My Tommy John Surgery Journey: A Guide to Understanding and Recovering from UCL Reconstruction

Earlier this year, I underwent Tommy John surgery, a procedure that has become almost synonymous with baseball pitchers. My experience has given me firsthand knowledge about the surgery, recovery, and the overall journey. In this post, I’ll share my insights to help others who might be facing this procedure or just want to learn about the surgery itself.

On my way into surgery with Dr. Altcheck, I ran into Mariano Rivera in the waiting room. 

Update (September 2026): My Second Tommy John Surgery

A little over a year after I finished this recovery and got back to pitching, my elbow gave out again. This year I had my second Tommy John surgery, a partial reconstruction performed by Dr. Christopher Ahmad, the New York Yankees' team physician and one of the busiest UCL surgeons in the country. Dr. Ahmad has performed more than 1,000 of these procedures and sits on Major League Baseball's own research committee looking into why so many young pitchers are ending up in an operating room like I was.

Because I had already been through the recovery once and was now going through a second, more involved version of it, MLB actually asked me to take part in a survey they are running on the rise of Tommy John surgeries in young players. I am currently pitching at Bryant University and rehabbing my way back for the second time. I am not alone in this either: several guys I grew up playing travel ball with in Connecticut have gone through the exact same surgery, some of them more than once. That is really the story behind the numbers below: this used to be something that happened to major leaguers in their thirties, and now it is routine among teenagers who have not even reached college ball yet.

What is Tommy John Surgery?

Tommy John surgery, or ulnar collateral ligament (UCL) reconstruction or repair, is a surgical procedure used to repair a torn UCL in the elbow. During the surgery the surgeon either reattaches your UCL to your bone or surgically repairs the tissues of your ligament. This ligament is crucial for stabilizing the elbow, especially during overhead throwing motions.

Origin of the Name Tommy John

The surgery is named after Tommy John, a professional baseball pitcher who was the first to undergo the procedure successfully in 1974. Dr. Frank Jobe performed the surgery, which allowed Tommy John to return to pitching, marking a significant milestone in sports medicine.

What Happens During the Surgery?

In Tommy John surgery, the damaged UCL is repaired and reinforced with a second tendon harvested from another part of the patient’s body, typically the forearm or hamstring. The surgeon drills holes in the humerus (upper arm bone) and ulna (forearm bone) to thread the new tendon, effectively reconstructing the ligament.

Why Would Someone Need Tommy John Surgery?

Tommy John surgery is necessary when the UCL is torn or severely damaged, causing pain and instability in the elbow. This injury often results from repetitive stress and is common among athletes who perform intense, repetitive throwing motions.

Common Causes of UCL Injury

• Overuse from repetitive throwing, especially in baseball pitchers
• Poor throwing mechanics
• Sudden, high-stress impact or trauma to the elbow
• Inadequate warm-up or conditioning

Fun Facts About MLB Pitchers with Tommy John Surgery

• More than 33% of MLB pitchers have had Tommy John at some point in their careers.
• Notable pitchers who have had the surgery include Jacob DeGrom, Stephen Strasburg, Adam Wainwright, and Justin Verlander.
• Many pitchers report returning to the mound throwing harder After the surgery.

Why This Is Now Happening to Younger Players

A 2025 clinical review from Hoag Orthopedic Institute, published in the Journal of Bone and Joint Surgery Reviews, found that UCL reconstructions in athletes under 18 now account for nearly a third of all UCL procedures at some major U.S. orthopedic centers. That is a real shift: these surgeries were historically seen almost exclusively in older professional players, and now roughly a third of them are happening to kids.

The American Sports Medicine Institute's own position statement on Tommy John injuries puts a number on the professional side too: 16% of U.S.-born pitchers and 16% of Latin American pitchers in professional baseball have a history of Tommy John surgery. ASMI names the amount of competitive pitching and pitching while fatigued as the factors most strongly linked to injury, along with pitching on multiple teams, pitching year-round, and playing catcher on days a kid is not pitching. Their recommendation is that pitchers take at least two consecutive months off from all throwing every year, something a lot of travel-ball schedules do not leave much room for.

None of that is meant to scare anyone off the mound. It is meant to explain why a surgery that used to be a footnote in a big leaguer's career is now something a lot of parents at the field have heard about firsthand.

About the Surgery

The Different Types of Surgery

1. Traditional UCL Reconstruction: Uses a tendon from the patient’s body.
2. Allograft Reconstruction: Uses a donor tendon.
3. InternalBrace™ Augmentation: A newer method that uses synthetic materials to reinforce the repair.

Pros and Cons of Different Types

• Traditional: Reliable but involves a second surgical site.
• Allograft: Avoids a second surgical site but has a slight risk of rejection.
• InternalBrace™: Promises faster recovery but is relatively new and less studied.

The Most Trusted Surgeons

Some of the most renowned surgeons for Tommy John surgery include Dr. James Andrews, Dr. Neal ElAttrache, Dr. David Altchek, and Dr. Christopher Ahmad.

Dr. Ahmad is also known for developing the Triple Tommy John, or TJ3, technique: a newer approach that repairs the native ligament with strong sutures, secures it with a bone anchor, and reinforces the repair with an internal brace, all in the same procedure. It is designed for exactly the kind of case a second surgery often is, where preserving as much of the original ligament as possible matters.

The Average Cost of Surgery

The cost of Tommy John surgery can range from $15,000 to $50,000, depending on various factors such as the surgeon’s expertise, location, and hospital fees.

Recovery from Tommy John Surgery

Timeline of Recovery

Recovery typically spans 12 to 18 months and includes several phases:

1. Immediate Post-Surgery (0-2 weeks): Immobilization and pain management.
2. Early Rehabilitation (2-6 weeks): Gentle range of motion exercises.
3. Advanced Strengthening (3-6 months): Intensive conditioning and sport-specific drills.
4. Throwing Program (6-12 months): Structured throwing regimen.
5. Return to Sport (12-18 months): Full return to competitive play.

What to Expect at First

• Pain and discomfort managed by medication
• Arm immobilization in a splint
• Regular follow-up appointments

Different Braces You'll Be Put In

• Splint: Immediately post-surgery to immobilize the elbow.
• Hinged Elbow Brace: Allows controlled movement during early rehabilitation.

The Process of Getting Back in Shape to Throw

• Gradual introduction of light exercises and conditioning
• Focus on regaining full range of motion and strength

Throwing Plan to Return to Pitching

• Starts with short, light throws
• Progresses to longer and more intense throws
• Carefully monitored by a physical therapist or coach

Why People Come Back Throwing Harder

• Enhanced focus on mechanics and conditioning during rehab
• Stronger, more resilient muscles and ligaments
• Psychological boost from overcoming adversity

The Mental Side of the Surgery

Long Process That Takes a Toll Mentally

Recovery is long and can be mentally challenging. Patience and perseverance are crucial.

Lots of Therapy

Physical therapy is essential, and psychological support can help cope with the ups and downs.

It’s Not Going to Feel Good Every Day

Expect some pain and discomfort as you progress through recovery. It’s normal and part of the healing process.

Ups and Downs Throughout the Process

Recovery is not linear. There will be good days and bad days. Stay focused on the long-term goal.

Good to Find Other Hobbies to Keep You Occupied

Engage in hobbies or activities that you enjoy and that can distract you from the stress of recovery.

Frequently Asked Questions

How Long Does Tommy John Surgery Take?

The operation itself typically takes 60 to 90 minutes, though it can run longer if the surgeon finds additional damage once the elbow is open. It is almost always done as an outpatient procedure under general anesthesia.

How Long Is Tommy John Surgery Recovery?

Most players are looking at 12 to 18 months from surgery to a full return to competitive pitching, following the phases above: immobilization, early rehab, strengthening, a structured throwing program, and finally a return to the mound.

How Much Does Tommy John Surgery Cost?

Costs typically range from $15,000 to $50,000 depending on the surgeon, the facility, and where you live, before insurance.

Does Tommy John Surgery Make You Throw Harder?

Many pitchers do report coming back throwing harder, but it is not the surgery itself doing that. It is more likely the mechanics work, conditioning, and strength building that come with a serious rehab program.

What Is TJ3 (Triple Tommy John) Surgery?

TJ3 is Dr. Christopher Ahmad's technique that combines a native ligament repair, a bone anchor, and an internal brace in one procedure, aimed at a faster and more durable recovery than a traditional full reconstruction alone.

Conclusion

Tommy John surgery is a challenging journey, but with the right approach and mindset, it’s possible to come back stronger. My experience has taught me the importance of patience, dedication, and mental resilience. If you’re facing Tommy John surgery, know that you’re not alone. Follow your rehabilitation plan, stay positive, and use this time to grow both physically and mentally.