It was July 17, 1974. Dodger Stadium. Los Angeles left-hander Tommy John was having a dream season, leading the National League with 13 victories while the team was in first place in the NL West.

The Dodgers were facing the Expos, and John had started the third inning by allowing a single to Willie Davis, followed by a walk to Bob Bailey. Hal Breeden entered the batter's box. After two pitches to Breeden, John felt excruciating pain in his elbow. He flexed his elbow back and forth, then threw another pitch.

Big mistake.

The pain grew worse. John called time out and walked off the mound.

“When he walked off the mound, I thought he had some kind of equipment problem, like his jock had snapped,” said Ken Singleton, the Expos’ right fielder that day. “But then he walked up the tunnel and never came back.”

John thought his career was over. That’s what a doctor outside the Dodgers organization told him. No one could have known that the events to follow would change baseball forever.

John underwent an unprecedented elbow reconstruction surgery -- now famously known as Tommy John surgery, perhaps the most important medical advancement in baseball history.

John initially waited to have the surgery, hoping that rest would help him get back on the mound before the season ended, but the pain never subsided. The procedure was performed on September 25, 1974, by Dr. Frank Jobe, the Dodgers’ team physician.

During the operation, Jobe took a tendon from John's wrist, drilled holes into John's ulna and humerus bones and grafted the tendon in a basic figure-eight design, held in place by anchors. Jobe had no idea the operation would become a success. It had never been performed on an athlete but had been done on polio victims, according to John, in the hope of improving their mobility. John knew the odds were against him, but he had a lot of faith in Jobe.

“If Dr. Jobe told me to take a pail of my dog’s poops and go back to second base at Dodger Stadium and bury them, I would be OK with it,” John said. “I would have done it because I believed in Dr. Frank Jobe.”

His faith, in the end, was well-founded, but it took John a year and a half to get back on the mound. He pitched his first game after surgery on April 16, 1976, against the Braves and became one of the Majors’ most consistent pitchers, winning 164 games over the next 14 seasons. In fact, John notched more wins after the surgery than he had pre-surgery (124).

This fall will mark 50 years since this historic advancement. More than 2,400 “Tommy John” surgeries have been performed on the elbows of professional baseball players, according to baseball analyst/journalist Jon Roegele, who maintains a list of those who have had the procedure. Few people have complained about the aftermath since then. The arm is stronger, with fastball velocity usually clocked a few ticks higher than before the surgery.

• The best Tommy John success stories

“The surgery has become incredibly predictable because with experience comes precision and with precision comes better outcomes,” said Dr. Christopher Ahmad, the head team physician for the Yankees. “Unfortunately, the higher frequency of the injury over the years are making us do them more and more.

“There are days I will do eight or nine Tommy John surgeries in one day, and I operate two times a week. The number of operations is going up, so we are better at the surgery. … We make the [elbow] stronger than ever. Stronger is better for success. There is a rehab component to it, and the rehab takes a year or longer depending on what the nature of the surgery and the injury is. So the quality of the rehab has gotten better.”

Returning from Tommy John surgery
The number of Major League success stories is far too long to recount. Astros right-hander Justin Verlander is one recent example of having the surgery and returning better than ever, winning his third Cy Young award in 2022 at age 39.

“[The surgery] extended my career. I’m very thankful for the surgery. It allowed me to keep pitching,” Verlander said. “I tried to realize why I had the surgery -- what went wrong to create that weak point in my body. … So I took it as an opportunity to revamp my body from head to toe. There isn’t a main thing, but it’s all connected. Everything has to work together to make you throw a baseball. My surgery went really well, and my rehab went really well. The way it was scripted is the way it went. There were no setbacks. I continued to do that and focus on the rest of my body.”

Getting your body right is only half the battle. The mental state of the player after the surgery also plays a role in its success. The ligament may be stronger, but there must be newfound commitment when it comes to training. The athletes are now taking care of their bodies with better sleep, nutrition and preparation.

“They discover how important and meaningful baseball is to them, so they get religious about it,” Ahmad said. “And suddenly, they are throwing harder than ever after the surgery. It’s not really the surgeon as much as players getting more committed and dedicated.”

Cardinals right-hander Kyle Gibson was one of those pitchers who was committed after having his elbow procedure done in 2011 while he was in the Twins organization. Entering the ‘24 season, Gibson has 104 career victories, and he appeared in the ‘21 All-Star Game as a member of the Rangers.

After having the procedure, Gibson started taking his shoulder program more seriously.

“At the University of Missouri, we did a lot of shoulder programs. It was important for the pitchers to take care of themselves, so I had a foundation of it, but that rehab program [after Tommy John surgery] expanded on it,” Gibson said. “It expanded on my rolodex of different exercises and different movements to try and stay healthy and keep strengthening things.”

Tommy John after Tommy John
Almost 50 years after undergoing that historic elbow procedure, John finds himself in another battle: He is currently dealing with bladder cancer. On this day, John is feeling like himself. His dogs, Arnold Palmer and Jack Nicklaus, are barking in the background and John has no idea what’s troubling them.

By the sound of John’s voice, one would think that nothing is wrong. He sounds vibrant, and he jokes that he takes urine to his doctor, Wade Sexton, who arrives in Tampa every six to eight weeks to make sure that his health is stable. Even now, like with the elbow reconstruction surgery, John has a positive attitude towards his future.

“If I was Debbie Downer, I would have lasted maybe a year after the surgery. [Having a positive attitude] is how you beat these things,” John said. “If I go, ‘Oh, I have cancer. I’m going to die,’ well, yeah, we are going to die [eventually]. I happen to have cancer, and I’m going to beat the son of a gun and it’s not going to take me down.”

After a 26-year career that concluded in 1989 with the Yankees, John believes his career warrants election to the Baseball Hall of Fame. It’s not because he made history under the knife; it’s because he produced on the field.

“It has to do with the 288 wins,” John said. “That's the Hall of Fame [to me].”

According to his former teammate Joe Ferguson, it bothers John that he is not enshrined in Cooperstown.

“If he doesn't get picked to the Hall of Fame, it’s going to be an absolute tragedy,” Ferguson said. “This guy was one of the best pitchers in the Major Leagues for a long time. He had a tremendous career. To keep him out of the Hall of Fame is absolutely ridiculous.”