did you notice the tendon weakening and rupture side effect with both types of steroids?  Ligaments, tendons - when one weakens, so does the other.

There are so many different natural remedies for inflammation. Isnít that something that would be better for the athlete?

Okay, but why doesnít the body repair these tears in the ligaments.


What can be done?

Pro-Lo Therapy

This procedure should surely be used first to see what it can do before surgery.

Prolotherapy stimulates the growth of cells and tissue that stabilize and strengthen weakened joints, cartilage, ligaments and tendons. It works by injecting an irritant into the area (sugar water) which then activates the bodyís immune system.

The injected solution intentionally causes controlled irritation in the injected tissue. This irritation is an inflammatory response, which increases the blood supply, bring nutrients to the area, and thereby stimulates the tissue to heal and regrow new tissue.

The body will muster its resources to combat the irritants and thus bring its own healing powers to the area in need of help.

Takes about 6 weeksí worth of injections... No drugs to weaken the body, no invasive surgery and no long recovery period.

You can read more this at Prolotherapy

The cost of this therapy is a lot cheaper then the surgery but medical doctors are not trained to do this. I do know a D.O. in California and other doctors well trained in structure that does this. This should be better disseminated and should be an alternative to surgery.

Per research done (see article)  Prolotherapy will get the same results

 

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