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Returns From Tommy John Surgery Are Common, but Recovery Can Bring Grief, Isolation

— More than 2,200 professionals have undergone the surgery since its introduction 50 years ago

MedpageToday
 A photo of Giants pitcher Daulton Jefferies in the dugout after pitching against the Seattle Mariners during spring training
AP Photo/Ross D. Franklin

OAKLAND, Calif. -- One August morning in 2022 while all alone at the Oakland Coliseum, Daulton Jefferies plopped down in the grass and wept.

The pitcher cried for a good 45 minutes. Six years after becoming a first-round draft pick and days after his 27th birthday, he contemplated giving up baseball altogether -- a first for him, in spite of multiple injury roadblocks.

Jefferies made eight starts for the Athletics that season and knew his right elbow had something seriously wrong – again. He had been through one Tommy John surgery in 2017 and would soon be headed for another.

"I needed a good cry," he said. "Sometimes, you need it."

Elbow injuries have plagued generations of pitchers, and damage to the ulnar collateral ligament (UCL) in the pitching elbow used to be a career-stopper. That changed , when Frank Jobe, MD, reconstructed the UCL of Los Angeles Dodgers left-hander Tommy John and salvaged his career. More than 2,200 professionals have undergone the surgery since.

Success rates are now so high that Tommy John surgery is practically commonplace, and some players like Jefferies are able to endure the daunting recovery more than once.

Still, when it's your livelihood at stake, the physical challenges, stress, and isolation can be downright overwhelming.

It all hit Jefferies on that day in 2022 -- "probably the loneliest I've ever been," he said. His arm had been hurting for more than a year and his season already ended in June with a different procedure to address thoracic outlet syndrome.

"I thought about retirement for the first time," he said.

In September, barely a month after Jefferies broke down on the field, he underwent a second elbow ligament reconstruction.

Jefferies is back on a major league mound at last this spring and vying for a spot on the regular-season roster. He signed a minor league contract with the San Francisco Giants in December.

He is no longer in full-time rehab mode and has appeared in three big league spring training games through Tuesday, allowing two earned runs and seven hits while striking out eight batters with one walk over seven innings for a 2.57 earned run average.

"Everything is going well, I couldn't be happier," Jefferies said. "Living the dream."

The hope is that at some point this season, Jefferies will be back in the Bay Area, where he starred at the University of California Berkeley before being drafted by Oakland. With a chance to still play close to where he grew up in California's Central Valley, Jefferies considers himself "the luckiest guy ever."

"It would be totally reasonable to say, 'I'm going to move on to the next thing at this point,'" Giants President of Baseball Operations Farhan Zaidi said. "But the guys who want to keep going, who have the determination to keep going, you figure you'll bet on them because they've been through so much already."

A Lonesome Recovery Process

For Jefferies, the road back to this point became filled with self-doubt. On game days, he would arrive at the stadium around 8 a.m. to work on his elbow recovery, left with hours of quiet time before teammates began filtering in around midday.

The isolation made every negative emotion that much worse. And through all those days when his self-esteem was shot and Jefferies questioned his future, he regularly, purposely, kept to himself. He didn't want anyone to see him in such a down state.

That had never been the case before with the typically cheerful Jefferies, who loved coming to the ballpark and cherished the daily baseball routine.

"I think you're lonelier, at least I was lonelier, surrounded by people, which was kind of weird. ... I wanted to separate, because baseball for the first time ever made me sad," he said. "Going to the field made me sad, which I hated that, because it's my safe space, like a sanctuary kind of thing. So, in order to kind of flip that, I didn't want to seek help from any athletic coach or anything like that."

Instead, he started therapy.

Reaching Out for Help

Jefferies began meeting with a doctor in the Bay Area, and they talked about anything but sports. As much as he needed to recover physically after his surgery, he came to realize that his mental health needed even more attention. Taking lessons from those two-hour sessions, Jefferies changed his focus.

"What really helped me is I started kind of just doing whatever made me feel happy," he said. "I love being outside, I love being on the field, so I created a new routine because athletes or anyone, it's just better if we're on a routine."

He couldn't run or lift weights for a while, his arm protected in a bulky brace with dials to adjust his range of motion. He couldn't sit in the dugout out of an abundance of caution, in case a stray ball came his way.

In an effort to lift his own spirits, there were days Jefferies had to take his mind elsewhere and far from the rigors and repetition of rehab. He tried to activate his five senses during walks on the field, some of them in bare feet. Fresh air helped.

For example, he'd stroll as long as it took to finish a Blow Pop lollipop -- working his right arm all the while by continually lifting the sucker up to his mouth.

That didn't make it easier to cope with not playing, not feeling part of the group, not being able to take part in the home-run dugout dances or postgame celebrations.

Jefferies recognized the enormous void.

"The grief period is losing your identity," he said. "A good amount of days, I felt stuck in a rut. One day, I didn't get out of bed until 1 p.m. That's not like me. I'm up and at 'em."

Through the counseling, Jefferies began to learn and appreciate himself as a person, not just as a professional athlete and pitcher.

"I kind of discovered me," he said. "I really had to focus on who is Daulton Jefferies."

Seeking Out the Small Victories

Jefferies shifted his mindset to focus on what he could do and accomplish, the small victories.

There were days he'd look up at the radar gun and his fastball clocked 86 mph -- far short of the 94 mph he averaged his first year in the majors.

"All right, this is what I got today," Jefferies would tell himself.

He went out of his way to engage with others, bringing in three dozen doughnuts for each day game and printing out an old photo of a player or coach to adorn the box.

"I overemphasized being the best teammate I could be," Jefferies said.

He took pride in learning who liked what – such as Stephen Vogt's apple fritter or maple bar favorites. Teammates took notice, too.

Vogt, now the Cleveland Guardians' first-year manager, admired how Jefferies carried himself despite the obstacles.

"He was great," Vogt said. "Hope he's back sometime soon."

Jefferies has plenty of others in his support system also cheering this comeback. That includes new teammate Robbie Ray, rehabbing his own Tommy John surgery with the Giants this spring.

"To see a guy like that that's had two Tommy Johns and is still at it and still persevering, it's really fun to watch," Ray said. "It's really cool."

Jefferies knows his arm has to hold up this time.

He smiles as he points out there's not another tendon in his leg to take if he somehow were to go through this all again. In his first Tommy John reconstruction, they used the tendon from the gracilis muscle in his left thigh, then for the second one they did the same from the right side.

"I don't have any more legs to get another one, so we're just not going to get another one," he said chuckling.

In November at a charity golf event hosted by Tyson Ross, Jefferies chatted with former pitcher and Giants fan favorite Sergio Romo, who offered some encouraging words.

"I told him it's my last shot," Jefferies recalled, "and he said, 'No, it's your next shot.'"

And Jefferies has finally come to believe it.