Yankees: Jordan Montgomery and the controversy over Tommy John surgery

The Yankees starting rotation was thrown a curve ball on June 5, when the club announced that Jordan Montgomery required Tommy John surgery. There are now questions being raised about the overuse of the surgery.

Toward the beginning of the 2018 season, the Yankees thought that left-hander Jordan Montgomery had an elbow strain after he had complained about feeling a twinge in his pitching arm.

His initial recovery was going well until something again didn’t feel quite right while playing catch. Unfortunately, a second MRI revealed a much more disturbing diagnosis: he had a tear in the ulnar collateral ligament (UCL) in his left elbow and required Tommy John surgery. The procedure was done two days later at New York-Presbyterian Hospital. Montgomery’s season was over just like that.

The Yanks know that Monty might not return until late 2019 at the earliest. Given the typical length of the recovery process for this type of operation, however, he is more likely to return for the start of the 2020 season.

Montgomery, 25, was 2-0 with a 3.62 ERA in six starts in 2018 — after going 9-7 with a 3.88 ERA in 29 starts as a rookie the year before. Complete recovery from Tommy John surgery is not guaranteed, and most pitchers never regain their same level of ability following rehabilitation.

Who is Tommy John and what is Tommy John surgery?

Tommy John was a top-notch southpaw starting pitcher who played for various teams, including the Yankees, from 1963 to 1989. He was a four-time All-Star and went 288-231 during his tenure. He had a career earned run average of 3.34 while racking up 2,245 strikeouts.

In July 1974, during a game between the Los Angeles Dodgers (his team at the time) and the Montreal Expos, John severely damaged the UCL in his left elbow. The injury didn’t heal after one month’s rest, leading Dr. Frank Jobe to come up with a creative (almost Frankenstein like) idea.

Jobe had recently grafted a tendon on a polio victim’s ankle for stabilization, and he thought that maybe a tendon could be grafted to John’s elbow and restore its function.

He told John that he would never pitch again without the surgery. After giving Jobe’s option some thought, he decided to undergo surgery.

In late September, Jobe removed a tendon from John’s right wrist and attached it to his left elbow. Following a long, prescribed rehabilitation program, the southpaw returned to the Dodgers’ starting lineup in 1976 and had a 10-10 record that season.

In 1977, he finished second in voting for the Cy Young Award and had a complete game victory in the NLCS, which allowed the Dodgers to enter the World Series. John won 164 games following UCL reconstruction surgery and retired from major league baseball in 1989 at the age of 46.

Tommy John won 91 games and lost 60 games in two separate stints with the Yankees, first between 1979-1982 and then 1986-1989. In fact, thanks to Dr. Frank Jobe, John was a spectacular 21-9 and 22-9 in 1979 and 1980, respectively, for the Yanks. Unfortunately, as we discovered later, Tommy John’s stunning recovery was atypical.

Since 1974, over 500 MLB players have undergone what has become known as Tommy John surgery. Recently, doctors have recommended that Shohei Ohtani (Los Angeles Angels) undergo UCL surgery during this coming offseason.

Most but not all players who have had this procedure are pitchers; position players such as Paul Molitor, and more recently Gleybor Torres have also undergone the procedure. John Smoltz is the first pitcher who has had TJ surgery to be elected to the Baseball Hall of Fame (in 2015).

Writing for FiveThirtyEight, Travis Sawchik reports that the number of procedures of this kind, involving major league baseball players has decreased during the last two years.

This may be due to declining pitch counts and innings pitched, the increased quality of strength and conditioning programs, fewer fastballs being thrown, and increased caution concerning workload. At the same time, younger pitchers are now throwing harder, and it is uncertain whether the decline in operations will continue.

The controversy

Tommy John, now 75 years old, is not upset to see his legacy being undermined by an operation that has saved the careers of so many baseball players. However, he is upset that his name is now associated with something that affects more children than pro athletes.

Today, 57 percent of all UCL reconstruction surgeries are done on teenagers between 15 and 19 years old. One in seven of those teenagers never fully recover.

John believes that this is happening because too much pressure is being put on children to perform in sports optimally and, if things go awry and they show potential, they should have Tommy John surgery to “fix the issue.” In his view, youth sports has become a big business.

The problem is that kids today are being pushed to pursue sports at all costs and with little protection and active management of their efforts. It is the extraordinary amount of hours spent on athletics and competing and succeeding at such a high level that is leading to all sorts of serious injuries, including damage to the UCL, more than ever before. Tommy John argues that this must stop and that significant reforms must take place.

Jordan Montgomery, who wasn’t even born when Tommy John had his UCL operation, must now endure a long and challenging recovery. Whether he can return to the same level of performance, he showed as a rookie pitcher is uncertain, but he certainly will try. As fans, we should cheer Monty on and wish him all the best.