Everything You Need to Know Before Tommy John Surgery

If you’re considering a Tommy John procedure, you might be wondering how to prepare, what to expect during surgery, and what to expect during your recovery. This article will answer all of these questions and tell you where to find the best Tommy John surgeon in San Francisco.

Man athlete holds elbow in pain suffers Tommy John injury

Tommy John surgery is a common nickname for an ulnar collateral ligament (UCL) reconstruction — a surgical procedure that repairs a torn UCL in the elbow. It’s a common surgery that can help get athletes back to playing their favorite sport when non-surgical treatments haven’t worked.

For athletes who make repetitive overhand throwing motions, Tommy John surgery can help you return to pain-free peak performance. Read on to learn what to expect when you have Tommy John surgery performed by the best orthopedic surgeon in San Fransico.

What is Tommy John Surgery?

Before discussing how this surgery is performed, let’s review the anatomy: The UCL is a ligament that connects the humerus bone to the ulna bone and helps stabilize the elbow joint during throwing motions.

Overuse or repeated stress can cause your UCL to tear. Typically, people with a UCL tear have the following symptoms:

  • Elbow pain and stiffness, especially throwing arm pain

  • Swelling in the elbow

  • Bruising and tenderness on the inside of the elbow

  • Decreased grip strength

  • Pain or inability to make a throwing or swinging motion

  • A decrease in athletic performance

  • Reduced range of motion in the arm

How to Prepare for Tommy John Surgery

If you’re scheduled for a Tommy John surgery, you might be wondering what you can do to prepare. Your surgeon will likely go over instructions, but here are some general things you can expect:

  • First, your surgeon may order a few tests to make sure you’re healthy enough to undergo surgery. This may include blood tests and an electrocardiogram (ECG) to make sure your heart is healthy and functioning properly.

  • You will also discuss what medications and over-the-counter supplements you take with your surgeon, as you may need to stop taking some of them before your surgery.

  • Your surgeon will tell you what to stop eating and drinking before your surgery. In most cases, you’ll have to fast from food and drink for 12 hours before your surgery. This is important to prevent vomiting while you’re under anesthesia.

Your surgeon or the intake nurse where you plan to have surgery will go over these details and any other instructions when you schedule your surgery. If you feel unclear on anything, don’t be afraid to ask — your medical team is always happy to help!

What Happens During Tommy John Surgery?

On the day of your surgery, you’ll be given an arrival time and told how long to avoid drinking and eating beforehand. When you arrive and get checked in, your surgical team will help you get ready for surgery. Once you’re settled in, your surgery will go something like this:

  • You’ll lie on your back with your arm supported to your side during surgery, and an anesthesiologist will administer anesthesia medication that will help you sleep.

  • Your surgeon will take around six to seven inches of tendon from another area of your body. Usually, this tendon graft is taken from the palmaris longus tendon in your forearm, your hamstring tendon, or your big toe extensor tendon. A cadaver tendon can also be used.

  • Next, a small incision is made on the inside of your elbow and any damaged tissue from your torn UCL is removed. Holes are then drilled into your ulna and humerus, where your surgeon will thread your tendon graft. The tendon graft is looped through the holes of your ulna and humerus and then stitched to itself with dissolvable stitches.

  • After the tendon graft is in place, your surgeon will stitch your small incisions closed and put your arm into a splint that will hold your elbow stable during recovery.

All together, Tommy John surgery lasts around 60 to 90 minutes from beginning to end.

What Happens After Tommy John Surgery?

Recovery from a Tommy John Surgery will be a little different for everyone, but some general things you can expect are:

  • You’ll have to wear a splint to brace your elbow while your tendon graft heals. You might begin physical therapy right away, or wait a short time — either way, follow the instructions given to you by your surgeon.

  • A few weeks after surgery, you’ll start moving your elbow joint again. You may experience some stiffness and pain as you begin to move your elbow again, but this should be minimal. You can still use your sling for comfort. Physical therapy is very important at this stage for proper healing.

  • With regular physical therapy, most people regain a normal range of motion in the elbow two to four months after the surgery. Although you will still have physical therapy for several weeks.

If you are a throwing athlete, you can expect to gradually return to your sport between six and nine months after Tommy John Surgery. Continuing a strength and stretching program with your trainer will help your recovery. Returning to competitive performance will usually take around a year or longer, depending on your recovery.

Where to Find the Best Tommy John Surgeon in San Francisco

Tommy John surgery is a great solution for a common sports injury that affects throwing and swinging athletes like baseball pitchers, football quarterbacks, golfers, and tennis players. For competitive athletes, getting back in the game as quickly and pain-free as possible is important. That’s why it's important to choose an experienced orthopedic surgeon with a reputation for Tommy John surgery success.

Dr. James Chen is one of San Francisco’s best orthopedic surgeons — and an expert in orthopedic procedures, including the Tommy John procedure. Dr. Chen and his team have built a reputation for high-quality surgical care using state-of-the-art surgical suites, innovative technology, and the most advanced techniques. This leads to higher surgery success, less pain, and faster recovery times for patients in the Bay Area.

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