PITTSBURGH -- Twenty-six years after throwing his last Major League pitch, Tommy John remains a daily subject of conversation -- and not in a good way. He is used to hearing his name taken in ... pain.
When he hears his name dropped on the air -- "So-and-so is the latest pitcher to undergo Tommy John surgery" -- how does the left-hander react?
"Just another big wave in the front end of a tsunami, that's what I think of," said John, 71, speaking from Palm Springs, Calif., his regular refuge from harsh East Coast winters.
John is acutely aware of the burgeoning epidemic of the elbow ligament replacement surgery for which he was the guinea pig.
Neither John nor Dr. Frank Jobe could have possibly foreseen the sports medical frontier they were throwing open on Sept. 25, 1974, when the pitcher reposed on an operating table and the orthopedic surgeon replaced the torn ulnar collateral ligament in his left elbow with a tendon from his right forearm.
Maybe the procedure would not have been hailed as a pitchers' panacea, certainly not have become as prevalent, had John not won more games after the surgery (164) than he had before (124). But he did.
Video: PHI@LAD: Dodgers honor Dr. Jobe with pregame ceremony
John's commitment to arduous rehabilitation may have had even more to do with popularizing the operation than Dr. Jobe's visionary genius. Put it at 60-40.
"When I had the surgery," John said, "Dr. Jobe told me, 'I can do about 30, 40 percent of the work. You have to do the other 60.' I had an otherwise healthy athletic body and the mechanics of knowing how to pitch. If I'd been a school teacher and had the operation, my success with it would have been far less."
John thus unfairly did not make baseball's Hall of Fame -- for his 15 years on the ballot, voters somehow decided 288 wins were not worthy of Cooperstown -- but instead belongs in the American Medical Association shrine.
If there is also a hall of fame for post-op recovery, perhaps John should be in that, too. John had hip-replacement surgery in August, and by March was playing golf five days a week in Palm Springs.
Googling "Tommy John surgery" returns 2.9 million hits. Not that many pitchers have had the operation -- it just seems that way at times.
The prevalence of Tommy John surgeries is a remarkable trend. Previously, tearing an elbow ligament would jeopardize careers. Yet MLB of the pre-1970s did not see dozens of careers end with the injury. The epidemic confounds just about everybody -- but not John, who has lucid theories he has discussed with the best possible experts.
"Go back and ask these guys [having the operation] when they started to pitch, and they'd probably say when they were 7, 8 years old," John said. "And if they were pitching year-around -- and almost all have -- they never gave their arms a chance to rest.
"It's not Little League managers letting kids throw 125 pitches in a game. It's all those hours they spend pitching year-around."
John frequently discussed the epidemic with Dr. Jobe, who passed away a year ago at 88. John often discusses it with Dr. James Andrews, whose Birmingham, Ala., clinic is the current mecca for torn ligament sufferers. John has yet to have an opportunity to chat up the third leg of this influential medical trinity, Dr. David Altchek.
Video: Dr. Frank Jobe passes away at age 88
"But I'm sure Dr. Altchek agrees with Dr. Jobe and Dr. Andrews that what we're seeing are the results of overuse -- not in-game use," John said. "Dr. Andrews is adamant about 'six on, six off.' Kids can spend six months a year pitching, then six months laying off."
If such an expert voice as Dr. Andrews' is broadcasting the message, why isn't the message being received?
"The culprits are the parents," John said. "They think they know more. They see their little Johnny being the next Clayton Kershaw, or the next Max Scherzer. 'My kid can pitch' -- you hear it all the time.
"There is a kid in my hometown," said John, a New Jersey resident, "and he had some elbow pain and his parents asked me, 'What should we do?' I said, 'Shut him down, go to a competent doctor and get an MRI and see if there is any damage, then let him lay out for a while.'
"And his dad tells me, 'But there's some great games coming.' You see," John said. "His son plays on this travel team, and kids' arms are not ready to handle that. If we could only get rid of that, get parents to listen. They're afraid that if their kid lays off, all the other kids will pass him by. But that's not going to happen, because whatever you do from 8-to-14 is not going to make you a better pitcher at 18-20. If you start throwing more at 16-17, you can be just as good at 18-20, and probably healthier."
John isn't preaching that gospel in a vacuum. He scales whatever podium is available.
"I got a pitching academy back home, and we go out and talk to parents and kids. I tell them, 'You can hit year-around, but you cannot throw year-around.'"
That message echoes the Pitch Smart initiative recently undertaken jointly by Major League Baseball and USA Baseball -- the governing body for amateur baseball -- to educate youth coaches and parents. Oddly, John was not aware of that program, but wholly endorsed it once its mission was explained to him.
"My son, Tommy, is a chiropractor now, but before he was a personal trainer who worked with a lot of the Chicago Bears," John said. "He thinks Little League Baseball should give strength tests every year to pitchers. Some are not yet strong enough to support the stress put on their bodies -- and that makes the chances of getting hurt greater. When you watch the Little League World Series and see those great pitchers -- they're the biggest kids on the team. They are the exceptions."
Pirates general manager Neal Huntington has undertaken a vocal personal campaign against the misguided notion that Tommy John surgery makes one a better, faster pitcher. Huntington has been moved to speak out by the troubling suspicion that in some cases, Tommy John surgery has actually become elective, not corrective.
Huntington's proactivity also drew John's enthusiastic support.
"Dr. Jobe had a view of that, too," John said. "He would say, 'Surgery doesn't make you throw harder. It only corrects a defect in your elbow.'"
Tom Singer is a reporter for MLB.com and writes an MLBlog Change for a Nickel. Follow him on Twitter @Tom_Singer.