The name “Tommy John” has been synonymous with pitchers in Major League Baseball. The surgery is common among pitchers who are facing pressure to throw harder, and the Guardians are among the teams willing to take a chance on pitchers recovering from the procedure.
Ideastream Public Media’s sports commentator Terry Pluto said the surgery was first performed on pitcher Tommy John in 1974.
“At this point, he's about 10 years into his career (and) his elbow is shot," Pluto said. "Frank Jobe, the surgeon, had thought of this, basically a ligament transplant thing to try and help these pitchers. They took a ligament out of his wrist and they went into his elbow and you drill into the bone and you re-tie the damaged ligament there with this ligament from your wrist."
John went on to win 164 games over the next 14 seasons after undergoing the procedure.
Now, this surgery is common among pitchers.
“One third of all big-league pitchers at least have had this Tommy John surgery,” Pluto said. “This past draft of 2024, 23 pitchers picked by major league teams out of high school or college already had Tommy John surgery.”
Pluto said it’s the result of players feeling the pressure to throw harder.
"There's something also called the spin rate," Pluto said. "You snap your wrist and your elbow to make the ball spin harder and break more. For example, in 2008, so that's basically 17 years ago, the average fastball was 91 miles per hour and now it's approaching 95.”
The Cleveland Guardians have been proactive in signing pitchers who have had Tommy John surgery, viewing it as a cost-effective way to acquire talented pitchers who may be able to recover and contribute.
Last April, 2020 Cy Young Award winner Shane Bieber underwent Tommy John surgery after making just two starts. This offseason, he signed a one-year, $14 million contract that includes a $16 million player option for 2026. He’s beginning to throw at Spring Training but isn’t expected to be able to rejoin the rotation until around midseason.
Late last season, the Guardians signed pitcher Matthew Boyd, who had Tommy John surgery in June of 2023 when he was pitching for the Tigers. He went 2-2 with a 2.7 earned run average in eight starts last year. He also made three postseason appearances. He’s since signed with the Chicago Cubs.
Cleveland also has reliever Trevor Stephan recovering from the procedure he underwent last March. He could be ready to return in the first half of the season.
This month, the Guardians signed left-hander John Means to a one-year deal worth $1 million with a club option worth $6 million for 2026. The former Baltimore Oriole is recovering from his second Tommy John surgery on his left elbow.
“It goes into dollars and analytics,” Pluto said. “The dollars tell you that the most expensive quantity to acquire in Major League Baseball is good starting pitching. So, one way to kind of get a guy cheaper is you get a guy like Means who at one point was a top prospect, but, he started 26 games in 2021. He's only started 10 since.”
Pluto said the idea is to get these pitchers back to top form.
“They have Cleveland Clinic and all the top medical people here and (they say), ‘We're going to work with them and we'll get them back and frankly get them kind of on the cheap,’” Pluto said.
Pluto said many players can successfully recover from the procedure.
“One of the remarkable ones was Justin Verlander who had won a Cy Young earlier in his career," Pluto said. "He came back from Tommy John in 2022 the age of 39 and he won a Cy Young award again…. (For) a number of pitchers, you know, it's been a career saver for many.”
Pluto said for many of these players, it’s a waiting game.
“Cleveland and a few other teams are also signing these guys right as they're headed into surgery or right after, willing to wait sometimes up to two years to see if they can get them back," Pluto said. "Like the guy Means that the Guardians have signed. They'll be thankful if he comes back and pitches in September, but it's really a kind of an approach to having this guy ready to go in 2026. You figure well one or two of these guys make it, it’s worth it.”
