Tommy John surgery, formally known as an ulnar collateral ligament reconstruction, is a procedure designed to repair damage in one of the two main ligaments in your elbow. It gets its name from a professional baseball player who was the first person to undergo the procedure. To recover from Tommy John Surgery, you need to participate in a course of rehabilitation.
Basics
Your ulnar collateral ligament, or UCL, is also sometimes called the medial collateral ligament because it sits in the inside portion of your elbow joint. Along with a matching ligament on the outside of your elbow called the lateral collateral ligament, it connects the ulna bone in your forearm with your humerus and helps the ulna track smoothly around a groove in the humerus' tip. Baseball pitchers can damage the UCL by making repeated throwing motions over time. You can also damage your UCL if you dislocate or otherwise injure your elbow.
Initial Rehabilitation
During the initial phase of rehabilitation, the main goals are protecting your healing surgery site, reducing any pain or swelling and preventing your muscles from shrinking, according to Dr. Farhad O. Moola, orthopedic surgeon with New West Orthopedic and Sports Medicine Center in British Columbia. For roughly 10 days following your procedure, your arm will be immobilized with your forearm straight and your elbow at a 90-degree angle. During this phase, your rehabilitation will consist of cold treatments, hand grip exercises and gentle mobility exercises for your wrist and shoulder joints. Some of these exercises will be isometric, which means you perform them without moving your joints or changing the length of your muscles.
Second Phase
Goals during the second phase of rehabilitation include gradually gaining full range of motion in your elbow, keeping your elbow joint safe and improving your muscular strength. Exercises used during this phase include isometric forearm exercises and external shoulder rotations, as well as low-weight resistance exercises such as elbow extensions and flexions, wrist curls and pronation/supination exercises for your forearm. At the start of this phase, you will keep your elbow immobilized between exercise sessions. Eventually, you will only immobilize your arm as needed.
Final Phase
During the remainder of your rehabilitation, you will maintain your elbow range of motion and continue increasing power, strength and endurance throughout your arm and shoulder. In addition, you will perform exercises that increase your flexibility, coordination and overall physical fitness. If you play sports, you will also begin activities specifically designed to return you to competitive form.
Recovery
For pitchers, recovery from Tommy John surgery can easily take a year. Recovery times for others will typically be shorter. During rehabilitation, you may experience pain and swelling symptoms that cause your physical therapist to temporarily return you to more limited types of exercises and activities. Roughly 85 to 90 of people who undergo a Tommy John procedure completely recover from their UCL injuries.
