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Tommy John Surgery 

Ulnar Collateral Ligament (UCL) Reconstruction

What is Tommy John Surgery 

Tommy John surgery is also known as Ulnar Collateral Ligament (UCL) Reconstruction. When the stress of pitching or overhead throwing tears the UCL, Tommy John Surgery is the procedure to stabilize the inner side of the elbow.

The UCL is a thick triangular band found inside the elbow. It runs from the inner side of the humerus to the inner side of the ulna. It must endure extreme stresses as it stabilizes the elbow during overhand throwing. Over time, the UCL can develop tiny or large tears. The ligament stretches and lengthens to the point where it can’t hold the bones tightly enough during throwing or other activities.

The procedure is named after former MLB pitcher, Tommy John, who was the first player to undergo surgery in 1974.

Why is Tommy John Surgery Common in Baseball?

Baseball consists of many repetitive movements, making injuries common. Athletes who throw too hard, too early or too often without rest are at risk for elbow and shoulder injuries.

Pitchers are at a particularly higher risk of damaging their UCL. The rate of injury is highly correlated to the number of innings pitched, a number of pitches thrown, and time spent throughout the year spent pitching.

Symptoms of an Injured UCL

Pain during or after throwing is the most common symptom. The pain will often limit the ability to throw or decrease throwing velocity. A tear may sometimes feel like a “pop” after throwing followed by pain.

Conservative treatment is the first option for those who do not put much strain on the injured elbow. These treatments mayinclude: rest and ice, anti-inflammatory medications and/or physical therapy. For baseball players, Tommy John Surgery is chosen so they can return to their sport.

Preventing Tommy John Surgery

Although far too common, overuse injuries can be prevented. It is estimated that 1 out of 2 injuries in youth athletes is an overuse injury, which means nearly half of the current injuries can be avoided. Some key suggestions for baseball players:

  • Play multiple sports – don’t specialize too early.
  • Take at least 3 months of your chosen / main sport.
  • Rest 1 or 2 days per week.
  • Speak up when fatigued. Pitchers who throw with arm pain or while fatigued have the highest injury rate.
  • Use proper body mechanics.
  • Follow pitch-count guidelines.
  • Follow a warm-up routine that allows gradual increases in distance and velocity.

We strive to help baseball athletes stay in the game through injury prevention education.

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