Major League Pitchers Should Fear Forearm Tightness and Tommy John Surgery

If a pitcher on your favorite major league team suffers from “forearm tightness” you have a reason to worry, as over the past couple of seasons this innocuous sounding “boo-boo” has wound up being an indicator of a major injury that can necessitate Tommy John surgery.

For whatever reason, it seems that over the past few years “forearm tightness” has become an occurrence of dire portent for pitchers in the major league.  In many cases this innocent sounding “condition” has become a sign that severe elbow and/or shoulder trouble is on the horizon for hurlers.

Most recently one of the New York Yankees’ most recent busts – right-hander Carl Pavano – was sidelined by forearm tightness, which we now know was due to elbow ligament damage.  Pavano’s career is probably over as he is about to undergo Tommy John surgery.

For all of you who may not be familiar with Tommy John, he was a pitcher who plied his trade quite successfully for 26 years.  During the 1974 season – his 12^th – John’s arm was “dead;” the description of a symptom suffered by pitchers which is usually due to a strained medial collateral ligament (MCL) of the elbow. John’s MCL had actually ruptured. Thanks to John’s prodding, surgeon Dr. Frank Jobe devised a procedure in which a ligament from the forearm of the non-injured arm is taken and transplanted in the place of the blown out ligament. 

Ligaments from cadavers have been used, although more commonly this ligament comes from the leg of the patient. Anyway, this surgery gave John a second life, and after the surgery he actually won 164 games from 1976-1989, more games than he won during the first half of his career. Since this revolutionary moment in sports medicine history baseball players at all levels of the game have had their careers saved by this surgery.  

There are indications that a ball player’s arm actually becomes stronger as a result of having Tommy John surgery. The “dead arm” syndrome experienced by pitchers in the old days – and that doomed careers – seems to have been replaced by “forearm tightness” in current day pitchers. 

Frankly, I think most of the injuries that are plaguing pitchers these days can be attributed to their off-field preparation, and not from throwing the baseball.  However, that is a different argument for a different day. If you go back over the past several seasons, forearm tightness is the precursor to a severe elbow ligament injury. 

In September of 2005 Atlanta Brave pitcher Mike Hampton experienced tightness in his left forearm, which wound up being an elbow problem that necessitated Tommy John surgery. After missing all of 2006, Hampton’s left forearm starting aching, and ultimately his flexor tendon went bye-bye and the southpaw has undergone his second T.J. procedure.  Smart money says he’s done.

Journeyman reliever Tom Gordon – most recently of the Phillies suffered from forearm problems last season and this year has had both elbow and shoulder problems.  Gordon was recently diagnosed with a tear in his rotator cuff and a date for his return to baseball has yet to be determined.

Cincinnati Reds bench player outfielder Chris Denorfia – who has since been traded to Oakland – suffered a torn ligament in his throwing elbow and was initially reported as having a strained right forearm. He got his T.J. job this spring.

Chicago Cub former young stud starting pitcher Mark Prior has suffered from a variety of injuries since his incredible rookie season, including forearm and elbow stiffness that was reported back in spring training of 2004.  Prior’s injury woes began with a bad Achilles and his trip through the Disabled List started with this injury to his lower leg.  Since then he’s served as a living example of the old song, “The Ankle Bone is Connected to the Shin Bone,” as the injury train has made the journey from his shin to his shoulder.

Yankee farm hand Humberto Sanchez reported tightness in his right forearm in February and underwent his TJ-ectomy on his elbow in April. You should get the idea by now.  Forearm tightness is something to be scared of if you are a major league baseball player.

The latest on the “Forearm Tightness Watch” are Seattle Mariners’ 21-year old phenom Felix Hernandez, Arizona Diamondbacks’ over-the-hiller Randy Johnson, Boston Red Sox hurler Jon Lester (also recovering from cancer), Milwaukee pitcher Greg Aquino and the Florida Marlins’ top pick in 2006 Brett Sinkbeil .  

If you’re a Mariners fan you should be especially worried.