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…

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.

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.

So next time out I did the same thing, and this time it was 65-68.  An improvement, but still terrible, and it still felt like I was throwing as hard as I could.  Everyone else said it looked like I wasn’t trying, but I sure felt like I was.

This was how the next month or two went.  I would feel like I was throwing my hardest, but I really wasn’t recruiting much of my arm or body.  Velocity crept up in each bullpen, and I gained 3-4 mph per session for a couple of weeks.

But even as velocity crept up, I felt so far away from throwing the way I used to. After seeing 75 mph leave my hand and feeling like it was the best I could muster, I couldn’t believe how I ever used to throw a ball 90, or would again.

I still suffered from that months later, and I had been sitting in the upper 80s for about 2 weeks.  The velocity has been stabilizing in my outings, but I still wasn’t where I once was.  So I wondered, had I finally plateaued?  Everyone said no.

At that time I was doing nothing but pitch from a mound, and I had no idea how little extension I was getting until I finally long-tossed.  What a difference.

Since I was throwing so much on my rehab program, I also had no idea how fatigued my arm had gotten. It wasn’t until I took 5 days off that I realized, again, what a fresh arm felt like. What a difference.

Those little victories came and went, and over such a long time of throwing and rehabbing I had forgotten the little nuances of my delivery, such as really reaching out, and how to schedule my throwing, including when to rest up.  I finally broke through my plateau and started throwing a few ticks harder because of it.  It just took a new stimulus and a little rest.

Little plateaus will happen, and it’s hard to not get frustrated when you wonder if its finally THE plateau at the end of the recovery, when the new you is finally fully baked.  I’m still not there yet, even 13 months later, because I had a 2 month battle with forearm tendinitis.   I decided after taking care of that and going to a tryout, I was gonna take my off-season rest, which I am currently enjoying.

Doctors and trainers say that a lot of times it takes that first off-season before the new elbow reaches its full, and hopefully greater, potential.  As much as seeing the changes throughout rehab was exciting, man, it feels nice to not worry about it for a little while, and focus on myself in other ways.  To be continued.

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

Weeks 3-4
Tossing 50ft 25 throws daily and 100ft 10 throws every other day

Week 5-6
Warm up 50ft 25 throws to and 100ft daily and 150ft every ohter day for 10 throws

Weeks 7-8
Same long toss regimen but allowed to finish up the daily throwing with 10 throws at 50ft at 75% effort like a flatground.

Weeks 9-10
Same long toss begin bullpens @ 50ft 90% effort

Weeks 11-12 this is the (8 month mark post surgery)
Full length bullpens 60ft @ 90%

Checkup after this and then cleared to pitch 100% velocity. Dr didn’t say when I was cleared to throw different pitches so I will wait and call him or just slowly work them in once i start flat grounds.

*STEVES UPDATE*

I also wanted to add on to this. First my program is a little bit accelerated I am hoping to be back in a game at 10 months with the Dr’s blessing and normally Dr. Jordan waits until the 12 month mark. Each of the steps mentioned above is normally about an extra week added to what I am doing. Currently I have a little tendinitis, which I think is more from working out too much too quick, than throwing. Either way I am taking 2 weeks off and am taking prednazone.

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.  

Yes, at 9 months I could throw within 4 mph of my old best velocity, but those last 4 were apparently on backorder, and I really needed them at tryouts.  They just took more time.  My curve and change were there, but not like they once were.  These last “little” details are actually quite huge in determining the effectiveness of a pitcher, and I just had not anticipated how long it would take before they came back.  Before I knew it, what looked like a very fast recovery turned into a very average recovery.  I wasn’t going to receive any medals for it anyway, but it was still surprising.

One of the biggest problems was the every other day throwing schedule.  It’s just too little throwing per week to really get a feel for throwing offspeed pitches.  I think most need a few hundred reps a week with each the change and the curve to get them consistent, but that is just not possible throwing every other day.  Once I was cleared to throw as much as I wanted (around 10 months) things started to get better in the offspeed and location department.

But even then, these last little bits of what makes a successful pitcher eluded me.  Is 10 months a realistic recovery time?  Physically, yeah.  However to be your old, finely-tuned self (or your new, better self) its likely gonna take more than that. Probably 12-15 months, give or take a few.

Throw in a little bout of tendinitis (I battled the forearm variety last month) and the recovery time can keep on growing.  It’s not always smooth sailing all the way through, and when exactly the finish line is, may be very uncertain.

But, all in all, it can extend that optimism that comes along with this, that the best is still yet to come.  Glass half full, right?

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.

Before you get going…

Go in order:  The order in which you perform these exercises matters!  LYTP is ideal because it progresses from most difficult to least difficult, thus allowing you to face the hardest exercises when you are fresh.

Choose your posture: you can perform this circuit a few different ways: 

-laying prone on a flat bench, training table or the floor

-standing with knees bent and a flat back (as if doing an RDL)

-with knees bent and stomach on a stability ball

-standing with your back bent to 45° (this is good as a way to work the same muscles on a new angle).

-prone on an incline bench, at any angle up to 45°. (Again, to alter work angle) 

The following video goes deeper into the issue of posture:

Gimme a L

The L is the first exercise.  To perform, lay prone with arms hanging down. Pinch your blades together as you pull your arms straight back, keeping your elbows at 90°.  Then externally rotate them back to finish.  Lower them in the reverse sequence.  

Finish position for the L raise

Gimme a Y

The Y is next.  Rather than rehash, watch the video below for full instructions:

Gimme a T

Third in line is the T.  Again, we have a good video to explain:

 Gimme a P

And we will end with the pivot prone, which represents our P.  As Nick explains in the following video, the pivot prone reinforces a developmental movement pattern that we are all born with.

What’s that spell?

LYTP!  Well maybe it’s not that exciting, and it’s certainly doesn’t spell anything, but it will do wonders for your shoulders and scapular stability.  

As a pitcher, I usually perform these with 2-4 lbs, for 2-3 sets of 12-15 reps, 2-3 times per week.  Each rep is done with a 1-3 second pause at the top.  If you’re a beginner, start without weight, get a good pause at the top, and then progress with weight as strength increases.  

I can remember doing these without weight for 20-25 minutes a day a few years ago, trying to correct for a condition called SICK scapula. I got stronger in a hurry, and have had healthy shoulders since. The LYTP is a great circuit to get that bullet-proof rotator cuff.

So here I’ve compiled a list of the top 5 good things one can get out of a little elbow-slicing action…

1. A well conditioned arm

      -Doing the rehab is necessary for a full recovery, but will also leave one with a very well conditioned arm, assuming the shoulder is well taken care of as well. This is the reason many pitchers throw harder when rehab is complete.

2. Time to reinvent pitching mechanics

      -Especially if one is a college pitcher, it is hard to get enough time off to break down and completely berid oneself of bad mechanical habits.  Pitching all fall, spring and summer typically makes this difficult.  The time off during rehab can allow one to start back up as a clean slate.

3. Time to address flexibility/mobility problems

      -It is tough to get rid of joint mobility problems and tightness when one is playing year-round the sport that causes those problems.  Time off mixed with a little yoga and a dedicated stretching program can make tightness a thing of the past. Getting a functional movement screen from a trainer is a must.

4. Time to get stronger

      -Trying to be fresh for outings can prevent one from focusing fully on strength training.  The time off from surgery gives one a chance to focus on specific weaknesses and lay down a really good base of strength, which can be maintained once returned to action. 

5. A work ethic

      -People undergo surgery with varying degrees of commitment, and some finish rehab with a different perspective on what it means to take care of their arm and body.  As previously said, the reason many throw harder after surgery is because they take care of it for the first time.  Hopefully that result provides incentive to continue on a path of physical furtherance.  

The Common Theme?

Time.  You can do the required 20 daily minutes of  rehab and throwing, and spend the other 23:40 bullshitting, or you can use those months off to (re)build a better you. If you make the most of it, that arm injury can turn out to be a blessing.

Out of sling: 2 days

Stopped taking painkillers: 1 day

Started forearm rehab: 1 week

Full Range of motion: 3 weeksIncision closed: 3 weeks

Forearm stopped being sore while performing rehab: 2 weeks

Surgical elbow moved like it used to: 8 weeks

No swelling: 3-4 weeks

Start strength training: 6 weeks

Start shoulder prehab: 4 weeks

Start running: 3 weeks

Do full pushup: 8 weeks

Full Chin-up (without soreness): 7 months

Could hold a 50lb dumbbell without any soreness: 16 weeks

Start throwing: 12 weeks

Throw off mound: 6 months

70mph: 7 months

80mph: 7.5 months

90mph: 9.5 month

Full-out long toss: 8.5 months

Start changeups: 7 months

Start curveballs: 8.5 months

100% fastballs: 8.5 months

100% changeups: 8.5 months

100% curveballs: 9.5 months

Curveball actually starts to break: 10 months

Pitched in game: 9.5 months

Cleared by doctor forever: 10 months

Threw back-to-back days: 10 months

Velocity all back: 11.5 months

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

Having tight hips is a bad for arm health and detrimental to one’s throwing velocity.  Having loose and fluidly moving hips will make anyone a healthier and likely harder throwing pitcher.  Rotating against tight muscles causes a loss in transferred power, which in turn is a loss in velocity.  Get it back with just a few sets of stretches done daily.

Do you have a problem?

First thing’s first: You need to find out if your hips are tight.  Now, when I say hips, I really mean the singular hip on your stride leg.  Because of the constant rotation around that hip from so many throws, the stride leg will get tight but the back leg will remain normal.  

So, you compare.  At the doctor’s or PT’s office this will be done with a goniometer, but you can get a general Yes or No diagnosis without one.

Test # 1: Lie on your back, bend your knees to 90° and let them fall to either side as far as they will go.  Do this facing a mirror, or have someone assess you from behind.

This photo shows a significantly tighter left hip

If your hips fall like this (nearly symmetrical) you're in great shape.

Test #2 (and Stretch #1): Try the knee-in stretch, and self-diagnose any differences.  If one hip is tight, you’ll feel the difference and see that it won’t go down or over toward the midline very well.  

Note that while stretching, the left knee is higher revealing inflexibility

The goal in the knee-in stretch, which I feel is the best stretch to cure hip external rotator tightness, is to pull the knees down and in while maintaining your feet flat on the floor, toes pointed straight, and lower back flat on the floor.  You can vary the stretch by arching your back while on the floor, or sitting.  You’ll feel a difference each way.

Knee-in start

Knee-in finish

Knee-in angle variation

Stretch #2: Knee Cross-over

This is one where I feel a glaring difference between my left and right.  Start on all fours and cross your tight leg behind the other.  While maintaing good posture squat back until you feel the stretch in the side of your hip, while keeping your knees on the floor.

Cross-over start

Cross-over finish

Note that in the pictures the difference between start and finish is small.  I actually had to use my loose leg (my right) for the picture to show a difference.  On my left I can only squat back about 4 inches or so, which is hardly a perceivable difference on film.  It really takes a lot of stretching to gain symmetry on this one.

Stretch #3: Hip Mobilization

This mobilization drill was shown to me by my friend Nick Tumminello.  It works the hips in a similar way to the knee cross-over, and really shows the difference between legs.

To perform, you get on all fours with back straight and arms straight.  Point your off leg straight back, and then squat backward as far as you can while maintaining straight arms and a straight back.  Hold for a few seconds, then come back up. Dont let your body roll to either side, and go straight back, hinging at the knee. Repeat for 2-3 sets of 8-15 reps.  

Coach Nick's hip mobilizer start

Coach Nick's hip mobilizer finish

This exercise is easy on my right, looser hip.  I can sit back all the way with no problem.  It’s downright difficult on my left, both in range of motion and in stabilizing myself.  When an exercise is hard like this, though, it means you’re really going to benefit from it.

Stretch #4 : Seated piriformis stretch

The piriformis is a strong external rotator that also acts as a hip abductor (helps move the thigh bone away from the body).  This stretch and the next one I’ll show you target the piriformis.  To perform, sit in a chair and cross one leg over the other. GENTLY press the knee down, while pushing your chest out and sitting up very straight and you will feel the stretch.  It is important, as Coach Nick was explaining to me, to keep the knee within the body, so the piriformis can relax fully.  If the knee is outside the body, then the piriformis will engage as an abductor, thus preventing it from relaxing and ruining the stretch.

GENTLY press down to feel the stretch

Stretch #5: Wall figure-4 stretch

This is another stretch pioneered by Nick Tumminello, and stretches the piriformis better than the laying figure-4 stretch (not shown).  It is again imperative, as previously explained, to keep the knee within the body.  One slides up close to a wall, and with legs straight crosses one over the other at the thigh.  Then you press your butt into the ground and bend your knee.  Pull the crossing leg in to the chest if more stretch is desired.  The closer your butt is to the wall, the stronger the stretch will be.  

Coach Nick's improved figure-4

Final Thoughts

Be gentle with all these stretches, as they all involve the knees.  If your knees hurt on any, back off and maybe choose another that works for you. I recommend the knee-in, one on all fours and one of the piriformis stretches, but try them all and find out which ones work best for you.  The seated piriformis tends to give me some problems, but the knee-in and both on all-fours get me in great shape.  Everyone’s different.  

If your hips are far from symmetrical like mine once were and sometimes still are, it’s necessary to do a few of these stretches everyday, 3x each for 30 seconds.   Remember that the goal is symmetry and not hyperlaxity.  We’re ballplayers, not dancers, so don’t go overboard. There are also a few dynamic stretches for the the same symptoms that I’ll post in the future.