Tommy John Surgery
What is Tommy John Surgery?
Tommy John Surgery, also known as ulnar collateral ligament (UCL) reconstruction, is a procedure performed to repair or replace a torn UCL in the elbow. This ligament is crucial for stability, especially in athletes who perform repetitive overhead or throwing motions, such as baseball pitchers, javelin throwers, and other high-demand athletes. When the UCL is torn or severely damaged, the elbow may feel unstable, weak, or painful, making it difficult to throw or even perform daily activities.
Causes of UCL Injury
UCL injuries typically result from repetitive stress on the elbow joint. Over time, the ligament can stretch, fray, or tear. Common causes include:
Who Should Consider Surgery?
Tommy John Surgery is usually recommended for:
The Surgery Procedure
During surgery, the damaged UCL is replaced with a tendon graft, often taken from another part of the patient’s body (such as the forearm, hamstring, or big toe tendon) or from a donor. Steps include:
- Making a small incision along the inner elbow
- Removing the damaged ligament
- Drilling small holes in the humerus (upper arm bone) and ulna (forearm bone)
- Threading the new tendon graft through these holes in a figure-8 pattern
- Securing the graft to act as the new UCL
Recovery and Rehabilitation
Recovery after Tommy John Surgery is a long but structured process, typically taking 12 to 18 months for full return to competitive throwing sports.
- First 6 weeks: The arm is placed in a splint or brace to allow healing.
- 6–12 weeks: Gradual restoration of range of motion and light strengthening.
- 3–6 months: Progressive strengthening and conditioning.
- 6–12 months: Sport-specific training begins.
- 12+ months: Most athletes may return to competitive play.
Success rates are high, with 80–90% of athletes returning to their previous level of play or higher.
Frequently Asked Questions
How long will it take to get back to sports after Tommy John Surgery?
Most athletes return within 12–18 months, though recovery time varies depending on the sport and position.
Is Tommy John Surgery only for baseball players?
No. While it is most common among pitchers, athletes in tennis, softball, javelin, gymnastics, and even workers with repetitive elbow strain may need the procedure.
Will my throwing speed and strength return?
Many athletes regain full performance, and some even report improved throwing mechanics, but outcomes depend on proper rehab and adherence to medical advice.
If you are experiencing elbow pain, instability, or difficulty throwing, I am here to help.