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Tommy John Surgery
Tommy John Surgery

The long-awaited baseball season is here once again! After a year of limited baseball due to the COVID pandemic, players and fans alike seem to be particularly excited to see action on the diamond once again. With baseball comes sore elbows. Without fail, sore elbows find their way into our clinic every year. There is nothing worse for a fan than seeing the ESPN notification scroll across the screen informing you that your favorite pitcher was put on the disabled List with a pending Tommy John surgery.

Tommy John surgery is more formally referred to as ulnar Collateral Ligament(UCL) Reconstruction. The UCL is a ligament on the inside of the elbow that connects the humerus bone of the upper arm to the ulna bone in the forearm.This ligament assists in providing stability to the joint-stability that is vital to motions such as throwing a baseball. If the UCL is damaged or ruptured, a patient will likely report pain, swelling, instability, loss of motion, and perhaps some radiating numbness and tingling into the ring and small fingers. Throwers usually report a loss of velocity as well.

For patients with UCL damage who are not trying to return to competitive sport, conservative management of the injury is recommended. This can include rest,ice, compression, oral medications, physical therapy with modalities, bracing, and activity modification.

Reconstruction of the UCL is usually necessary for competitive athletes who use their elbows in a high-velocity fashion or have to regularly put weight through their arms (think baseball & softball players, wrestlers, cheer and dance participants, and gymnasts) to restore function that allows them to participate at their pre-injury level. If conservative management fails to resolve symptoms for a lay person over the course of a year or so, reconstruction may be considered. This procedure involves harvesting a graft from elsewhere in the body (typically the palmaris longus tendon in the forearm) to reconstruct the damaged ligament. This tendinous tissue is then woven through holes drilled into the bone where the UCL once resided. A patient will be splinted or brace after surgery and active range of motion will be carefully progressed over time. Formal physical therapy including a throwing-specific program will help baseball players return to sport. Typically, this is a 9-12 month recovery to get athletes back to their pre-operative state.

If you know a baseball player struggling with elbow pain, send them our way!

This blog is written by one of our very own-Morgan. She is a certified athletic trainer working in our clinic with our providers each and every day. She obtained a bachelor's degree in athletic training from Carroll University in Waukesha and a master's degree in Kinesiology from Michigan State University.