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Elbow Excellence Through Tommy John Surgery

One of the major advancements in sports medicine in the last 35 years, surgical repair of the ulnar collateral ligament (UCL) is named for Los Angeles Dodgers pitcher Tommy John, the first person to successfully undergo the procedure in 1974. John returned to the mound two years later.

This procedure, invented and pioneered by Dr. Frank Jobe, reconstructs a torn UCL by using a tendon from somewhere else in the body, such as the forearm or hamstring. The UCL, along with the lateral collateral ligament, gives the elbow stability. Before this operation, pitching careers usually ended when the UCL was damaged. The surgery is now common among collegiate and professional athletes in several sports, most notably baseball.

Tommy John surgery is necessitated when these two ligaments, which connect the humerus (the bone of the upper arm) to the ulna (the larger forearm bone), are

  • torn by injury or dislocation
  • damaged or overstretched from improper healing of an injury
  • stressfully overused, as would be typical of a college-level or professional pitcher

As important as the surgery itself is the rehabilitation period, which—to return to the previous level of expertise—can last approximately a year for pitchers and about six months for other baseball players and athletes. After a week to 10 days during which the elbow is immobilized, rehabilitation includes working back to a full range of motion, followed by gradual strength training at about four months postsurgery. Also crucial during this period are exercises to improve flexibility and coordination, as well as aerobic conditioning to improve overall fitness.

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