Recovery Process

The recovery process for Tommy John Surgery is a long and rigorous one. It takes about 10-12 months for pitchers and about 6 months for position players. Here's what a Tommy John patient can expect:

Week 1: the arm that was operated on gets put into a brace that is much like the one that goes on the knee after ACL surgery, but for the elbow. This brace completely immobilizes the arm at a 90 degree angle. The patient is, however, able to move their hand.

Week 2: the brace is adjusted to extend the arm outward, slowly, day-by-day. The patient may also start to use their arm for every day exercises.

Weeks 3-8: the patient will generally start exercising their range of motion and light dumbbell exercises, and they are usually eligible to be out of the brace at about 4-6 weeks.

Week 10: the patient can start simulating a throwing motion, slowly, and with an empty hand.

Weeks 12-14: the patient can start to swing bats and golf clubs and other things of that sort. They may also start to simulate a throwing motion while holding a 1 pound medicine ball.

Week 16: at week 16, the patient will begin a flat ground soft toss throwing program of two 25 throw sessions at 45 feet, done every other day. The distance and number of throws is increased each week until they can do all of it, pain free, at a distance of 150 feet.

Month 6: if the patient is a position player, then they are ready to return to play. If the patient is a pitcher, they will begin to throw straight fastballs on the mound with a gradual increase in effort.

Month 7: the pitcher will be ready to start throwing breaking balls on flat ground.

Month 8-10: the pitcher is ready to ready to start facing batters and pitching in simulated games.

Month 11-12: the pitcher is ready to return to competitive action.

It is not uncommon for pitchers to return from this surgery throwing harder than they did prior to. This is not because of the surgery itself but instead due to the amount of work and effort put into the recovery process. Their arm is usually stronger than it was before and this results in the increased velocity.

How is it done?

Tommy John Surgery is actually a somewhat simple process. In a nutshell, the doctors go into the elbow through an incision made on the medial side of the elbow, and remove the torn UCL. Then they retrieve another ligament from somewhere else in the body, most often the leg or the wrist. This new ligament is then put in place of the old UCL and woven through a series of holes that have been drilled in the bone so that the ligament is in a figure-8 pattern. Finally, they stitch up the entry place and the patient is on the road to recovery.

What causes Tommy John Surgery to be necassary?

The main reason someone would need to receive Tommy John Surgery would be if they have a tear of the Ulnar Collateral Ligament in their elbow. The most common reason this ligament would tear is stress placed on the elbow from overhead throwing. This is why the most common patients are baseball players, but there have also been some other athletes from track and field as well as football.

Who is Tommy John?

Tommy John was a Major League pitcher from 1963 to 1989. In 1974, while playing for the Los Angeles Dodgers, he suffered from an elbow injury. The injury was a tear of the Ulnar Collateral Ligament, which for players prior to Tommy was a career-ending injury. However, Dr. Frank Jobe believed that he may have found a solution to the problem that would hopefully allow players to continue their career. His solution was Elbow Ulnar Collateral Ligament Reconstruction surgery. Because Tommy John was the first to receive this surgery and return to play, the surgery is now widely known as Tommy John surgery. and a large number of baseball players undergo this operation and return to play.