1. Ulnar Collateral Ligament Sprain of the Elbow
Tommy John’s Surgery Rehabilitation Program
Devin Solvik
Therapeutic Exercises
For Athletic Training Professions and Athletes

2. Anatomy
Humerus
Ulna
Anterior Band
Intermediate Band
Posterior Band

3. Mechanism of Injury UCL can become stretched frayed or torn
Improper throwing mechanics
Number of pitches thrown
Percent of injury

4. Throwing mechanics
Valgus stress 1 2 3 4 5 6
Valgus torque

5. Pre-Surgery Treatment
RICE
Electric Stimulation
Ultra Sound
Heat

6. Pre-Surgery Rehabilitation
Range of Motion Exercises
Strength
Core

7. Tommy John Surgery Performed by Dr. Frank Jobe in 1974.
Named after major league pitcher Tommy John.
New tendon
Woven in a figure 8 pattern
Attaches to ulna and humerus

8. Post-Surgery Treatments
Ice
Elevation
Compression
Immobilization

9. Post Surgery RANGE OF MOTION
Wand flexion/extension
Passive extension- light medicine ball
Pulley-passive flexion/extension
AROM Wrist- circumduction, flexion/extension

10. Wand Flexion/ Extension
Good helps the bad

11. Passive Extension- light medicine ball
Allow medicine ball to assist with elbow extension

12. Pulley Passive flexion/extension
Make sure movements are controlled

13. AROM wrist- circumduction, flexion/extension

14. Post-Surgery Resistive Exercises
Isometrics- elbow flexion/extension
Theraband/theratubing- elbow flexion/extension
Dumbbell- elbow flexion/extension
Therabar- pronation/supination
Hand Web
Putty Squeeze

15. Isometrics- elbow flexion/extension
There should be no movement within the elbow joint during this exercise

16. Theraband/theratubing-elbow flexion/extension
Do through entire rang of motion.

17. Dumbbell- elbow flexion/extension

18. Therabar- pronation/supination
Uninjured arm will stabilize one end of thera-bar

19. Have patient flex and extend fingers against resistance
Hand Web
Have patient flex and extend fingers against resistance

20. Completely open and close hand using a slow and controlled manner.
Putty Squeeze
Completely open and close hand using a slow and controlled manner.

21. Prognosis Percent of complete recovery 85%-92%
Begin throwing at 16 weeks
Field players 6 months of rehabilitation
Pitchers 1 year of rehabilitation

22. Risk Factors Re-injury Damage to ulnar nerve Infection Area of injury

23. References … American Journal Sports Medicine
Current Concepts in Rehab
Defining Safe Rehab
Diagnosis and Treatment
Muscle Splitting of the UCL
Optimizing elbow Rehab
Rehab Following Elbow Surgery
Rehabilitation of Throwers
UCL Reconstruction