Tommy John is an elbow surgery that a lot of baseball players have undergone in the last 30+ years.  Tommy John is just the nickname for the surgery.  It is actually called ulnar collateral ligament reconstruction by doctors.  Tommy John was a former pitcher for the L.A. Dodgers and the first professional athlete to successfully undergo the operation.  The surgery was done in 1974 by Dr. Frank Jobe.  The surgery is done by replacing a ligament in the medial elbow with a tendon from some where else in the body like the forearm, hamstring, knee, or foot.  The tendon that is taken is then wrapped or woven into a figure eight pattern through tunnels that have been drilled into the ulna and humerus bone.  It took Tommy John 18 months to recover from the surgery he had in 1974 but he returned to baseball and pitched in the major leagues until 1989 at age 46.  Today the surgery only takes about an hour and full recovery takes about 10 - 12 months.  One misconception that people have about Tommy John surgery is that after the surgery the pitcher will throw harder (faster) then they did before the surgery.  There may be an increase in speed but it is not because of the surgery.  The increases that may occur in performance is usually because of the pitcher's increased attention to conditioning.  The rehabilitation program for post surgery is a very intense one that pitcher's are usually willing to work hard at because they don't want to be injured again.  This is what makes them stronger and gives them the gains.  Another reason people may believe that speed increases is because the UCL can degrade.  That means over the years the pitcher's velocity will slowly decrease.  After the surgery is done, the pitcher essentially has a new one, therefore they will be able to throw at the velocity that they could before their UCL started to degrade.

Rehab For Tommy John Surgery

Rehab for Tommy John Surgery takes about a year to fully recover.  Here is an idea of what goes on during those 12 months of rehab and recovery:

Days 1 - 7

The elbow is put into a hard brace and immobilized at 90 degrees.  The pitcher will be able to move their hand and do light grip exercises.

Week 2

Pitchers can begin to use the arm to eat and do other everyday movements.  The elbow extention is gradually increased.  The pitcher can get rid of the brace at 4 - 6 weeks.

Weeks 3 - 8

The pitcher will start working on their range of motion.  They can also start doing light dumbell exercises.

Week 10

The pitcher will be able to simulate a throwing motion.

Weeks 12 - 14

The pitcher will be able to start to swing a golf club!!  They will also start going through the throwing motion with a 1 pound medicine ball.

Week 16

Pitchers will begin a throwing program.  It will be a flat ground, soft tossing at 45 feet.  It will be 50 tosses broken into two 25 toss sessions.  This is to be done every other day.  Distance and repetitions will be increased every week until the pitcher can reach 150 feet.

Month 6

The pitcher will begin to throw off of the mound.  They are only to throw fastballs at 50% gradually increasing the number of pitches and intensity.

Month 7

The pitcher will begin throwing breaking balls on flat grounds.

Month 8 - 10

Start practicing in game conditions.

Month 11 - 12

The pitcher can return to competition.  It usually takes a full season for a pitcher to feel as good as he did before the injury.