What Every Baseball Player Should Know About Tommy John Surgery

Baseball players throw hard, so you’re no stranger to sore joints and muscle pain. But playing hard also puts you at risk for tearing your ulnar collateral ligament (UCL), a group of three bands of ligaments that run from one side of your humerus, or upper arm bone, to the other side of your ulna, or forearm bone.   

Your UCL helps provide stability at your elbow, and a torn UCL isn’t just painful. It can limit your range of motion and make it impossible to pitch, throw, and catch, keeping you sidelined for good. Symptoms of UCL injuries include:

• Pain on the inside of your elbow
• A feeling of instability or looseness in your elbow
• Tingling or numbness in your pinky and/or ring finger
• Inability or decreased ability to throw a baseball

Though UCL tears can result from an acute injury, they usually develop over long periods of overuse, which is why baseball players are often affected. The good news is that an innovative surgery can help restore function, stability, and range of motion to your elbow, getting you off the sidelines and back in the game. 

At OasisMD Lifestyle Healthcare in San Diego, Encinitas, and Temecula, California, our sports medicine surgeons, David Chao, MD, and Matthew Gargulinski, DO, specialize in Tommy John surgery, or UCL repair. Here’s a closer look at the surgery and what every baseball player needs to know about this innovative treatment. 

What is Tommy John surgery?

Tommy John surgery is a form of UCL reconstruction named after former LA Dodgers pitcher Tommy John, the first patient to undergo this type of surgery in the 1970s. During the surgery, your doctor takes a tendon from another area of your body, called a graft, and uses it to reconstruct the UCL.

Know that most patients with injuries to the UCL don’t require surgery. Before recommending Tommy John surgery, your provider reviews your injury and may try more conservative treatments, including:

• Rest
• Ice therapy
• Nonsteroidal anti-inflammatory drugs (NSAIDs) 
• Physical therapy

Based on a careful physical examination and information from any X-rays, MRIs, or other imaging studies, your provider creates a personalized plan for treating your injured UCL. 

What can I expect with Tommy John surgery?

Your OasisMD Lifestyle Healthcare provider will give you detailed instructions and explanations, but here’s a general overview or what to expect:

Before Tommy John surgery

Tommy John surgeries are performed at the hospital, and you can expect to be under general anesthesia during the procedure. Tommy John surgery usually takes about one to two hours.

Although you’ll be returning home after your operation, you won’t be able to drive because of the anesthesia, so arrange for a ride to and from the hospital. Since you won’t be able to move your elbow for several weeks, you should also arrange for help with meals and household chores. 

Our team discusses your preoperative preparations with you, but don’t hesitate to call us if you have a question or concern.

During Tommy John surgery

During Tommy John surgery, your provider makes two incisions: one at the elbow and another at the graft site. The most common graft sites include the hamstring, big toe, and forearm.   

Once your surgeon harvests the graft, he makes an incision on the inside of your elbow and cleans the joint, removing any bone fragments or damaged tissues. He then drills holes into the bones the UCL attaches to and threads the graft through the holes to reconstruct the UCL. 

The graft is secured with screws, anchors, or sutures, depending on your anatomy, and the incision site is closed. Your provider may also use regenerative medicine techniques, such as platelet-rich plasma (PRP) injections or stem cell solutions, to accelerate healing.  

Recovering from Tommy John surgery

Although the Tommy John surgery only takes about an hour, the recovery takes time. Your arm is first immobilized at a 60- to 90-degree angle. You will, however, be able to move your hand, make a fist, and move your shoulder. 

You’ll begin physical therapy immediately to keep your muscles from atrophying and retain some range of motion. After a week or two, you’ll begin moving your elbow during physical therapy only. 

About four weeks after your surgery, you’ll begin to straighten your elbow. During more intense physical therapy, you’ll work on rehabilitating the joint to regain range of motion. This continues for several months.

Recovery from Tommy John surgery takes at least six to nine months, but it generally takes up to 12 months. According to research, up to 97% of professional (MLB) players returned to play after one year, with 87% returning to the same level of play after about 15 months.   

Contact the OasisMD Lifestyle Healthcare in Southern California nearest you, or schedule an appointment online now to learn more about Tommy John surgery.