Why Do Pitchers Throw Harder After Tommy John Surgery?

On his most recent podcast, Eric Cressey talked about the myth that having Tommy John surgery (ulnar collateral ligament or UCL reconstruction) allows pitchers to throw harder. This was something that I heard growing up, but I would have never voluntarily had my elbow cut open just to throw harder. I thought that even if it was true, who would be willing to do something like that?

As many of you know, I went to the University of Miami for my doctorate (let’s go Canes) and while there I saw some high level athletes. I think that Northern Virginia has some special athletic talent, but Miami is a whole separate animal. Anyway, the point of this story is that we had a kid come in for elbow pain once and he was probably 14 or 15 years old. His dad mentioned that he was contemplating having Tommy John surgery so that he could throw harder. His dad’s logic was that he was probably going to get the surgery eventually anyway, and he might as well get it over with now. We tried to tell him there were other avenues to go down before surgery, but they didn’t seem very interested in waiting for physical therapy to help.

The problem with people thinking that surgery will help them throw harder is one of education. As healthcare professionals, we need to do a better job of teaching people that there are problems with surgery. The main issue is the replacement of your native UCL. Whatever the physician puts in its place is never going to be as strong as your own ligament. Oftentimes, the physician will take your palmaris longus tendon to create a new ligament. The palmaris longus is a very thin muscle in your forearm that you can see if you squeeze your thumb and pinkie together. It is the thin tendon you see popping up in the picture below: