Posts Tagged ‘Tommy John, Arm Care & Rehab’
January 5th, 2010 | 
Author: I jotted down notes about my bullpen or general throwing sessions from months 7-9.5 of my recovery. I discovered it while cleaning my place. I’m just rewriting what I had down, so I may or may not be able to clarify if you have any questions.
March 22 – Good, not sore
March 24 – Good, not sore
March 26 – 7 months – Good, not sore
March 28 – 15 Changeups; good, but not perfect
March 30 – 10 changeups, discomfort on 1/3 of them
April 1 – 3/4 speed; no changes, no pain, 66-71 mph. felt ok, not perfect next day
April 3 – felt good, not perfect; 45 pitches @ 3/4 (speed)
April 6 – 1st two digits had pain when pressure applied
April 9 – mid to upper 70s, little pain; felt good after 4 days off prior
April 17 – no pain! 65 pitches at 3/4
April 19 – long tossed to 240 no pain
April 21 – felt good. into low 80s maybe
April 23 – gun read 75-77. TIRED! but no pain
April 25 – 8 months – Hit 81, consistent 76-79 50/30 pitches
April 28 – long toss to 270, 45 pitches at 85%
April 30 – 30 + 45 vs hitters. 82-84. Felt good
May 2 – VERY tired from April 30. Arm achy and slight pain, very dead. threw 70 at 2/3 speed
May 4 – flat ground, 15 curves at 50 ft. pain still, arm not recovered from previous.
May 7 – Hard pen, felt good. 80 pitches at 90%
May 9 – good long toss, felt great.
May 11 – 100% from mound, 100% changes, 50% curves (15). felt good, no pain, but knotted up on forearm after.
May 14 – 100% fast + cu, no curves. Still knot in forearm but no pain
May 16 – 45 fast-curve-change, 75-75-50% respectively. less tightness, no knot next day.
May 18 – Light pen, 30 curves
May 20 – In game, 28 pitches. 30 curves beforehand. Bicep Dead, big knot afterward. No throw 21-24.
May 25 – In game 35 pitches, no knot after, felt good
May 27 – 70 pitch pen, 30 90% curves, felt good, bicep better
May 29 – 50 pitch, 70%, curves getting sharper!
May 31 – 60 in game; arm felt slow, but great after. 55 fb/ 5 curves. No tightness at all.
June 2 – Long toss, hard but not too many throws. Need to get intensity up and let go. Felt good next morning.
June 4 – Bullpen 20 max effort, 85-90. Arm felt achy, some occasional pain twinges, and very dead. Decent next day. Fatigue in bicep/tricep still, but not terrible.
Thats the whole log. Wish I had done more of that during it all, but I was more interested in getting after it than writing it all down. Hindsight…
By Steve Eagerton, Pitcher & Tommy John Patient @ Jacksonville University
The most painful part of coming back from my experience with Tommy John was restoring my range of motion. I was removed from a semi hard cast at two weeks post op., and the next day I started range of motion exercises. It took me about 5 weeks to get full range of motion with my therapist moving my arm and almost 8 weeks to get full range of motion on my own. I literally thought my elbow would explode some days- it hurt so bad. Of all the people I know who underwent Tommy John, I seem to have had the most pain. I think maybe it was because I had a lot of scar tissue, or maybe I am just a sissy (just kidding!).
Full range of motion for me, using my left arm as a guide, was 0-147 degrees. I think the first day I reached 20-88°. We tried to increase the ROM about 10° a week. I got full extension pretty quick, within about 3 weeks, but I made shorter strides in gaining flexion.
For TJ patients, I recommend making sure you keep it moving outside of rehab because if not you won’t progress as quickly. For the first week or two I was so sore that I would just keep my arm immobile on non-rehab days. Eventually I realized I needed to move it, even if just a little, to keep it from stiffening up.
I just want those who think they are hurting a lot while trying to reach full ROM just to know you aren’t the only one, and to grind it out.
The pictures come courtesy of Steve Eagerton, and they are simply amazing. I have absolutely no idea what is going on in any of those pictures. Surgeons are incredible.
Wow.
Steve Eagerton's Tommy John scar at 2 weeks
Probably the most difficult facet of the recovery process has been me, in my head, wondering if I have plateaued, and whether or not I will continue to improve in the coming months.
I remember the first time I threw off the mound. It was timed so that I started in Florida, during our spring break trip, and I can recall my 3rd bullpen session, which I threw on the side at the University of Miami. That day I felt really fresh, and was confident in my arm after having two mound sessions already under my belt.
So I did my 45 throws or whatever at 60 feet, and I remember feeling like I was popping the ball. It was on a line, and it had a nice crisp sound, and I was just pleased as shit about it.
3 or 4 weeks later, I was still doing largely the same routine, but throwing with more intensity. I felt like it was time to get out the radar gun. I was throwing 75%, so I figured I should be around 70 with very little effort. So I start throwing, and they start shouting back my velocities…
64. 62. 61. 64. Really? So now I try to throw a little harder. 64. 64. 63. What? I just muscled up and its still only 64? This is ridiculous. Thing was, I didn’t feel like I was throwing 75%, I felt like I was throwing 100%. It was the hardest I had thrown in 6 months, and it looked and felt like I would never again throw a ball over 65 mph. Not happy. Read the rest of this entry »
One of my readers here wanted to share his throwing program with everyone. It’s unique; I haven’t seen one like his and like I have said before, every player and doctor are different and it’s always interesting to see how the same surgery is handled in different ways. He left this to me as a comment, but I figured I’d do one better and post it.
This is actually a really nice idea, sharing each person’s surgery information. If anyone out there is interested in doing any writing, or sending me anything that they think would benefit the tommy john community, please hit me with an email. I’ve posted my thoughts, maybe we can post yours…
*Understand also that this, and any program posted here, is for reference only, and one should always consult a doctor before starting or altering a rehabilitation protocol*
The following is all courtesy of Steve Eagerton, so I want to send a big thank you out to him for providing this to all of us. I wish him all the best in his recovery, and it’s easy to tell that he is strongly in control of his rehab, which is great.
I thought I would leave my throwing program on here my Dr was Dr. Jordan out of Tallahassee, FL FSU team doctor has well as several other team doctors. I have been following this and am starting week 5’s throwing this week. I don’t follow this to the letter more than anything just listen to your arm. The first 6 weeks are not about velocity at all the DR has stressed just tossing. The Dr actually cleared me to start tossing @ 16 weeks and not at 4 months. My 1st day of throwing was August 16th. I am a 21yrs old RHP pitcher at Jacksonville University redshirt sophmore.
Week 1 @ 4 months
Tossing 50ft 25 throws every other day
Week 2
Tossing 50ft 25 throws daily Read the rest of this entry »
Time makes fools of us all.
At 8.5 months I thought I was ready to pitch in games. I thought I was ready to get back in front of scouts at 10.5 months. Not so fast.
I don’t know where the time went, but my smooth and swift cruise through rehab got choppy, eventually slowing me down to an idle this summer. Read the rest of this entry »
You may have heard of the Y-T-W-L circuit, which develops scapular stability by strengthening the shoulders and upper back. Scapular stability is of the utmost importance for overhead throwing athletes like pitchers. Talk to someone with healthy shoulders, and they probably have been using the YTWL.
Yet despite it’s popularity, the YTWL circuit is often done improperly, and actually contains some movement patterns that aren’t useful: specifically, the W.
My shoulder routine has consisted of the YTWL for a few years, coupled with an additional standing shoulder/rotator cuff circuit. However, for the YTWL, it is time for a upgrade, and that is why I have made the switch to the YTLP.
My friend Nick Tumminello at Performance University has been evaluating the YTWL for a while now, and has done a series of videos on how to perform his newly developed L-Y-T-P circuit perfectly, many of which are featured below. Read some of his other great training articles on this page.
Nick has made a lot of changes to the circuit, which I am going to highlight in this article. The biggest is a call to eliminate the W pattern, which he swaps for the (P)ivot Prone. Rest assured, adopting the new circuit is going to give you stronger shoulders and more scapular stability than you’ve ever had before, even if you’ve already been doing the YTWL.
Most good things in life can arise from something bad. So is the case with Tommy John surgery. TJ is unique among major arm surgeries in that it potentially provides a greater than 100% recovery. Getting to 100% or above, however, is a matter of capitalizing on the time off, and making the most of a bad situation.
So here I’ve compiled a list of the top 5 good things one can get out of a little elbow-slicing action… Read the rest of this entry »
I figured I would write a post of milestones of post-surgical activities, as that is a pretty common question people have. I asked other guys all the time when they could do this or that, so here you go. Some of these I can’t remember exactly, so bear with me.
Out of sling: 2 days
Stopped taking painkillers: 1 day
Started forearm rehab: 1 week
Full Range of motion: 3 weeks Read the rest of this entry »
Are you a chronic sufferer of hip external rotator tightness. You are not alone. The good news? There is help.
Pitching is a rotational activity, and the hips and core are the chief couplers of power to the arm. As the stride foot lands the internal rotators of the hips, along with the core, rotate the midsection to face the plate. The hip external rotators, if tight and inflexible, will impede this rotation. (Remember that the hip internal and external rotators are antagonist muscles, which means they oppose each other and that one must stretch while the other contracts.)
So while the internal rotators fire, the external rotators relax and stretch. If the external rotators are tight and do not stretch to their full and normal range of motion, the whole kinetic sequence is impeded. This, in turn, makes the arm bear an extra burden by being in the valgus position longer while trying to catch up and get in the proper position to deliver the pitch. Dr. Morgan and others told me that they believe this leads to elbow problems, including UCL tears.
Ed Bach's arm laying back in the valgus position