It’s baseball season and I’ve heard this term been thrown around a lot recently. We hear the term all the time within the baseball world, “(blank) is having Tommy John Surgery”. It’s happened to the best of pitchers – Tim Hudson, Jose Fernandez, Matt Harvey, Yu Darvish, etc. The list goes on and on.
But what is it exactly? Well, the surgery itself was named after the first baseball player to ever receive the surgery, Tommy John, and the surgery involves repairing the Ulnar Collateral Ligament.
This ligament is located on the inside part of the elbow connecting the ulna bone to the humerus. During the pitching motion, specifically during the “Cocking Phase” the inside portion of the elbow is placed under a high amount of stress when decelerating and accelerating the arm to throw a pitch.
Over time, this high frequency of stress can start to cause micro-tears within the ligament, until it eventually becomes fully torn. The surgery involves drilling holes within the humerus and ulna bone where a new tendon is grafted through the bones as so.
Full recovery takes about 1 to 1.5 years. During the recovery process, the pitcher is taken through a graded pitching program that limits the amount and velocity of throws. Physical therapy is ESSENTIAL and absolutely required to recover! Physical therapists will focus on reducing pain/swelling, improving joint mechanics of the scapula/shoulder/elbow, improving range of motion, increasing muscular strength, and improving dynamic stability. While the specifics are a lot to cover, those are the main objectives of PT after Tommy John Surgery.
While the recovery process is extensive and long, pitchers usually return to have successful seasons! Just as with any post-surgical process, Physical Therapy is necessary in recovery and healing!
Dr. Jomar Farrales, PT, DPT