Velo is on every young pitcher’s mind who dreams of getting to the next level..
Every year more and more amateur players are drafted that have already had Tommy John Surgery. In 2018 my colleagues and I published a study showing this increasing and interesting trend. Our study also showed that upon entering the professional level, drafted players with reconstructed ligaments actually advance to the big leagues faster than drafted players who have not had Tommy John Surgery. But still, baseball players who receive the news that they need Tommy John Surgery and have to miss a season, are typically devastated.
Most competitive pitchers have tremendous grit having to deal with the every day ups and downs of baseball performance. Still, injured players tend to find a lot of comfort knowing that other players have succeeded after TJ surgery. Highschool, college, and even the professional athletes tend to look toward players that have not only recovered from Tommy John Surgery, but have improved after their operation. As I write this, we are in a rain delay at Yankee Stadium. Jordan Montgomery started the game before the tarp came out. Monty had TJ surgery in June 0f 2018. Monty’s average 4 seam fastball in 2017 was 91.9mph. His average fastball velocity in 2022 after 4 starts is 92.6.
Another Yankee example is Jonathan Loaisiga, who had TJ surgery in 2016. After surgery his average velo is 97 and he has routinely hit 100mph,which is a definite increase from his pre-TJ velo.
Velo is on every young pitcher’s mind who dreams of getting to the next level. Not surprisingly, the question I frequently get asked from high school and college athletes after hearing that their UCL is torn is, “Will my velocity go up after the surgery?”
Former patient, college and professional baseball player Connor M had Tommy John Surgery in January of 2017 as a freshman competing in NCAA Division 1 ball. After tearing his UCL he told me he wanted Tommy John Surgery so that he could continue to go on and play baseball in college and then professionally to fulfill his dreams. Almost exactly to the day one year after his Tommy John Surgery, Connor completed his rehab and was regularly throwing 90mph strikes in his college baseball summer league, up 3mph from his pre-surgery velo of 87. Fast forward to junior year in college, Connor was identified as a top draft prospect, this time regularly clocking in on the radar at 92mph. Two seasons later Connor went on to top out at 94mph in the California Winter League, where he signed a 2 year contract to play out west! Over a 3 year span post Tommy John, Connors velocity jumped a whopping 7mph from his pre-surgery level. Did Tommy John Surgery give him the extra 7mph of velo? Did he suddenly feel like he had a bionic arm?
When I asked him recently if he was happy that he had Tommy John Surgery, he responded “I am incredibly happy and thankful in the sense that I had the surgery and was able to extend my baseball career, but I think the velo jump came from the magical combination of the weight room and good old fashioned hard work”…he chuckled.
Why Does Velo Increase After Tommy John Surgery?
Tommy John Surgery replaces the damaged or torn UCL. Some athletes have played for many years with a slowly deteriorating UCL without knowing it. Their elbow never felt good but they could still continue to play. They got so used to elbow soreness that they thought the feeling was normal for them. Eventually they develop enough pain through worsening UCL damage that they seek an evaluation, and eventually surgery is needed. Afterwards they recover and often say things like “my elbow feels amazing.” They then go on to enjoy increased velocity and performance. Eliminating the pain that holds back full effort throwing is likely how velo increases in some players post surgery. Here’s the analogy; one day I saw my son squinting to read a sign while we were walking in NYC. He was having difficulty seeing what I could see easily. We got his eyes checked and discovered that he needed glasses. Only after getting his glasses did he realize what he was not seeing over the previous few months. So whether it’s your uncorrected eyes or your sore elbow, it is truly a wonderful & pleasant surprise to get back to normal.
Uninjured high school and college athletes naturally develop increased velocity as they mature. They get taller, stronger, and improve their throwing mechanics that yields ever increasing results on the radar gun. If Tommy John Surgery is required during this natural progression of velo increase, then Tommy John Surgery allows the pitcher to continue with this trajectory. While the new UCL graft itself is not adding velocity directly, it is allowing velocity to manifest.
Finally, adversity such as injury, surgery, and rehab for many young athletes creates discipline, clarity of goals, and commitment. The intense grind of post-op rehab concentrates heavily on increasing leg and core strength in the athlete. Leg and core strength are the primary force generators for throwing velocity. The new elbow ligament does not create new leg strength, but the by product of a Tommy John Surgery rehab program is improved length strength that can yield new velo. In addition, players following TJ surgery & rehab tend to concentrate much more on developing great pitching mechanics. From a research analytical perspective, we say that Tommy John Surgery may be associated with increased velo, but Tommy John Surgery is not causal to increased velo.
Christopher Ahmad, MD is Head Team Physician for The New York Yankees, and author of the book Skill
To better understand Tommy John Surgery and velocity it is helpful to understand two concepts that researchers use to interpret data: correlation and causation. Two or more variables are considered to be related, in a statistical context, if their values change so that as the value of one variable increases or decreases, so does the value of the other variable. For example, for the two variables “hours worked” and “income earned” there is a relationship between the two if the increase in hours worked is associated with an increase in income earned.
Correlation is a statistical measure that describes the size and direction of a relationship between two or more variables. A correlation between variables, however, does not automatically mean that the change in one variable is the cause of the change in the values of the other variable. In contrast, causation indicates that one event is the result of the other event. The difference between the two types of relationships seems easy to identify and explain, but in practice it is difficult. e.g. the fact that smoking causes lung cancer took a long time to prove. And related, smoking is correlated with alcoholism, but it does not cause alcoholism.
What Does The Research Say For Professional Baseball?
For professional players already performing at the extreme limits of their velocity, velo may not go up after surgery. To better answer this, some colleagues and I conducted a study in 2014 that examined velocity in professional pitchers before and after Tommy John Surgery. When we compared 3 years prior to TJ with 3 years after TJ, there was no difference in fastball velocity for starting pitchers in Major League Baseball.
Summary Points
- Velo may go up if a pitcher’s velo has been held back by a slowly deteriorating UCL
- Velo may go up if Tommy John Surgery takes place during a players natural velocity increase/development period, i.e. young developing players
- Velo may go up as a result of the rehab process with energized discipline and increased strength in the legs, core, and arm
- Velo may go up with improved pitching mechanics following TJ surgery
- Velo may not increase if a pitcher was already performing at their max potential velocity
Christopher Ahmad, MD is Head Team Physician for The New York Yankees, and author of the book Skill