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I have inner elbow pain. Do I need Tommy Johns surgery?

With spring training right around the corner and recreational sporting activities gearing back up, we all may start hearing more and more about the famous “Tommy Johns” surgery to help treat elbow pain and dysfunction. This surgery tends to get a lot of attention, especially from our MLB fans when their favorite teams’ pitchers have elbow injuries. The good news is that surgery is often not the first line of defense! If you or someone you love has ever suffered from pain along your inner elbow, let the team here Desert Edge PT give you a little more information on what all the hype is about. Keep reading to learn more about this injury and what can be done about it! 


What is the UCL?

One possible source of inner elbow pain, especially in overhead athletes playing sports like baseball and softball, is the pesky Ulnar Collateral Ligament (or UCL). This ligament is found on the inner side of your elbow joint, between the upper arm bone (humerus) and forearm bone (ulna). The job of the UCL is to provide stability to the inner elbow against stresses that push the elbow in towards the body and provides important stability when throwing overhead. If there is an injury to this ligament, some symptoms could be a painful “pop” in the elbow, pain, swelling, stiffness, and occasional tingling or weakness in the hand. But be cautious about jumping to conclusions, these symptoms could be very similar to multiple other conditions on injuries. If you have questions regarding elbow pain, stiffness, arm or hand numbness or weakness, consult your physician or contact us at Desert Edge PT for a free discovery session. 


What is “Tommy John’s” surgery?

The term “Tommy Johns” comes from the famous baseball player who had the first ulnar collateral ligament reconstruction surgery in the 1970s. Typically, the surgery is indicated when the UCL is torn and conservative treatment is not an option or has failed to manage the issue. The surgery involves taking a tendon graft from a muscle in the forearm, leg, or foot from either the patient themselves or a human cadaver. The tendon is then used to provide additional stability to the injured area. The harvested tendon basically replaces the injured ligament and provides stability to the inner elbow. After surgery, the patient is typically in a brace for a period of time and eventually referred to Physical Therapy to begin the rehabilitation process. In therapy, we focus on things like range of motion and strength of the elbow, shoulder flexibility, core, and leg strength. The average full return to sport and throwing activities is around a year! 


So, do I need surgery?

The answer is, like so many things in life, it depends! Many factors go into the decision whether or not to operate, your healthcare provider will consider factors such as your age, if you play sports (and want to continue playing sports), and medical imaging results, among other factors. Alarmingly, recent research suggests that with the growing popularity of this surgical procedure and media coverage, medical professionals have seen an increase in patients coming to see them about having “Tommy John’s” surgery and don’t even have a UCL injury! In some cases, people believe that just having the surgery itself will make them pitch and throw with improved performance, just like their professional idols. While research does support that a full recovery is possible, and likely, just having the surgery to improve performance is not a good idea! If “Tommy Johns” reconstruction is not indicated, other options include physical therapy, biologic injections, or operative UCL repair. The good news is that both conservative and non-conservative management have good long term outcomes! 


Now that we have a better understanding of this type of injury and the different treatment options, don’t hesitate to contact us at Desert Edge PT with any additional questions or concerns! Go Diamondbacks!

published on Wednesday, February 3rd, 2021