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. 

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 reataches 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 reppaired and is 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.

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.

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.

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.