Orthopedics

What Is Tommy John Surgery?

Wed, Jan 31, 2024

What Is Tommy John Surgery?

Today, left-handed baseball pitcher Tommy John is famous not only for his illustrious career but also for the surgery that bears his name and allowed him to play 14 more years in the major leagues after a potentially career-ending injury. But what is Tommy John surgery? And is it only performed on baseball players? You may be surprised by the answers. North Carolina Specialty Hospital explains the surgery and what you should know if you or a loved one has a UCL ligament tear and needs it repaired.

Get the Facts About a Tommy John Injury and Surgical Repair

Tommy John surgery is also known as ulnar collateral ligament (UCL) reconstruction surgery. It’s commonly performed on baseball players and other athletes who have damaged or torn their UCL.

What is a UCL?

The UCL is a ligament on the inside of the elbow that helps stabilize the joint and allows for proper throwing motion.

What is a UCL tear, and what causes one?

UCL tears occur due to repetitive stress on the elbow joint, such as the repeated overhead throwing motion in baseball. This repetitive strain can lead to microtears in the ligament, which can eventually progress to a partial or complete tear, leading to instability in the joint and decreased performance.

What are the symptoms of a UCL tear?

Common symptoms of a UCL tear include pain on the inside of the elbow, swelling, and a loss of throwing velocity.

Do UCL tears happen only to athletes?

A tennis player in a yellow shirt holds his injured elbow and wonders if he has a Tommy John injury.

While most UCL injuries occur in athletes who participate in activities that involve repetitive overhead motions, such as throwing a baseball, hitting a volleyball, or serving a tennis ball, non-athletes may also experience similar injuries to their UCL.

Individuals who engage in occupations that require repetitive overhead motions, such as painters or construction workers, may develop UCL injuries over time. Additionally, non-athletes who engage in recreational activities such as swimming or weightlifting that involve repetitive overhead movements may also be at risk for UCL injuries.

Are there treatments for UCL tears?

Conservative treatments are often recommended as the initial approach for UCL tears, regardless of whether an individual is an athlete or non-athlete. These treatments aim to alleviate symptoms and promote healing without the need for surgery. These include:

  • Rest and restricted activity.
  • Immobilization techniques, such as wearing a brace or splint, to limit movement and promote healing.
  • Physical therapy to help strengthen the muscles around the elbow joint and improve stability.
  • Nonsteroidal anti-inflammatory drugs to reduce pain and inflammation.
  • Corticosteroid injections to help reduce pain and inflammation in the elbow joint.

If conservative treatments aren’t effective or if the tear is severe, Tommy John surgery may be recommended.

What happens during Tommy John surgery?

During the surgery, the damaged or torn UCL is replaced with a tendon from another part of the body, usually either the forearm or hamstring. This new tendon is attached to the bone in the upper and lower arm using screws or other methods. A splint or brace may be used to immobilize the elbow and promote proper healing.

The surgery is an outpatient procedure typically performed by an orthopedic surgeon. The surgery takes 60 to 90 minutes, and the patient is under general anesthesia. Barring complications, the patient can leave that day.

How long does it take to recover from Tommy John surgery?

Patients can expect a lengthy recovery process. It typically takes about 12-18 months for patients to recover and regain their strength and motion fully.

The first phase of recovery typically involves immobilization and rest. The patient may need to wear a brace or splint to protect the surgical site. Physical therapy may be started to help with range of motion and strengthening.

The second phase focuses on gradually increasing the elbow’s range of motion and strength. Physical therapy continues, and patients may begin light-throwing exercises.

The third phase involves a gradual return to sport-specific activities using strengthening exercises specific to the patient’s sport or situation.

Can Tommy John injuries be prevented?

Athletes can take several precautions. Firstly, use proper technique and form when performing overhead motions. Coaches and trainers should provide guidance on correct throwing or serving mechanics to minimize stress on the elbow joint.

Additionally, athletes should incorporate regular strength and conditioning exercises to strengthen the muscles around the elbow and shoulder. This helps to provide stability and support to the UCL, reducing the risk of injury. It is also important for athletes to listen to their bodies and take breaks when they feel fatigue or discomfort in their elbow.

North Carolina Specialty Hospital is a Leader in Tommy John surgery

If you or someone you love is showing painful and debilitating symptoms of a UCL tear, talk to the hand, wrist, and elbow experts at North Carolina Specialty Hospital. Learn more about our top-rated department here. And when you’re ready to request an appointment, click on the surgeon’s photo and complete the form. We’ve been helping North Carolinians for almost 100 years with the latest surgical solutions, and we look forward to helping you get back in the game and to your best quality of life.


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