If you play baseball, softball, or any other overhead-throwing sport, you probably have heard of the infamous Tommy John injury. Although damaging and potentially debilitating, a Tommy John injury can possibly be prevented by practicing a few simple strategies. Even if you experience this injury, it’s very likely that it can be treated without the need for surgery.
The sports medicine specialists at EmergeOrtho—Triangle Region have extensive experience diagnosing and treating Tommy John injuries. Many of our doctors are fellowship-trained, enabling them to provide advanced conservative and surgical treatment methods. Our Sports Medicine and Elbow and Arm Teams work to make sure each patient receives personalized, comprehensive orthopedic care so they can Emerge Stronger. Healthier. Better.
Pitcher Tommy John Set the Precedent for Innovative Treatment of UCL Injuries
A Tommy John injury is another name for an ulnar collateral ligament (UCL) injury at the elbow.
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 to 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—and how it got its name.
Tommy John is a former Major League Baseball pitcher who was the first athlete to have successfully received UCL reconstruction surgery in 1974. Prior to this, a UCL injury usually indicated the end of a professional baseball career.
Although a Tommy John injury can occur in any athlete who 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.
Tommy John injury symptoms include:
- Inner elbow pain
- Pain with overhead throwing motions
- Decreased throwing velocity
- Fatigue when pitching
- Numbness and tingling in the elbow, forearm, and/or hand
Tommy John Injury Treatment
Unless UCL tears are severe, Tommy 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:
- 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 UCL ligament is replaced with tissue graft (often harvested from another tendon within your body).
The Tommy John surgical method your surgeon will perform depends on a variety of patient-specific factors, such as the size/severity of the tear and the patient’s medical history.
Tommy John Surgery Recovery
The recovery process is tailored to each patient, but it typically involves three steps:
- 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.
- One week after surgery, the patient can begin to move the elbow joint. An arm sling or hinged elbow brace may be recommended at this point, which can be locked into different angles when not in use. Structured physical therapy will continue.
- 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 six weeks. Tommy John surgery recovery time in active and/or professional athletes typically takes longer, lasting between nine and twelve months before a 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:
- Velocity of the player’s fastball
- Number of pitches thrown
- Number of innings pitched
- Number of seasons spent pitching
- 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%. While these measures protect 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.
Whether you are looking to heal your Tommy John injury or are seeking to prevent it, EmergeOrtho—Triangle Region has got you covered.
To learn more, self-schedule an appointment now. Or, call us any time at (919) 220-5255.