Tommy John surgery is a procedure that is more commonly known amongst professional athletes as it addresses UCL tear injuries that are often a result of repetitive motion, physical trauma, and other instances that occur during intense sports activities. If you’re experiencing pain or other symptoms from a torn UCL, Orthopaedic Medical Group of Tampa Bay offers comprehensive treatment options to restore your joints to full health.
An Introduction to Tommy John Surgery
What is a UCL Tear?
The ulnar collateral ligament (UCL) is a key ligament located on the inner side of the elbow. It provides stability to the joint, especially during overhead throwing motions. Repeated stress or a sudden injury can lead to a partial or complete tear of the UCL, causing pain, instability, and a loss of throwing velocity.
UCL tears are most common among athletes involved in sports requiring repetitive throwing, such as baseball pitchers, javelin throwers, and quarterbacks. Non-athletes can also suffer UCL injuries from trauma or overuse.
Symptoms of a UCL Tear
A UCL tear often presents with:
- Pain on the inner elbow
- Swelling and tenderness
- A popping sensation during the injury
- Weakness or difficulty throwing
- Decreased performance in throwing sports
The Tommy John Surgery Procedure
Tommy John Surgery involves replacing the damaged UCL with a healthy tendon, often taken from the patient’s forearm, hamstring, or other areas. The steps include:
- Making an incision near the elbow.
- Removing the damaged ligament.
- Drilling small holes in the bones of the elbow to anchor the new tendon.
- Attaching the tendon to create a new ligament.
The procedure typically takes 60-90 minutes and is performed under general anesthesia.
Recovery and Rehabilitation
Recovery from Tommy John Surgery is lengthy but effective. An Elbow ROM brace will be placed in the OR and worn for 4-5 weeks depending on physician and operative management. The brace will be worn at all times including sleeping but may be removed for hygiene and exercises. Recovery and rehab protocols may vary by surgeon, but athletes can expect:
Stage I (0-2 Weeks)
- Elbow immobilization
- Wrist and hand isometrics as tolerated, Shoulder active and passive ROM (if necessary)
Stage II (2-6 weeks)
- Hinged elbow brace, with limits as set by the surgeon (Typically 30º to 90º of motion)
- Begin flexor/pronator isometrics
- Continue with wrist/hand strengthening
- Continue shoulder ROM
Stage III (6-12 weeks)
- Discontinue immobilization
- PROM and active assisted elbow ROM
- Begin unrestricted strengthening of flexors/pronators
Stage IV (3 to 6 months)
- Avoid valgus stress to elbow and ballistic movement in terminal elbow ranges
- Begin shoulder strengthening with light resistance (emphasis on cuff)
- Start total body conditioning
- May begin early tossing at 30 feet, progressing to 50 feet, no wind-up, 2-3 times/week, 10-15 min/session
Stage V (6-7 months)
- Add shoulder internal rotation exercise in side lying position Lob ball on alternate days, no more than 30 feet, 10-15 min/session;
2.Progress to lobbing with occasional straight throw at ½ speed, 60 feet, 20-25 min/session, 2-3 times/week
Stage VI (8 – 12 months)
Begin long easy throws from 150 feet with ball back to home plate on 5-6 bounces, 20-25 min/session. Begin 12 Day throwing cycle: Throw 2 days/rest one day, repeat 4 times.
Success Rates and Outcomes
Tommy John Surgery boasts a successful return to play rate of around 80-95%, with many athletes returning to their previous level of performance or better. However, proper rehabilitation and adherence to throwing guidelines are critical for long-term success.
Receive Treatment For UCL Tears at Orthopaedic Medical Group of Tampa Bay
Orthopaedic Medical Group of Tampa Bay offers treatment options for addressing UCL tears and restoring the elbow back to full functionality. Ask about our comprehensive elbow treatment options including Tommy John surgery, UCL reconstruction, and more.
