Overview
Tommy John surgery reconstructs the ulnar collateral ligament (UCL) in the elbow by grafting a tendon from the wrist or ankle. Named after MLB pitcher Tommy John, who underwent the first procedure by Dr. Frank Jobe in 1974, the surgery has a return rate exceeding 80%, though recovery from surgery through rehabilitation to game action takes approximately 12 to 18 months. In NPB, numerous pitchers including Yu Darvish and Shohei Ohtani have undergone the procedure, making it the most common major surgery for pitchers. The rising number of surgeries has raised concerns, shifting emphasis toward prevention through pitch count management and conditioning. Some pitchers report increased velocity post-surgery, attributed primarily to physical strengthening during rehabilitation rather than the surgery itself.