Tommy John Surgery: Understanding the Need & Procedure

Tommy John surgery (ulnar collateral ligament/UCL reconstruction) repairs a torn UCL in the elbow—critical for throwing stability.

Indications

Complete UCL tear (ligament fully detached from bone). Symptoms:

• Inner elbow pain
• Swelling/bruising medially
• Elbow instability
• Inability to throw without pain

Diagnosis

Clinical exam + MRI confirmation.

Procedure

1. Small medial elbow incision
2. Remove damaged UCL
3. Harvest healthy tendon graft (often palmaris longus from forearm or hamstring)
4. Reconstruct UCL with graft

Outcomes

• High success rate for return to prior activity level (including sports)
• Rehabilitation: 12–18 months for competitive throwing athletes

When to See a Doctor

• Persistent medial elbow pain unresponsive to rest/ice/meds
• Swelling/bruising inside elbow
• Throwing difficulty/pain
• Elbow instability/looseness
• Popping/snapping sensation when throwing

Early evaluation optimizes treatment planning and outcomes.