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The Pitcher's Dilemma: If you have an elbow problem, you have a body problem.

Major League Baseball history was made in 1974. It wasn’t made by a World Series deciding play at the plate or even a record breaking event. History was made off the field when Tommy John, the then left-handed pitcher for the Los Angeles Dodgers, became the first person to have ulnar collateral ligament (UCL) reconstruction surgery by orthopedic surgeon Frank Jobe. This surgery eventually came to be known as Tommy John Surgery or T.J. as it is called in the sporting circles.

This article is not about the surgery itself but rather the career-extending effect that it had on Tommy John’s career and the competitive breath of life that it has given baseball players and throwers. From a mechanical vantage point, Tommy had to change his throwing mechanics, not just for rehabilitation purposes, but to also relieve the stress on his throwing arm, enabling him to continue his career with the 1976 season and beyond (to 1989!).

Research is inconclusive towards any one factor that contributes to the stress and eventual injury and tear of the UCL. The factors vary with point of views, including different angles with pitching mechanics, pitch count, innings pitched, type of pitch, velocity of pitch and rest between outings. Rotator cuff endurance and postural endurance can also be added to the list of factors.

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