Tommy John Surgery

Tommy John surgery (also known as ulnar collateral ligament reconstruction) is a procedure to repair a torn or damaged ligament on the inner side of the elbow. During surgery, the damaged ulnar collateral ligament (UCL) is replaced with a tendon from another part of your body or from a donor.

The surgery is named after professional baseball pitcher Tommy John, the first athlete to undergo the procedure successfully.

Why Would I Have Tommy John Surgery?

Tommy John surgery is typically recommended when the UCL is torn or severely damaged, leading to elbow pain, weakness, and instability—especially during throwing or overhead motions. It is most common among baseball pitchers and other athletes who subject their elbow joints to repetitive stress.

You might need Tommy John surgery if you experience:

• A UCL tear from overuse or injury
• Chronic elbow pain that limits throwing or daily activities
• Reduced velocity or control while throwing
• A feeling of looseness or instability in the elbow
• Failure to improve with non-operative treatment like rest, therapy, or injections

How Can This Surgery Help Me?

By reconstructing the torn UCL, the surgery restores stability to the elbow joint, reduces pain, and allows athletes to return to their previous level of performance. With proper rehabilitation, most patients regain full use of their arm and can resume sports or other activities without pain.

What Type of Anesthesia is Used?

Tommy John surgery can be performed using general anesthesia, so you’ll be asleep during the procedure.

What Are the Risks?

As with any surgical procedure, there are risks, including:

• Bleeding or infection
• Nerve or blood vessel injury
• Anesthesia complications
• Persistent stiffness or pain
• Failure of the graft to heal properly
• Loss of range of motion
• Need for revision surgery in the future

What Will My Recovery Involve?

Recovery after Tommy John surgery is gradual and closely monitored by your care team.

• Immobilization: Your arm will be placed in a brace or splint for several weeks to protect the repair.
• Physical Therapy: Therapy begins within days to weeks to restore flexibility and prevent stiffness.
• Strengthening: Gradual strengthening exercises begin around 6–8 weeks after surgery.
• Throwing Program: A progressive throwing program starts between 4 and 6 months post-surgery under supervision.

How Long Does Recovery Take?

Full recovery from Tommy John surgery typically takes 12 to 18 months, depending on your progress, sport, and level of play.

What Improvements Can I Expect?

Most patients experience:

• Relief from pain and instability
• Restored strength and motion
• Improved throwing performance and endurance
• A successful return to sports or daily activities

Studies show that over 80–90% of athletes return to their previous level of play after surgery.

What Are My Alternative Treatment Options?

Nonsurgical Treatments

• Rest and activity modification
• Physical therapy to strengthen the surrounding muscles
• Platelet-rich plasma (PRP) injections to promote healing
• Anti-inflammatory medications

Surgical Treatments

• UCL repair with internal bracing (for partial tears in younger athletes): Uses a special suture device to reinforce the ligament instead of replacing it entirely.

What is the Outlook for Tommy John Surgery?

Tommy John surgery has a very high success rate; most athletes regain full elbow function and can return to competitive sports. Long-term outcomes are excellent; however, continued attention to mechanics and conditioning is essential to prevent re-injury.