Orthopedic Surgery

Dec. 02, 2025

Christopher L. Camp, M.D., an orthopedic sports medicine specialist at Mayo Clinic in Rochester, Minnesota, grew up playing baseball and continued with the sport through college. During his postgraduate medical training, he maintained his baseball theme through conducting research on injuries from the sport. Today, as a practicing physician, Dr. Camp serves as an educator at Mayo Clinic College of Medicine and Science, where he enjoys teaching medical students about these injuries. He also has served as the medical director, team physician and director of high performance for the Minnesota Twins baseball club.

While Dr. Camp focuses on shoulder, elbow and knee injuries, a significant portion of his practice relates to throwing and overhead sports injuries from baseball, basketball, football, volleyball, tennis and swimming.

The most common surgery Dr. Camp performs and what he is most known for is Tommy John surgery. As noted in an article in Cut4byMLB.com, this surgery is named after Thomas Edward John Jr., a major league baseball pitcher who had the first successful operative repair of this injury in 1974 and returned to the sport. Patients come from around the United States to see Dr. Camp for this surgery.

The Tommy John injury: Demographics, symptoms, risks and diagnosis

The Tommy John injury occurs in the medial ulnar collateral ligament on the inside part of the elbow. This ligament helps keep the elbow stable but can be disrupted when there is high stress on the elbow. Tommy John injuries occur most commonly among baseball players ages 16 to 30, though Dr. Camp notes he sees some gymnasts and wrestlers with this injury. More males than females present with Tommy John injuries, as it often corresponds with playing baseball. Ethnicity does not play a role in the development of this injury, says Dr. Camp.

Athletes who experience a Tommy John injury notice pain in the medial elbow and negative effects on performance, such as diminished control and inability to trust the elbow's stability. Baseball pitchers observe they cannot throw as hard as in the past.

Most often, this injury builds over time with increasing dysfunction and pain. Rarely outside of sports, patients incur a Tommy John injury in an acute setting from a traumatic fall or other accident.

Pain from a Tommy John injury is variable: It can range from small and subtle to excruciating. Yet, experiencing instability and apprehension with pain are universal to patients with this injury.

The No. 1 risk factor for the Tommy John injury is throwing. Following throwing, repetitive tumbling or load to the elbow in sports such as wrestling, football, hockey and gymnastics, put patients at risk of the injury.

Diagnosis of this injury is usually fast, according to Dr. Camp. It involves taking a thorough history of the injury, a physical exam and imaging, mostly with X-ray and MRI. Although the diagnosis is usually clear from these steps, at times the sports medicine specialist also needs to perform a stress ultrasound or a stress MRI, if not performed previously.

Treatments for Tommy John injury

Nonsurgical treatment for a Tommy John injury is common for low-grade, partial tears and for nonthrowing athletes. On the other hand, surgery almost always awaits a throwing athlete with a complete tear.

While these injuries are highly reparable through several techniques, the most significant challenge is time.

"Tommy John injuries have a greater than 90% success rate," says Dr. Camp, "but recovery takes a long time."

Dr. Camp has been conducting research on how athletes fully recover from a Tommy John injury so that they not only reach the end of that athletic season but also the end of their careers with that elbow in good form. His goal is recovery without career ruin due to time out of play.

The following are the three most common types of surgery for Tommy John injuries available today and their respective recovery times:

Traditional reconstruction. Reconstruction involves the use of a new tendon graft to replace the old ligament. Recovery after a traditional reconstruction lasts more than one year, which Dr. Camp says is a long enough interval to hurt careers.

Repair with a suture brace. Repair of the ligament means that the patient's own ligament is sewn back down to the bone and fixed with small anchors. Most repairs involve adding an internal brace from the suture to support the repaired ligament. If the tear meets specific qualifications and the ligament is high quality, a pitcher can return to play in 6 to 9 months after this surgery. However, Dr. Camp notes there are concerns about whether this repair will last until the end of a baseball player's career, and not all tear types are candidates for this procedure.

Anatomic medial ulnar collateral ligament (MUCL) reconstruction with an internal brace. Developed by Dr. Camp, this technique involves repairing the injured ligament, adding the above-mentioned suture brace plus a tendon graft, usually from the patient's wrist on the same side as the elbow or the patient's leg. Return to play with this surgery for a pitcher is 9 to 10 months, notes Dr. Camp, and initial results show good long-term outcomes.

Dr. Camp says he developed this surgical technique because he knew the prior techniques were successful, but the athletes' return to play took too long for a continuing career.

Recovery process following Tommy John surgery

Dr. Camp outlines the following recovery program he prescribes after Tommy John surgery:

• Work on motion for 6 weeks while using an elbow brace.
• Work on strengthening from weeks 6 to12 after surgery.
• Start a prescribed throwing program around 12 to 14 weeks after surgery, beginning with shorter distances, such as 45 to 60 feet, and progressing to longer distances and higher intensity throws.

Patients who live near Mayo Clinic in Minnesota participate in this recovery program on campus with sports medicine specialists. If patients live far from Mayo Clinic, Dr. Camp will prescribe the recovery program to be completed locally.

To refer or not to refer for this surgery

For the best possible outcomes as well as the latest technology, Dr. Camp recommends referring patients to Mayo Clinic in Minnesota for this surgery and its accompanying recovery program.

"With Tommy John surgery, the rehabilitation process is complex and not very well understood," says Dr. Camp.

While he notes effectiveness of this surgery is challenging to measure, he says he's seen 97% of athletes who have undergone this newer MUCL reconstruction with an internal brace for Tommy John surgery return to sport, and 90% of those were able to reach the same level of play as prior to surgery.

For more information

Landers C. Just who is Tommy John, and why does everyone talk about his surgery all the time? Cut4 by MLB.com.

Refer a patient to Mayo Clinic.