Definition:

Tommy John surgery, known in medical practice as ulnar collateral ligament (UCL) reconstruction, is a surgical graft procedure in which the ulnar collateral ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, hip, knee, or foot of the patient). The procedure is common among collegiate and professional athletes in several sports, most notably baseball.

Symptoms:

• Pain in the medial elbow
• Point tender to the medial elbow
• Sense of instability or looseness

Causes:

• Repetitive medial elbow stress- throwing
• Poor mechanics
• Poor flexibility

Treatment:

• Period of immobilization with a posterior splint with elbow at 90 degrees flexion
• Avoid full elbow extension for 3-4 weeks
• Maintain wrist and shoulder ROM (avoid shoulder ER)
• Passive elbow ROM, then progress to active elbow ROM
• Posture program
• Shoulder stabilization exercises
• Wrist strengthening and grip strengthening exercises
• Upper extremity strengthening