Tommy John surgery — also known as ulnar collateral ligament (UCL) reconstruction — is named after the procedure’s first successful recipient. Tommy John was a Major League Baseball (MLB) pitcher who tore his UCL in 1974. At that time, a UCL tear could be a career-ender for a pitcher.
Thanks to Dr. Frank Jobe, the Dodgers' team physician, Tommy John underwent a UCL replacement surgery that was then named for him. Although John missed the next season, he went on to pitch professionally for another 13 years.
The first step to ensure the best results for your Tommy John surgery is to pick a world-class, experienced surgeon, such as David Lintner, MD. He has performed hundreds of successful Tommy John surgeries. At our Houston Methodist Orthopedics & Sports Medicine clinic in Houston, Texas, you can consult with Dr. Lintner to discuss your UCL repair and recovery.
What can you expect during your recovery from Tommy John surgery? Below is a general timeline and protocol to help you get back into play, just like Tommy John did.
Although Tommy John returned to play after his UCL repair, understand that it takes time to recover from this surgery. A UCL reconstruction is a complex procedure that requires both recovery and rehabilitation.
In addition to your torn UCL, other tissues that support your elbow joint may have been damaged through overuse. Depending on your particular injury you may have also undergone other procedures at the same time, such as:
Most UCL reconstructions have a recovery time of 12-16 months before your arm is strong enough to pitch in competition. Less intense throwing is sooner and hitting in games even earlier. Dr. Lintner must clear you before you return to play, otherwise you risk re-injury and other complications.
Your first week of recovery (Phase One) is devoted to allowing your body to heal from the surgery and to care for your wound. We teach you how to bathe safely and to keep the wound clean and dry.
During this initial healing phase, you’re not ready for physical therapy. However, we may recommend gentle movements to prevent stiffness. You must wear your brace at all times. During days 0-7, your brace is locked at 90 degrees to prevent flexion.
As soon as your wound has closed and healed, we recommend beginning your recovery and rehab protocol with physical therapy (PT). We still have to protect your forearm muscles as they recover from the surgery. In addition, your physical therapist provides you with at-home exercises to do between PT visits.
You continue to wear your brace. However, it’s now hinged for functionality from 30-100 degrees. Your PT program stresses:
PT also helps you adjust to your brace. The team helps you improve your posture and core strength, which helps create muscle memory in a posture that can protect your elbow once you begin to throw. You’ll also receive soft-tissue massage and other supportive therapies.
During Phase 3 (weeks 6-12), we help you maximize strength while continuing to work on body mechanics. At week six, you can begin jogging, and by week 12, you should be able to sprint — as long as you minimize your risk of falling.
Phase 4 (weeks 12-16) concentrates on getting you ready to throw. We’ll help you maximize the power, strength, and endurance of your arms, core, and legs. Throwing is about your entire body, not just your arm. We continue to administer soft-tissue therapies and pain control as needed.
After week 16, if Dr. Lintner gives you the go-ahead, we prepare you for returning to your sport. However, we concentrate on either throwing or hitting initially— you can’t start both simultaneously. Depending on your priorities, first one, then the other a few weeks later.
In addition, we provide a warm-up and cool-down protocol that you must follow in addition to your PT and rehab exercises. When you’re ready, Dr. Lintner clears you to return to play.
You may be tempted to try to speed up your recovery by doing more than your body can handle. Unfortunately, this approach can backfire. Instead, be patient with your body and don’t do more than your PT prescribes. For at least 4-6 months, you must refrain from:
REMEMBER
You may have been told that you will throw harder after Tommy John Surgery than you did before. That can be true, but it is due to the work you put into the rehab and optimizing your entire body and mechanics, not just your elbow!
Are you scheduled for Tommy John surgery, or do you have a UCL that needs repair? Contact us today by phone or online form for Tommy John surgery or rehab. If you’re not in the Houston area, send Dr. Lintner an MRI for a second opinion or treatment recommendation.
