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Tommy John surgery refers to reconstruction of the ulnar collateral ligament (UCL) of the elbow. This ligament is one of the main stabilizers of the elbow during the throwing motion, and may tear with repetitive overuse. Young athletes with UCL tears may complain of elbow pain, swelling and the inability to throw with the same velocity or force as before the tear.

Often, athletes can recall a specific throw or injury when they felt a pop on the inner aspect of the elbow. In athletes with persistent functional limitations, Tommy John surgery may be considered to help return them to their prior level of throwing. 

You can have peace of mind knowing that the skilled experts our Orthopedic Center's Hand and Orthopedic Upper Extremity Program have treated thousands of babies and children with many upper extremity conditions.  We provide expert diagnosis, treatment and care, and we benefit from our advanced clinical and scientific research.

Research shows a dynamic warm up reduces pitcher's injury risk and improves performance.  Watch these videos to learn how. 

Tommy John Surgery | In Depth

How is a UCL tear diagnosed?

An ulnar collateral ligament tear is usually diagnosed by a careful medical history, specific physical examination and x-rays or MRI.

What factors go into the decision about surgery?

The decision to have Tommy John surgery is complex and individualized for each patient-athlete. Surgery has risks, and the recovery from Tommy John surgery is long. The athlete's age, level of baseball participation, athletic goals, and any associated conditions must also be considered.

What is the surgical recovery process like?

Following Tommy John surgery, athletes are typically immobilized in a splint or brace for 6 weeks, followed by months of physical therapy and rehabilitation. In general, athletes may not be ready to throw or pitch competitively for nine to 12 months after surgery. With current surgical techniques, the success rate of Tommy John surgery is 80 to 90 percent.

Are there any other relevant factors for parents to consider?

Children are not small adults, and the types of injuries sustained by young, growing athletes are different as well. Tommy John surgery is not typically performed in younger patients with open growth plates, though there are many ways in which orthopedic surgeons and sports medicine doctors can help younger, growing throwers with elbow pain and problems.

Donald Bae, MD, a Boston Children’s Hospital orthopedic surgeon whose specialties include sports injuries of the upper limb and elbow injuries. Click show more below to read his answers to parents’ questions about Tommy John surgery and ulnar collateral ligament (UCL) tears:

To learn more about preventing common baseball injuries, download Boston Children’s Injury Prevention guide. To read a Sports Illustrated feature about Boston Children's approach to Tommy John surgery click here.

Tommy John Surgery | Programs & Services