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For a pitcher or position player in baseball, going through tommy john surgery is a scary, potentially career-ending injury. Though the prognosis has never been better, the recovery and road back to baseball is still frightening, uncertain and long.
In this guide, we’ll cover everything you need to know about Tommy John rehab and recovery. As a former pro pitcher, I underweight Tommy John not once, but twice. So, I know a thing or two and can help make your rehab and recovery easier.
In this article we’ll cover:
- The surgery, alternatives and expectations
- The tommy john rehab timeline
- What to expect during your tommy john recovery
- The success rate and MLB pitchers who have returned from surgery
- The different phases of rehab
- And how to come back stronger than ever before.
This guide is meant for pitchers of all levels, from the Little Leaguer with a torn UCL to the pro ballplayer going through their second TJ. Whether you’re looking for information on the surgery itself or tips on making a full recovery, we’ve got you covered. Let’s get started.
What is Tommy John Surgery?
Tommy John surgery, or UCL reconstruction surgery, is a procedure to replace the ulnar collateral ligament in your elbow with a tendon from elsewhere in your body. The UCL is the ligament that stabilizes the inside of your elbow, and it’s crucial for pitchers because of the immense stress placed on it during throwing. A torn UCL usually comes from years of repetitive stress and micro-tears, until one day it finally gives out.
While tommy john surgery has become increasingly common in recent years, it’s still a major operation with a long road to recovery. The silver lining is that the success rate is now higher than ever, and many pitchers are able to come back stronger than before.
What should you do when you have elbow pain as a baseball or softball player?
If you think you might have a torn UCL, the first step is to see a doctor or orthopedic surgeon. They will perform a physical examination and order an MRI to confirm the diagnosis. From there, you’ll likely be referred to a sports medicine specialist or elbow surgeon to discuss your treatment options.
Tommy John surgery is usually only recommended if you’re experiencing pain that significantly interferes with your ability to pitch, or if you’ve already tried conservative treatments like rest and physical therapy without any relief.
Who Is a Candidate for Tommy John Surgery?
Most pitchers who tear their UCL will require tommy john surgery to return to pitching. In some cases, the injury can be treated non-surgically with rest and physical therapy. However, this is usually only recommended for patients who are retired or no longer want to pitch competitively.
Check out the video below on steps to take if a ballplayer is having elbow pain.
The decision of whether or not to have tommy john surgery is a personal one that should be made after consulting with your doctor, family, and coaches.
What are the risks of Tommy John Surgery?
As with any surgery, there are always risks involved. Complications from tommy john surgery include:
- Infection
- Nerve damage
- Stiffness and loss of range of motion
- Blood clots
- Persistent pain
Most of these complications are rare, and can usually be treated with medication or additional surgery.
What is the Tommy John Surgery Recovery Timeline?
The tommy john surgery recovery timeline varies from pitcher to pitcher. It typically takes around 12 to 18 months to fully recover from the surgery. The first few months are spent allowing the graft to heal, and then the focus shifts to regaining range of motion and strength.
During this time, you’ll likely need to wear a splint or brace to protect your elbow. You’ll also need to do physical therapy exercises and stretches every day.
As you get closer to your return date, you’ll slowly start throwing again. This process starts with playing catch at short distances, and then gradually increases as you regain strength and range of motion.
You’ll need to be careful during your tommy john surgery recovery not to overdo it. Pushing yourself too hard can set you back and delay your return date.
What Are Alternatives to Tommy John Surgery?
Not every UCL injury requires surgery. Some alternatives are:
- Rest and rehab (PRP injections may also be prescribed)
- UCL Repair surgery with internal brace
UCL repair with internal brace
A new and increasingly successful alternative to Tommy John surgery is UCL repair with internal brace. This surgery involves less cutting and trauma to the elbow, which means a quicker recovery time.
If you’re considering tommy john surgery, be sure to discuss all of your options with your doctor. They will help you make the best decision for your individual case.
PRP Injections
PRP (platelet-rich plasma) injections are a new treatment option for UCL injuries. PRP is made from your own blood, and contains a high concentration of healing cells.
PRP injections have been shown to be effective in reducing inflammation and pain, and helping the injury heal faster.
If you’re considering tommy john surgery, PRP injections may be an option to try before resorting to surgery.
What are the Different Phases of Tommy John Rehab?
Frank Alexander from the Rehab team of Dr. Chris Ahmad, the New York Yankees’ team physician, sat down with me to do an extensive video series chronicling the rehab of UCL injuries in baseball and softball players.
We went phase-by-phase in our talks, walking parents and athletes through the rehab and surgery process.
Phase 0: Preparing for Surgery
Preparing and understanding the expectations and results of surgery are important. In this video below, we go through preparations for surgery as well as non-operative treatments.
Phase 1: Months 0-4
In months 0-4 of tommy john surgery recovery, players have limited range of motion are are tasked with regaining mobility, range of motion, strength and endurance without throwing.
Phase 2: Months 4-8
In months 4-8, the player begins throwing and progresses to longer distances and higher throwing speeds.
Phase 3: Months 8-12
In months 8-12, position players will return to games whereas pitchers will return to pitching off the mound.
Phase 4: Months 12+
Around the 12 month mark in tommy john rehab, the pitcher will be cleared to return to full pitching duty. But, this is usually not the point where they are just as good as they were before surgery – it usually takes 14-18 months to return to a pitcher’s full level of previous skill.
What is the Success Rate of Tommy John Surgery?
The success rate of tommy john surgery is very high, with most pitchers returning to their pre-injury level of pitching. In some cases, pitchers even come back stronger than before.
Pitchers return successfully to the previous level of play about 82-92% of the time.
No matter what route you decide to go, tommy john surgery is a serious operation with a long road to recovery. But with dedication and hard work, you can make a full recovery and get back to pitching better than ever before. Good luck!
Ulnar collateral ligament reconstruction, or tommy john surgery, is not the only treatment option for pitchers with elbow injuries. In some cases, patients may be able to avoid surgery altogether with a combination of rest and physical therapy.
However, tommy john surgery is still the most common treatment for torn UCLs that require surgical intervention, for ballplayers who want to continue their competitive careers.
Which MLB Pitchers Have Had Tommy John?
Some of the most famous pitchers in MLB history have undergone tommy john surgery, including:
- Mariano Rivera
- Johan Santana
- Chris Sale
- Jacob DeGrom
- Adam Wainwright
- Steven Strasburg
- Justin Verlander
These are just a few of the many successful pitchers who have been able to come back from tommy john surgery and return to their previous level of play.
How to Come Back Strong and Crush Your Tommy John Rehab
If you are a pitcher who has undergone tommy john surgery, there are a few things you can do to help ensure a successful recovery:
- Follow your physical therapy exercises and stretches religiously.
- Don’t try to rush your recovery. Let your body heal at its own pace.
- Stay positive throughout the entire process. It’s normal to have ups and downs, but try to focus on the progress you’ve made.
- Find a support system of family and friends who will help you through the tough times.
These tips will help you make a full recovery from tommy john surgery and get back to pitching better than ever before. Good luck!
Conclusion
Tommy john surgery is a major operation, but it’s becoming increasingly common among pitchers. The success rate is high, and many pitchers are able to come back stronger than before. The key to a successful recovery is to follow your physical therapy exercises and stretches religiously, and to take things slow.
Stay positive throughout the entire process, and find a support system of family and friends to help you through the tough times. With these tips, you’ll be back on the mound in no time!
Do you have any questions about tommy john surgery? Leave them in the comments below!