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Study: 124 current MLB pitchers have undergone Tommy John surgery

Mark Townsend
Big League Stew

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Adam Wainwright underwent Tommy John surgery in February of 2011. (USA Today)

Aside from general managers working the phones in preparation for the upcoming trade deadline, Major League Baseball will be quiet on Wednesday and Thursday. That means the players will be getting a much needed breather from the 162-game grind, and for at least 48 hours — longer for those not involved in the All-Star game — will be able to recuperate rather than add more wear and tear to their worn out bodies.

After reading through the exhaustive study put together by Bleacher Report injury analyst Will Carroll on Wednesday, it’s pretty clear that any rest they can get over the All-Star break is just as important as it welcomed. That's especially true for the pitcher, who are now seeing the toll on their arms add up at an alarming rate.

Here’s an excerpt from Carroll:

One-third of current MLB pitchers have had Tommy John surgery. Of the about 360 who started the season, 124 share the all-too-familiar triangular scar.

How surprising is this number? It stunned me! In recent talks with baseball officials, none guessed more than the one-in-nine number I had often seen quoted over the last decade (and quoted myself). Worse, none of us had any idea when this change had happened or noticed the acceleration.

Among the startling number of current MLB pitchers to undergo Tommy John surgery: Adam Wainwright, Stephen Strasburg, Jordan Zimmermann and even closer Joe Nathan. In their cases, all four have bounced back to a similar or higher level than before their injury. Not all are that lucky, however, and many on the list are still rehabbing, such as Texas Rangers right-hander Neftali Feliz.

Everybody recovers at a different pace and with varying results, but Carroll's research does give us at least some idea of how long the ligament is expected to hold up and what the long-term outlooks might be for those who undergo a successful procedure.

Research I did in 2006 led me to the concept of the "Tommy John honeymoon." I found that five years after surgery, there were very few additional elbow problems, which indicated the transplanted ligament was stronger. Further research showed that the process called ligamentization was at work.

However, after the five-year period, the tendon becomes a normal ligament, subject to the same kind of overuse injuries. With so many pitchers getting a first surgery, often when they're quite young, there's a greater chance a second surgery will be necessary.

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Brian Wilson (USA Today)

Former San Francisco Giants closer Brian Wilson falls under the category of a pitcher who needed a second procedure. The surgeries were nine years apart — March 2003 and April 2012. He's still working his way back and hopes to audition for teams in another couple weeks. Pitchers like Anibal Sanchez, A.J. Burnett and C.J. Wilson — all had Tommy John in 2003 — are now well beyond the five-year window Carroll referenced. Francisco Liriano, Josh Johnson and Tim Hudson —2008 procedures — are just now moving into the more at risk category.

I'm not trying to startle anyone, of course, but the list and the information is fascinating. And this is just a small part it. There's a whole lot more to Carroll's piece, including a closer look at 19 of the most notable Tommy John cases dating back to 1974. Of course Tommy John himself and Dr. Frank Jobe's creation of the surgery are chronicled and examined, as are possible reasons for the increase in Tommy John surgeries such as overuse beginning as far back as Little League.

It's a worthwhile read on an otherwise slow day in sports, so if you get the opportunity to check it out, I highly recommend you do.

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