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November 28, 2011

Experts separate Tommy John surgery fact and fiction

Can a pitcher tear his ulnar collateral ligament on one pitch? Is it true that Tommy John surgery to replace the ligament can make you a better pitcher?

Two experts on Tommy John surgery — Dr. Luke Oh and Dr. Thomas Gill — talked about myths and realities of the procedure in separate interviews with The Eagle-Tribune.

Oh is a sports medicine orthopedic surgeon at Massachusetts General Hospital and a Boston Red Sox team physician. Gill is the chief of Massachusetts General Hospital's sports medicine service, a former Red Sox medical director and a current medical director for the New England Patriots. Here are excerpts from the interviews.

Q: Can the ulnar collateral ligament tear on one pitch?

Dr. Oh: Some pitchers may describe throwing a single pitch, they hear a pop and have pain in the medial aspect of the elbow and discover that they have torn the ligament. But these usually happen in people who have been throwing for a while. Their ligament has undergone some attenuation and stretching over their careers. And it very well may be that a single pitch can complete that tear or complete the injury to a full-sized tear.

Q: Is surgery needed for a partial tear?

Dr. Oh: Sometimes it's possible to rehab through it and get back to pitching. But if it's a really big partial tear, it really functionally behaves like a ligament that can't sustain the torque of throwing. So those people may end up having surgery if they fail rehab.

Q: What is the normal recovery time from Tommy John surgery?

Dr. Oh: About 11 months to 16 months. The professional athletes at the minor league and major league levels take closer to the one-year mark. ... But at the high school and college levels, they do take a little bit longer because these young athletes don't have the same rotator cuff strength that major league ballplayers have.

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