Rehabilitation After Tommy John Surgery

One of the most common injuries we see in baseball is a torn ulnar collateral ligament (UCL). This occurs when a pitcher throws the ball, then grabs his elbow. In most cases, these players choose to have Tommy John surgery to reconstruct the UCL. 




Tommy John Surgery is named after a Los Angeles baseball pitcher who tore the inside of his elbow and had surgery to rebuild  it. The surgeon, Dr. Frank Joe, invented the procedure to rebuild ligament inside the elbow. It was so successful that 25 years later we call the procedure Tommy John Surgery.


Athletes who throw very hard, like baseball pitchers, or javelin throwers usually get Tommy John Surgery. For everyday folk, it is less common. 


Elbow ligament is replaced with a healthy tendon from the patient’s arm or leg, or from a donor’s. The tendon is threaded through holes in the bone around the elbow. 



Rehabilitation therapy for Tommy John Surgery takes about 1 year for pitchers, and 6 months for position players. The following is a general timeline of the rehabilitation process:

1 to 2 Weeks After Tommy John Surgery

The goal is to control pain and maintain motion in the shoulder and wrist. The elbow is placed in a brace with no movement in a 90-degree position. The player is still able to move his wrist and shoulder. 

2 to 6 Weeks After Reconstruction

The goal is to increase movement in the elbow so the player can regain full motion by the end of the sixth week. This is accomplished by increasing the range of motion the brace allows.

6 to 18 Weeks After Reconstruction

There is a minimal increase in exercise intensity. But exercises for the shoulder and scapula will become increasingly harder and encourage safe elbow motion. These exercises will help strengthen and prepare the pitcher to start throwing again.

18 to 40 Weeks After Reconstruction

The pitcher starts throwing a baseball 30 times at 45 feet every other day. Then progresses to 50-60 throws, increasing by 30-foot increments every two to three weeks. The end goal is 100 throws with 24 of those throws at distances as high as 210 feet.

8 to 10 Months After Reconstruction

As soon as his throwing strength is reached, the pitcher progresses to throwing from the mound. Pitchers will throw 20 to 25 pitch bullpens. Additionally, they continue the long toss three times per week. As soon as he can throw 40-45 pitch bullpens with good mechanics, the pitcher throws in batting practice and eventually pitch in a live game.


If you have found yourself on the sidelines due to a sports-related injury or pain in New York, schedule an appointment or call us at (212) 310-0100

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