That first throw was pretty scary, but I knew I was ready for it, and it went fine.  It felt just like it used to. I started out at 30 feet, progressing to 40 feet x 60 throws by the month’s end.  Month two moved me back to 50 feet, and month three to 60. Midway through month three, however, I switched to a different throwing program because I was progressing faster than my throwing program would allow.  

I talked earlier about falling on my arm when I was running and how important that was in trusting my arm.  The first day I let a ball go on a line was another such moment.  After every single throw was on a soft arc, letting one go on a line was one of the first tests of my new ligaments.  I can remember that first throw, and how liberated I felt when I did it without pain.  I only uncorked a few of these per session, but they always provided me with a release from the tension of wondering if my elbow was really strong enough to get me back to where I once was.  

In the middle of my third throwing month I jumped into Dr. Andrews’ throwing program, which my training staff had a copy of from a previous TJ patient.  It called to move up in distance and in throwing volume every time a stage was completed twice without discomfort.  On this program, one can move as fast as his arm is able, and if he has pain, he just backs off and slows down.  I moved through this program without a hitch until a month into the mound phase.

I started having some slight pain in my forearm once I was throwing about 3/4 speed from the mound.  It was only initiated through pressure on my fingertips, however, and not really with throwing, which assured me that it wasn’t a ligament problem, and was probably just one of those minor complications that accompany the surgery.  It only slowed me for a few days, and it later subsided.  My doctor told me it wasn’t something that I need to worry about, since I stopped having pain with it while throwing.  

I threw some long toss days in with the program, as long toss always helped my arm feel good and it keeps me in good mechanical timing.  The thing I realized most was that the throwing program was just a guide for incremental progression. Progressing continually was the key, and whatever I wanted to do was fine as long as it stayed within the confines of moving up in small steps.  Long tossing to 300 feet one workout after only long tossing to 240 feet before would not be OK, because that’s a big jump in the throwing load.  But from 240 to 270 is a better choice, and one after which your arm won’t hate your guts.  

You'll get there, one at a time

I wish I had a copy of the throwing program to post, but I don’t.  At first, I wanted to adhere to it 100%, and any deviation from it made me feel afraid that I might hurt myself.  But the farther I got in my rehab the more I learned that my arm would tell me what it could and could not handle, and that just moving progressively but prudently was what really mattered.

The first 3 months post-op were exciting in the sense that everything was new and changes were dramatic.  Things returned to normal rather quickly, and it was all building up to that fateful day when I would chuck that pill again, even if it was only for 30 feet at first.

Surgery Day

I was in and out of the O.R. in about 75 minutes, and I had minimal pain and wasn’t overly groggy or out of it.  I had a prescription for Vicodin and a sling on my arm that I was to keep on for two days.  I was told I could move my hand and arm around in any way I wanted, and I could squeeze a soft ball.  I went home and did all of the above, though I only had the strength of an infant with low blood-sugar.

I was worried about my arm not being immobilized, as I had previously mentioned, but I dealt with it, and I was quite nice after those two days passed and I had only an Ace bandage left covering my incision.

Week 1

I was given 4 different Thera-Bands  at my 7 day post-op visit and was instructed to perform 4 exercises with them every day.  I was to start light and move up once I could perform 2 sets of 20 reps with each exercise. The four, which I still do daily 9 months later, are: Wrist Flexion, Extension, Supination and Pronation.  I also continued to squeeze a soft ball.

Weeks 2 to 3

My other goal, beside strengthening my forearm, was to extend my arm.  As soon as the brace was off I was on my own to do this as tolerated.  All day I would just flex and extend, flex and extend, flex and extend.  The first 150 degrees or so of extension came within about 2 weeks, but the last 30 and then 15 degrees were tough to get.  By about 3 weeks I could fully extend my arm, but upon awakening It would usually be a little less than straight until a week or two later.

Since Dr. Morgan views glenohumeral internal rotation deficiency (GIRD) as a chief factor in elbow problems, I was instructed to resumed sleeper stretches and hip flexibility exercises at week 3.  Addressing and correcting flexibility problems before throwing was a necessity.

One of the most helpful exercises in getting my arm to extend was to prop a pillow under my tricep and hold a 1 lb dumbell in my hand, allowing gravity and the weight to extend it.

Weeks 3-6

At the week 3 check-up I was given the green light to start conditioning again, as my incision was closed and sweat would no longer cause an infection risk.  So I started running, doing Bikram yoga, and lifting weights to the extent I could without using my right arm.  I also started with light scapula exercises, which I also performed with Thera-Bands.

Slightly Swollen Elbow at Week 3

I was able to squat using a Top Squat attachment, and I did a lot of sled dragging with a harness, and body weight and weighted vest exercises.  I was happy to be active again.

Weeks 6-12

I was cleared to lift weights to my heart’s content at week 6, but again, I had to start light.  I started with wall pushups and worked up (or down) to floor pushups. Holding a 15 pound weight  would make my forearm nearest the elbow pretty tired, but over time that effect would only occur with heavier and heavier weights, until around week 10 I could hold 50s in each hand with no problem.  Most of my upper-body work was done with light dumbbells and bands until my strength was back up.  It was crucial to get my overall body strength up before the throwing phase started at week 12.

I also resumed my rotator cuff circuit at week 6.  This was the Orioles shoulder workout and is very extensive.  It takes about 30 minutes to complete 2 cycles.  I credit this with the fact that my shoulder has been perfect and very strong since.  Many pitchers return from elbow surgery just to tear a labrum or rotator cuff afterward because they neglect their shoulders while rehabbing their elbows.  While injuries are never totally controllable and preventable, I did everything I could to avoid any further arm problems.

What the doctor told me was that my elbow was fine, and that I could lift and run around and fall on it if I wanted.  I didn’t really believe this, but an important event took place around week 8 when I started running agilities and sprints with the team.  Within ten minutes in the first session of agilities I clipped a cone, slipped, and caught myself as I fell with my throwing arm.  I got up, finished the drilled, looked down at my arm, and let out a big sigh of relief.  It was a big moment, because I didn’t really trust my arm before that fall.  But fall I did, and nothing happened.  No pain, no soreness, no stiffness, nothing.  It was a blessing in disguise, and I trusted my arm from that point on.

At week 10 it was swelling-free and ready to go

At Week 10 I was feeling pretty strong, with full range of motion and no swelling left in my arm.  It felt normal and ready to go.

At week 12 I had another check-up and was cleared to start throwing.  It was exciting yet nerve-racking at the same time.  It was the next step, and I was physically ready for it, but mentally was a slightly different story…