Shohei Ohtani, Haruto Takahashi, and Others… Why Have Professional Baseball’s Ace Pitchers Begun Opting for “Tommy John Surgery”?

Surgery That Has Saved Thousands of Pitchers in Japan and the U.S.

“A magical surgery that implants a strong tendon into a damaged elbow and increases pitch speed after a year of rehabilitation—some people may harbor such illusions, but that is a complete misunderstanding. There is even a risk of ending one’s baseball career without regaining one’s former form.

“Now that fastballs in the high 150 km/h range have become the norm and the number of pitchers suffering elbow injuries is on the rise, it’s all the more important to emphasize this point,” says Ryota Igarashi, a professional baseball commentator.

On August 15, former MLB pitcher Tommy John passed away at the age of 83.He is best known for undergoing the world’s first ulnar collateral ligament (UCL) reconstruction surgery in 1974, performed by Dr. Frank Jobe.

This surgery, which was groundbreaking at the time, came to be known as the “Tommy John surgery” after its first patient, and has since saved the careers of thousands of pitchers in Japan and the U.S. over the past half-century.

For example, Shohei Ohtani (32) of the Dodgers and Yu Darvish (40) of the Padres have each undergone the procedure twice during their careers. In the NPB as well, players such as Haruto Takahashi (30) of the Hanshin Tigers,Hiroto Saiki (27) of the Hanshin Tigers, Iori Yamazaki (27) of the Yomiuri Giants, Atsuki Taneichi (28) of the Chiba Lotte Marines, and Katsuki Higashi (30) of the DeNA BayStars have all returned as their teams’ ace pitchers after undergoing Tommy John surgery and rehabilitation.

Why exactly have professional baseball’s ace pitchers come to choose Tommy John surgery?

To explore the reasons behind this trend, let’s first ask baseball analyst Shohei Tateyama—who has undergone the procedure three times—to explain the surgery.

“While there are subtle differences in surgical techniques, the procedure involves removing the damaged elbow ligament and replacing it with a tendon harvested from another part of the patient’s own body. Recently, the ‘hybrid method’—in which the patient’s own tendon is reinforced with an artificial ligament—has become more widespread, and pitcher Ohtani has also opted for this approach.”

On September 24, Kenta Maeda (38) of the Rakuten Eagles—who underwent the hybrid procedure in 2021—made headlines by reaching 170 career wins combined in Japan and the U.S.

A high fever of 40°C…

A major reason why more and more pitchers are opting for Tommy John surgery to treat elbow injuries is that there is no end to the number of pitchers who go on to perform at a high level after their return.

In fact, Saiki increased his top pitch speed from 154 km/h before surgery to 158 km/h afterward, and Taneichi also raised his top speed from 153 km/h to 156 km/h.

Given these results, isn’t this surgery essentially “magic that increases pitch speed”? It wouldn’t be surprising if some fans thought so, but Mr. Igarashi, mentioned earlier, shakes his head.

“It’s not as simple as saying that the surgery strengthens the elbow ligaments, which in turn increases power. What happens is that, as a result of steady, diligent effort over a year to a year and a half of rehabilitation—such as reevaluating one’s pitching form, dedicating oneself to weight training, and building explosive power—pitchers sometimes see an increase in velocity upon their return.

“Once you turn pro, there’s almost never a time when you can devote an entire year to anything other than pitching. The key is whether you can make effective use of that time.”

What does the rehabilitation period look like for NPB ace pitchers who have undergone Tommy John surgery? Mr. Tateyama, mentioned earlier, explains.

“The surgery itself takes about two hours, but in my case, I had a high fever of 40°C that lasted for about three days, and I was hospitalized for a week.I had to wear a cast for about five weeks, and for four to five months after the surgery, I couldn’t even hold a ball—I could only do range-of-motion exercises, weight training, and running. The range-of-motion exercises were truly monotonous—it was like continuously peeling the thin layers of an onion with tweezers. A baseball player who can’t even play catch is just an ordinary person.

Every time I saw my rivals getting better, I’d be overcome by the fear that “I might get cut from the team,” and it was a truly painful time.

“While I focused primarily on rehab, I wanted to immerse myself in something to make up for not being able to play baseball, so I kept studying the mechanics of the human body. Even when I was finally able to grip a ball again, during my first catch session, I could only throw about three times, each over 5 meters. I gradually increased that distance—to 10 meters, then 15 meters—working hand in hand with my trainer toward my return.”

This kind of steady, methodical work continues even in today’s NPB. For example, during his rehabilitation, Saiki reportedly repeated “net throws”—where he completely immobilized his left leg and used only the rotation of his upper body to throw toward a net—thousands, even tens of thousands of times.Keiichi Yabu, a baseball commentator who once served as a pitching coach for the Hanshin Tigers, explains:

“Professional pitchers have a memory of their ‘peak release’—one ingrained in their brains from throwing tens of thousands of pitches before their injury—that’s deeply embedded.

However, even if they try to pitch with the same feel using their ‘new body’—where muscle composition and joint stiffness have changed—a desperate awkwardness arises: the fastball might become a ‘dead straight’ pitch or, conversely, sail wide. Pitcher Saiki corrected that misalignment through net throws, acquired a new form, and achieved an increase in pitch speed.

NPB ace pitchers choose Tommy John surgery not because “it increases pitch speed,” but because they want to take the time to fundamentally heal their injuries and rebuild their form from scratch.”

[Part 2] Is “Conservative Treatment” Not Enough? Who Pays the Costs? The Reality of “Tommy John Surgery” That Saves Professional Baseball Players

From the October 16, 2026 issue of *FRIDAY*