Tommy John Surgery

What is a Tommy John Surgery?

Tommy John surgery is reconstruction of the ulnar collateral ligament (UCL) in the elbow. The ligament is strengthened by either a tendon from elsewhere in the patient’s body or donated tissue. UCL damage can be a minor or complete tear in the ligament. UCL tears are the most commonly torn ligaments in baseball pitchers.

Who Should Have a Tommy John Surgery?

UCL damage can be a minor or complete tear in the ligament. Minor damage can sometimes heal well enough on its own to avoid surgery.

Nonsurgical treatment includes:

• Physical therapy
• Anti-inflammatory medication
• Change of position to allow rest and reduce stress on the elbow

If nonsurgical treatment is effective, you may be fully recovered in six to nine weeks. If nonsurgical treatments remain unsuccessful, surgical treatment may ensue.

Does a Tommy John Surgery work?

The fact that 25 percent of MLB pitchers have had Tommy John surgery is good evidence that this procedure works well. There is a misconception that this surgery can actually improve performance because of high-profile cases, but improved strength and conditioning habits following surgery are the real reason. Tommy John surgery carries the same risks as any open surgical procedure, including blood clotting, infection and others. Overall, successful recovery is estimated at 85 – 92 percent.

What Can I Expect When I Have a Tommy John Surgery?

After you schedule surgery, you may need a pre-surgical physical to make any necessary accommodations based on your health history. When you arrive at the hospital, you’ll speak to your surgeon and anesthesiologist. You will likely be under sedation with a nerve block in the arm for this procedure. This is an outpatient surgery, so you will go home the same day.

Following the procedure your arm will be placed in a cast or splint with you slowly beginning to move your arm. You can return to most normal activities, including driving, when you are off the pain medicines, typically one to two weeks. After the cast or splint is removed (typically at two weeks), physical therapy will help you gain back your range of motion and strength. Your therapy will also focus on strengthening your shoulder and core, so there is less load on the elbow when you recover.

Tommy John surgery has a long total recovery process. It is typically a full year before athletes are throwing at 100 percent, but it may be more or less depending on the individual.