Recovering from Tommy John Surgery Requires These 5 Phases

Here’s a familiar scenario for the major league baseball fan: your team’s pitcher gets hurt, requires Tommy John Surgery, and disappears for about a year or two before coming back (hopefully) as the same pitcher he was prior to injury. But what happened in between?

Recovering from Tommy John surgery is an untold story in baseball. With the increased frequency of Tommy John at all levels of competition, it is easy for an outsider to take for granted what it actually requires to make a comeback. There is a grueling rehabilitative process involved if the player plans on ever competing at a high level once again. And while many sports therapists vary on the way they approach recovery, here is what you can generally expect when rehabilitating your elbow post Tommy John Surgery. For an easier break down, we’ll describe them as phases:

Phase 1:

Immediately following the surgery, the elbow is kept bent at 90 degrees and placed in a brace that prevents any and all movement. This robotic position is maintained for about 7 to 14 days of hard rest. Nothing about this position is very comfortable, but nothing about recovering from Tommy Johns really is.

Phase 2:

For the next few weeks, manual therapy sessions are used to gradually stretch the elbow until the athlete achieves a full (albeit uncomfortable) range of motion. The brace is still utilized, though it is adjusted in accordance with progress in order to allow more movement. You might even be able to use that arm to eat cereal again!

Phase 3:

Fast forward to about 6 weeks after surgery. Now that the player has achieved full movement, it’s time to shift focus from stretching to exercising. Workouts consist of cardiovascular, lower extremity, and core stabilization exercises, but don’t even think you’re going anywhere near a baseball yet. The sports therapist needs to monitor your movements and correct any defects/abnormalities first.

Phase 4:

Fast forward again. Now we are about 20 full weeks after having the surgery. By now, the player is itching to get their hands on a baseball, and depending on their progress thus far, that wish could be granted. It starts with long toss – and lots of it. The recovering player will work his way up from having catch sessions of about 50 throws from 45 feet, to eventually throwing it as far as 200 or more feet. Arm strength will be at an all-time low at the start of this phase of recovery. It is important to gradually return that strength well before stepping foot on the pitcher’s mound, and strength never comes back quickly. This phase lasts almost 5 months.

Phase 5:

Just to recap, the recovering athlete has just spent almost a full year exercising multiple days a week, and only now are they ready to revisit the pitcher’s mound. At first, the mound feels almost foreign. Pitchers need time to work on mechanics, and continue to build strength and stamina. They practice by throwing bullpens for months before they are finally ready for a live game setting.

Tommy John Surgery is a long term commitment. Ever since the surgery’s big league debut in 1976, we’ve seen countless players make a recovery back to the MLB, and they’ve certainly earned it. If you are a baseball pitcher at any competitive level who suffers elbow pain, request a consultation with Dr. Palumbo and we’ll explore what’s necessary for your own recovery.

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