Posted on Tuesday, 12th January 2010 by Eric Cressey
Q: I was wondering the other day about why guys often come back from Tommy John surgery pitching better and harder than they did before. My first thought was they can’t do any upper-body strength training for months while they recover from the surgery, so they’re forced to work on lower body, core, and mobility - and, in turn, come back as better conditioned athletes with more control and velocity. Or, do you think their improved velocity and command is just an illusion made possible because we’re comparing them to the way they pitched while they were hurt, but not yet “disabled?” Or, is there another factor I’m missing altogether? I figure there’s a sample-size issue — we’re just looking at the guys who make it all the way back, and ignoring the ones who don’t.
A: It’s an excellent question - and one I actually get quite a bit. I’d say that it’s a combination of all three.
In my eyes, an ulnar collateral ligament tear is usually an injury that speaks to YEARS of dysfunction. Guys usually have a history of elbow pain/soreness in their teenage years, and then it finally goes in their college/pro years. They may have been managed conservatively (physical therapy) for a long time just because doctors don’t like doing surgeries on 16-year-olds. However, when they’re 20, it becomes “acceptable” to do a Tommy John surgery.
In the meantime, many of these injured pitchers will modify their deliveries to avoid the pain and end up with some crazy mechanics that leave the ball all over the place at erratic radar gun readings. So, that can usually cover the velocity drop and control issues. This is in stark contrast to what you’ll see with serious injuries to the labrum (SLAP2 lesions), which generally give you the quick velocity drop, and eventually, loss of control - even in the absence of pain. Elbow stuff doesn’t usually directly influence velocity as quickly; a lot of guys can throw through it for years.
So, yes, we are comparing them to their pre-injury numbers. However, there is - at least in my eyes - a better reason.
They are often lazy and inconsistent with their training and arm care before they get hurt. Quite often, you’ll see an ACL reconstruction leg coming back and being stronger than the uninjured side long-term. The same thing can happen with a Tommy John. The rehab is crazy long, so guys have time to learn arm care as religion and - as you noted - focus on athletic qualities that are often partially or entirely “squeezed out” by competing demands.
I remember talking with Curt Schilling along these lines - although it was with respect to his shoulder. He had a shoulder surgery in 1995, and it made him “religious” about arm care. His best years came years after that even though he’d gotten older.
So, usually, the guys who wind up throwing harder are just the ones who were lazy in the first place and were finally forced into actually taking care of their bodies. The guys who DO take good care of their arms and wind up tearing UCLs rarely come back throwing harder, and to be frank, probably have a lower chance of returning to their former selves than their lazy counterparts.
Of course, this obviously excludes issues with the graft type (allograft or autograft), graft site (Palmaris longus, or another site), surgeon’s abilities, physical therapy, athlete motivation, strength and conditioning, and return-to-throwing progression.
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Tags: Baseball Workouts, curt schilling, Elbow Pain, pitching injuries, Pro Baseball Pitcher Workout, Tommy John Surgery
Posted in Blog | Comments (4)
January 12th, 2010 at 8:25 am
Eric-
I had a TJ when I was 19 an then put the final nail in the coffin by blowing out my shoulder when I was 21. (The joys of having mediocre talent and trying to get/keep your scholarship.) In high school I didn’t really have too much elbow pain, but because I was so violent mechanicaclly I went from no pain to full tear in a couple of weeks.
I think you last paragraph glazes over a lot of important points in the arguement. Having experience with this surgery I feel there is a psych aspect to it. I feel a lot of guys come back from the sugery with much better breaking stuff (I did) because the doctors tell you that they are putting so much material in that joint you will never tear it. You are encouraged once you heal to really take the performance of the joint to the limits.
That said I do agree with most of your thoughts frankly because I doubt elbow strength has much to do with velocity. Velocity is more a result of shoulder mechanics (lay back) and the ability of the hips and spine to hold and release torque.
Any of your guys had a TJ?
January 12th, 2010 at 2:49 pm
Really good comments by BigJawnMize especially about the ability of the hips & spine to hold & release torque. This is a concept that few really understand.
JW
January 13th, 2010 at 11:02 am
Eric is 100% correct. Good Doctors will tell you the truth, they can make you 100% perfect, better than you ever were.
However the surgery is a complete waste if you don’t get ‘religion’ about your arm, shoulder, elbow and the kinetic chain, and understand EXACTLY what does what, and why things do what they do in the effort it takes to throw a baseball.
Understanding the chain starts at your toes, and ends at your fingertips, and that every part in between is part of a lever and pulley system that transfers power from bottom to top.
Think about it like this. You have 100% of your throwing power when the chain begins to work, as you come out of your wind up into the throw, when the power begins to transfer up your body, from your foot, each part of your body in between is a conduit for that power, if you start at 100% and the result of the throw is you using only 70% of your power, where are you losing it in the chain? That’s the piece you need to strengthen, and it’s a constant, 12 month a year process.
January 14th, 2010 at 9:36 am
Curt-
I don’t disagree at all. I didn’t have surgery after my rotar cuff tear…it took me almost 10 years (of basically rehab) to throw a ball with any velocity. I found my religion.
I believe that the body is ineffecient at delevering the power developed in the lower body to the ball. People need to maximize the transfer of the power in the body more robust joints (hips and core) to minimize the amount of power needed in some of the more delicate joints (shoulder).
Talking about the body being ineffecient. If the body was perfectly effiecent in transfering power from the lower body, then to increase pitch velocity we would work the quads. Obviously it is a more complecated answer. What I wonder about is if we should be teaching high schoolers the “Chain” thought which takes an incredible amount of mind muscle connection and athletic abilty to practice. Or as I have been doing the last couple years and focusing on the proper use of a limited number of very powerful muscles (quad, hips, core) because I don’t want to adversely affect a kids arm action be it perfect or flawed.