When Tommy John had his right forearm tendon transplanted into his left elbow by Dr. Jobe in 1975, nobody knew what the results would be. After taking a year off post-surgery at age 31 in 1975, Tommy John came back and started 383 more games until he retired at age 46 in 1989.

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Why is it today that a pitcher needs more time to come back from the same surgery that was performed almost 40 years ago?

Numerous other pitchers have come back from the same surgery, like John Smoltz, who became a dominant closer after being a starter for 11 years.

Smoltz had the surgery performed when he was 32. After missing a year and a half, he came back as a top 9th inning man for four years, setting a National League record with 55 Saves at age 35. When Smoltz was 38 he returned to being a starter and worked 100 games from age 38-40. He started 21 more games over the next couple of seasons before retiring at age 42 in 2009.

Another case is that of Ryan Dempster, who had the TJ surgery performed when he was 26. He missed only 12 months and came back as a closer from age 27 through age 30 in 2007. The following year he went back to starting and pitched over 200 innings from 2008-2011, and 178 last season.

Now Boston has four other Tommy John alumni in Andrew BaileyJohn Lackey, Rubby De La Rosa, and Junichi Tazawa.

Bailey had his surgery when he was 21, the year before he was drafted by Oakland.

Lackey had surgery 16 months ago at age 33, and he is counted on to return to the rotation in 2013.

Considering the success’ of Dempster and Smoltz, who transitioned into becoming relievers during their first four years after surgery, maybe Lackey is trying to do too much, too quickly.

Then there is the case of Junichi Tazawa. He had his surgery done at age 23 and missed all of 2010. He started eight minor league games at age 25. He was made a reliever at age 26 in 2012 and pitched 86 innings between AAA and Boston.

Why is it thought that Tazawa needs more time in the pen, now three years removed from surgery, and Lackey is ready to assume a full-time starters role in 16 months?

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Rubby De LaRosa had the surgery when he was 22 in August of 2011. He came back in less than a year, pitching 13 innings before being traded a year after his surgery by the Dodgers to the Red Sox.

Rubby’s case is closer to that of Stephen Strasburg, who had the surgery in August of 2010 at the age of 22. Both Strasburg and De La Rosa threw 100 mph fastballs before the surgery.

Strasburg came back and threw 24 innings just one year after his surgery.

If he followed the pattern of Smoltz and Dempster, Strasburg could have used his 2012 season as a reliever. Then he would not have been shut down for the playoffs due to his organization-imposed 160 innings limit.In 2012, Strasburg was limited to 160 innings in what might be the most questionable utilization of a pitcher’s season in the history of the game. If Washington had held Strasburg back until June, he could have pitched in the NLDS and maybe his team would have defeated the Cardinals.

If the Red Sox are smart, they will limit the amount of innings pitched early in the year by Rubby, and maybe he will be a gem of a ruby in September and October.

Any way you slice it the Red Sox pitching staff has five members  that all belong to a limited fraternity, a fraternity that started out as a 100-1 shot for Tommy John’s healthy return to the Big Leagues.