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A pitcher's worst nightmare is hearing that they need to have Tommy John surgery. The surgery has an extremely long recovery period, and pitchers may not always return to their original pitching performance. Thankfully, stem cell treatments are beginning to make a difference in helping to heal injuries that, in the past, would require Tommy John surgery. Some MLB players have even used stem cell therapy in hopes they could avoid Tommy John surgery. Before we get into how stem cells can help prevent Tommy John's operation, it may be helpful to understand the history behind Tommy John's surgery and what causes it. Ulnar Collateral Ligament The ulnar collateral ligament is a triangular band that runs on the inside of the elbow. The ligament stabilizes the elbow through various motions, such as throwing. Typical injuries range from minor inflammation to a full-blown tear, which requires Tommy John surgery. During the throwing motion, the ulnar collateral ligament goes through an extreme amount of tension. When pitchers throw as hard as they can, the maximum tensile stress of the ligament is reached. Doing this every day for years can cause serious problems. What Causes the Injury? In baseball, the injury is caused by excessive throwing. Pitchers have been performing the same motion their entire life; it is no surprise that the ulnar collateral ligament begins to wear after thousands of baseball games. Early childhood sports specialization is another significant cause of this injury. Children who play a variety of sports will develop muscles and will not overuse tendons and ligaments. There is a strong correlation between the number of pitches over time and an ulnar collateral ligament tear. There is only so much that the ligament can take before it tears. History of Tommy John Surgery Tommy John surgery was first performed back in 1974, on none other than Tommy John. The first time it was completed, it was extremely experimental, and there was no guarantee that he would ever be able to pitch again. Tommy John went on to have a very successful career after he underwent surgery. He played until he was 46 years old and won 164 more games. The surgery is straightforward. A surgeon will go into a patient's elbow and create space for the new tendon. The tendon is usually taken from the forearm but can be taken from several places in the patient's body, such as an accessory hamstring. The cord is anchored onto the bones and then patients go through a rigorous rehab process. The number of surgeries in teenagers is on the rise as sports become more and more competitive and because early specialization into one game, baseball. Nearly two-thirds of Tommy John surgeries are performed on teenagers. This epidemic does not appear to be slowing down anytime soon. Granted, the success rate is high, at about 85% for the procedure. There are several issues that Tommy John surgery creates, even though it does help get pitchers back on the mound. Problems that Tommy John Surgery Presents: