Tommy John surgery gets its name from the first athlete who successfully underwent the procedure. Tommy John was a Major League Baseball pitcher from 1963-1989. In 1974, John tore the ulnar collateral ligament (UCL) in his elbow, which could have ended his career.
Instead, Dr. Frank Jobe, team physician for the Dodgers, replaced the torn ligament in the pitcher’s arm. John missed the entire next season as he recovered from his surgery. But he played as a top-level athlete for another 13 years, earning the nickname “the bionic man.”
Tommy John surgery didn’t just fix Tommy John’s UCL. It’s been used to repair the UCL of countless athletes who throw while playing their sport. Of the professional pitchers who underwent Tommy John surgery, 75% were able to play professionally again.
However, even Tommy John had to give his arm plenty of time to recover and undergo intensive rehabilitation. So will you.
David Lintner, MD, is a Tommy John specialist who’s performed more UCL replacements than anyone else in the Houston area. At Houston Methodist Orthopedics & Sports Medicine, with clinics in Baytown and Houston, Texas, Dr. Lintner offers Tommy John surgery to players of all ages and skill levels.
If you’re about to undergo Tommy John surgery, you probably wonder what your life will look like afterward and have plenty of questions. Will you be in pain? Will it take long to recover? Can you ever throw or pitch again?
After surgery, you go home
Dr. Lintner performs Tommy John surgery as an outpatient procedure. That means you don't have to prepare for a hospital stay. Just be sure to arrange for somebody else to drive you home. You may be groggy from anesthetics, and you won’t be able to use your arm right away.
We put your arm in a brace that keeps it at an angle that can range anywhere from 60-90 degrees. You want to keep your elbow protected and stable. The brace also helps control inflammation. You can take over-the-counter pain medications to manage any discomfort.
Start physical therapy ASAP
Don’t try to move your elbow when it’s protected by the brace. However, that doesn’t mean you should delay physical therapy (PT). In fact, you should start PT as soon as possible.
In the first days following your surgery, PT focuses on moving your wrist, fingers, shoulder, and flexing your biceps. The goal is to keep your arm muscles engaged and reduce the risk of muscle atrophy. We may also treat you with electrical stimulation (i.e., E-stim), to facilitate healing, reduce pain, and enhance range-of-motion.
An athlete’s recovery goes through four phases
Paramount to your recovery as an athlete is regaining full range of motion and strength in your elbow and all of the tissues and muscles that support it. Each phase lasts several weeks.
Phase 1, weeks 1-4
In phase 1, the goal is to keep your elbow stable, reduce inflammation, and lightly contract adjacent muscles.
Phase 2, weeks 4-8
You start to increase your range of motion (ROM), while still controlling inflammation with ice and other modalities. We switch you to a hinged brace, and gradually add strengthening exercises, too. When not in PT, you lock the brace to keep your elbow stable.
Phase 3, weeks 8-12
At this point, our goal is to restore full ROM to your elbow, while still working to minimize pain and inflammation. You can now begin a functional training program that will gradually get you back into your sport.
Phase 4, weeks 12-24
Although the rehab protocol is designed to be finished in six months, you could take nine - twelve months or more to be back at a high level of play. It depends on your position, throwing mechanics, and how well you rehab. During this phase, the focus is on maximizing power, strength, proprioception, and arthrokinematics.
Throwing involves your entire body, not just your arm. So a lot of effort is spent on your legs, core, hips, etc. When this phase concludes, you should be ready to step back into your game.
Tommy John surgery is an effective way to repair your UCL and get back to your game, as long as you give yourself the time you need to fully heal and regain strength. To book your Tommy John surgery, set up an appointment today by phone or online form at our office nearest you.
Special message: Even if you live far from Houston, if you have had an elbow injury caused by throwing and have been diagnosed with a tear in your UCL consider sending your MRI on a DVD to Dr. Lintner along with a summary of your injury/symptoms for a second opinion. If appropriate, we can schedule a video visit, review your MRI, and discuss whether surgery is appropriate. Many of our patients come from far away for their surgery, then rehab closer to home with close follow up by Dr. Lintner via telemedicine!