Recover From Ulnar Collateral Ligament Injury (Tommy John Surgery)

A UCL injury is an injury of the ulnar collateral ligament of the elbow, most commonly among throwing athletes or other overhead athletes, that typically develops over time.

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From the Blog

Tommy John injuries

In this column, I discuss an injury that I talk about among professional baseball players on my show, but it seems to only rarely occur among recreational athletes.

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From the Blog

Partial UCL injuries of the elbow

Does an athlete with a partial ulnar collateral ligament injury of the elbow need Tommy John surgery? Can you make it worse if you avoid surgery? I address these questions in my latest Ask Dr. Geier column.

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From the Blog

Pitching with a Tommy John injury

In this Ask Dr. Geier video, I discuss this concept with a serious injury often suffered by baseball pitchers – a UCL injury of the elbow.

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The Sports and Exercise Injury Primer

This series explains the top 20 injuries suffered by athletes and active people.

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Ask Dr. Geier: Elbow and Forearm Injuries

How to get rid of pain, anxiety and frustration from your elbow injury.

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The Injury Evaluation Course

Does the thought of seeing a doctor for your injury scare you?

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That’s Gotta Hurt

The Injuries That Changed Sports Forever

Through the stories of a dozen athletes whose injuries and recovery advanced the field (including Joan Benoit, Michael Jordan, Brandi Chastain, and Tommy John), Dr. Geier explains how sports medicine makes sports safer for the pros, amateurs, student-athletes, and weekend warriors alike.

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Frequently Asked Questions on Ulnar Collateral Ligament Injury Injuries

+What is this injury?

-What is this injury?

A UCL injury is an injury of the ulnar collateral ligament of the elbow, most commonly among throwing athletes or other overhead athletes. It is typically an injury that develops over time. The thrower will usually complain of pain on the inside of the elbow that worsens over the course of the competition. It typically worsens as the season goes on, and the pain takes longer to go away after each game. He often complains of not having the same velocity or “zip” on his pitches or throws, and he often feels that he cannot locate pitches or throw as well as he could.
+What are the common treatments?

-What are the common treatments?

Nonoperative treatment for a complete rupture of the ulnar collateral ligament is notoriously unsuccessful. Rest for several months with gradual return to throwing can be tried, but success in returning to the same level of pitching or throwing is unpredictable at best. High-level throwing athletes are usually good candidates for surgery. There are a variety of different techniques for “Tommy John” surgery, but they are all essentially techniques to make a new ulnar collateral ligament. Typically one of the small tendons in the wrist, either on the same side or from the opposite wrist, is used. The tendon is passed through drill holes in the humerus and the ulna to make a new ligament.
+How long could it take to recover?

-How long could it take to recover?

Return to pitching at the same level after Tommy John surgery takes about one year, on average, although some pitchers feel that it takes even longer for the elbow to feel normal. If the injury involves a partial tear that doesn't require surgery, an athlete might recover and return to play in as little as 6 to 12 weeks.
+What should I ask my doctor?

-What should I ask my doctor?

It is always a good idea to ask if surgery is necessary and if there are nonsurgical treatment options that can be tried first. If you choose to undergo surgery, understanding what restrictions the surgeon will place after surgery and what you can safely do, such as driving and working, are important. If you don't play a throwing or overhead sport, ask if you can return to what you want to do without surgery. Also ask when you could expect to safely return to your sport or exercise.