The elbow complex is made up of three bones, three ligaments, two joints and one capsule. The formation of the elbow is when the humerus joins with the ulna and radius creating the elbow joint. The elbow is a hinge joint that allows only flexion and extension. There is a joint between the radius and ulna called a radio ulnar joint. This joint is a pivot joint which allows clockwise and counter clockwise rotations (Anderson, Tracey). The elbow plays a major role in throwing activities, especially in the game of baseball. Unlike softball and bowling, which are natural arm movements, baseball involves a non-natural movement and depends heavily on the shoulder and elbow. Tommy John is a surgical procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (for example: the forearm, hamstring, knee, or foot of the patient) to repair the ulnar collateral ligament (UCL). The procedure is common among collegiate and professional athletes in several sports; mainly in baseball. The surgery is named after Tommy John, a pitcher who was the first professional athlete to successfully undergo the operation. The procedure was performed by Dr. Frank Jobe in 1974 (Heisler, Jennifer). The surgery in preformed as an outpatient under a regional nerve block with general anesthesia (Gamradt, Seth). When the patient is knocked out, a small incision is made as the procedure is done using a laparoscope (Heisler, Jennifer). The old tendon is removed and the new one is placed in the elbow. After the surgery the recovery process is straight forward. The patient will be put in an arm splint which will immobilize the elbow for approximately ten days because the new tendon is very fragile and without moving it allows the soft tissues to heal. To reduce swelling and numbness in the fingers the patient must make sure to move their fingers frequently. After the ten days the splint is removed and a removable hinged brace which allows a safe range of motion. While wearing the brace the patient must attend physical therapy for sixteen full weeks to gain full range of motion, it could take even longer than the sixteen weeks. After therapy the patient can return to the baseball field somewhere between nine and twelve months to begin a throwing program. After the patient does his full eighteen months of rehab he or she can return to competition (Gamradt, Seth). Stephen Strasburg was born July 20th 1988; A 22 year old right handed pitcher. Strasburg was drafted by the Washington Nationals in the first round in 2009. He made his pitching debut on June 8th 2010, against the Pittsburgh Pirates. His debut was a success getting the win, pitching a solid seven innings with 14 strike outs. For his short 2010 season he pitched 68 innings with 92 strike outs in 12 games, topping out throwing 100 mph. He tore his UCL during the 2010 season and rehabbed until the 2012 season (Stewart, Mark, Mike Kennedy, and Ron Jaffe). Strasburg is a great example on how Tommy John surgery can be a success. He returned to baseball in 2012 and had a stellar season, and his team made it to the play offs. He was put on a pitch count during the 2012 season and hopes to be able to throw more in the 2013 season.
There are possibilities in which the surgery can have positive effects. In some cases baseball