Tommy John surgery, also known as ulnar collateral ligament (UCL) reconstruction, is a surgical procedure performed to repair or replace a torn UCL in the elbow.
The procedure is named after the former Major League Baseball pitcher, Tommy John, who was the first player to undergo the surgery in 1974 and later returned to his career with success.
Exploring the causes and symptoms of UCL injuries in athletes
The UCL is a ligament on the inside of the elbow that connects the humerus bone to the ulna bone and provides stability to the joint during throwing or other overhead activities. When the UCL is torn, it can cause pain, instability, and weakness in the elbow, making it difficult to perform normal activities.
People who typically undergo this procedure are those who participate in overhead sports such as baseball, softball, tennis, and volleyball.
Factors that may contribute to UCL injuries in athletes include:
– Overuse:
Overuse is a common cause of UCL injuries in athletes. Repeatedly performing the same motions, such as throwing a baseball, can place significant stress on the elbow joint and increase the risk of injury.
– Poor technique:
Using improper throwing or hitting techniques can also increase the risk of UCL injuries. For example, throwing with improper arm mechanics or releasing the ball too late can place excessive stress on the UCL.
– Muscle imbalances:
Imbalances in the muscles surrounding the elbow joint can also contribute to UCL injuries. Weakness in the shoulder or forearm muscles, for example, can
During Tommy John surgery, a small incision is made in the elbow and the damaged UCL is replaced with a tendon from another part of the patient’s body or from a donor. The tendon is then attached to the bones in the elbow using small screws or sutures. The procedure is typically performed under general anesthesia and takes several hours to complete.

The Role of Occupational Therapy in Tommy John Surgery Rehabilitation
Recovery from Tommy John surgery can take several months and typically involves a period of immobilization followed by physical/occupational therapy to regain strength, range of motion, and function in the elbow. Patients are typically able to return to sports or other activities within 9-12 months after surgery, although the specific timeline can vary depending on the individual patient’s healing process and the nature of their activities.
Occupational therapy can play an important role in the rehabilitation process following Tommy John surgery. The goal of occupational therapy after this surgery is to help patients regain full function and strength in the affected arm so they can resume their normal daily activities, including work and leisure activities.
Initial Stages of Occupational Therapy
During the initial stages of recovery, occupational therapy may focus on controlling pain and swelling, maintaining range of motion in the elbow joint, and preventing stiffness and muscle atrophy in the arm. This may include gentle exercises, manual therapy techniques such as massage and stretching, and the use of splints or braces to support the elbow.
As the patient progresses in their recovery, occupational therapy may shift to more challenging exercises and activities designed to improve strength, endurance, and coordination in the arm. This may include resistance training, functional exercises that simulate real-life activities, and sport-specific drills for athletes.
In addition to these physical interventions, occupational therapy may also address other aspects of recovery, such as adapting to changes in work or leisure activities, managing pain and fatigue, and addressing any emotional or psychological challenges that may arise during the recovery process.
Collaborating with a Qualified Occupational Therapist
Overall, occupational therapy can be a valuable part of the recovery process following Tommy John’s surgery, helping patients to regain function and achieve their goals for work, leisure, and sports activities. It is important to work closely with a qualified occupational therapist to develop a personalized treatment plan that meets your individual needs and goals.
Written by Hoang Tran
About the author – Hoang Tran
Hoang Tran is a Miami certified hand therapist , the owner of Hands-on Therapy Services and author of the book “The Hands-On Approach”. She loves helping people with hand, neck and shoulder problems, because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!).
The aim of her occupational therapy practice in the Miami area is to bring patients back to full functionality, without pills, injections or surgery. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care.
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