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Tommy John Injury: Prevention, Symptoms, Treatment, and Recovery

Triangle Region / 01 Jun 2020
EmergeOrtho
by EmergeOrtho
Tommy John Injury: Prevention, Symptoms, Treatment, and Recovery

Eliminate Tommy John Pain With Help From EmergeOrtho–Triangle Region

If you play baseball, softball, or any other overhead-throwing sport, you probably have heard of the infamous Tommy John injury.

Even though baseball and softball seasons are (currently) temporarily suspended, these favorite spring staples (along with other sports) will resume in the near future. And, with the return of sports will inevitably come the wins, losses, and (unfortunate) injuries for which we are accustomed.

The Tommy John injury, although debilitating, can be possibly be prevented with simple tips and tricks, and if successful, can potentially avoid the need for surgery. The Sports Medicine Specialists at EmergeOrtho—Triangle Region have extensively studied and successfully treated thousands of Tommy John injuries. Through their experience, they have garnered an in-depth collection of knowledge on the injury’s causes, symptoms, treatment techniques, recovery plans, and prevention tips.

What Exactly Is a Tommy John Injury?


A Tommy John injury is the nickname for an ulnar collateral ligament (UCL) injury at the elbow. UCL reconstruction surgery bears a similar nickname—Tommy John surgery. Who is Tommy John? He is a former Major League Baseball pitcher who was the first athlete to have successfully received UCL reconstruction surgery in 1974. Before that, a UCL injury usually indicated the end of a professional baseball career.

Although a Tommy John injury can occur in any athlete that participates in overhead throwing, it is most commonly seen in pitchers. Tommy John injuries can occur because of a sudden accident, but they are most often caused by repetitive overhead throwing.

The UCL is a thicker ligament that runs on the inside of the elbow from the humerus (upper arm bone) to the ulna (one of the two bones in the forearm). It has two important jobs: to hold the elbow joint together and prevent dislocation. Every time an athlete performs an overhead throwing motion, the UCL is put under an extreme amount of stress in order to stabilize the elbow. This is partially why it is the most commonly damaged ligament in overhead throwing athletes.

A Tommy John injury can range in severity from minor damage and inflammation to a complete tear. Symptoms will typically include inner elbow pain and a noticeable decreased throwing velocity, or easy fatiguability when pitching.

Tommy John Injury Treatment

Unless the tear is severe, someTommy John injuries have a high likelihood of healing with the use of conservative treatment methods. Nonsurgical techniques will typically include one or more of the following options:

  • Rest
  • Icing
  • Bracing
  • Anti-inflammatory medication
  • Structured physical therapy
  • Throwing technique modification
  • Platelet-Rich Plasma (PRP) injection

If nonsurgical methods fail, or the UCL is severely damaged, Tommy John surgery will likely be recommended.

Since most ligament tears cannot be stitched back together, they need to be reconstructed. During the Tommy John surgical process, the torn ligament is replaced with tissue graft (often harvested from another tendon within your body).

The method chosen of Tommy John Surgery will depend on a variety of patient-specific factors, such as the size/severity of the tear and the patient’s medical history, as well as surgeon background and experience.

Tommy John Surgery Recovery


The recovery process will be tailored to each patient, but it typically involves three steps:

  1. Immediately after surgery, the elbow will be secured with a brace at a 60 to 90-degree angle. If the patient feels well enough, physical therapy can begin within days.
  2. One week after surgery, the patient can begin to move their elbow joint. They may be switched to a hinged elbow brace, which can be locked into different angles when not in use, or an arm sling. Structured physical therapy will continue.
  3. In usual cases, the elbow will be able to fully extend and a brace will no longer be needed by the end of the first 6 weeks. In active and/or professional athletes, the rehabilitation process will likely take longer (nine to twelve months) before return to competitive baseball.

Tommy John Injury Prevention

Since most Tommy John injuries occur due to overuse, the earlier you commit to prevention measures, the better. Particularly with pitching, the rate of injury is directly influenced by the velocity of the player’s fastball, number of pitches thrown, number of innings pitched, and the number of seasons spent pitching, along with patient age.

To combat this, the MLB has created a youth and adolescent pitch-count guideline. Following these recommendations can reduce overhead injuries in youth pitchers by 50%. Although this protects younger athletes, older athletes in the major leagues are still exposed to overuse dangers.

Certain pitchers are at a higher risk for injury, including those that are taller, heavier, and throw at a higher average velocity.

Keep Your Head (and Elbow) in the Game with EmergeOrtho—Triangle Region

Whether you are looking to heal your Tommy John injury or are seeking to prevent it, the Sports Medicine Specialists at EmergeOrtho—Triangle Region have got you covered.

To learn more, schedule an appointment now. Or, call us any time at (919) 220-5255.

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