UCL Reconstruction — Elbow UCL Reconstruction

Sutter Health / Palo Alto Medical Foundation · Kevin Roth MD

Weight-Bearing

N/A (upper extremity)

Key Restrictions

Splint 1 week; no valgus stress; sling optional wk 1-2; total body conditioning from wk 2; easy tossing at 3-4 months (requires full pain-free ROM at 14 weeks); off mound at 7-8 months; up/down bullpens at 9-10 months

Timeline & Phases

Days 0-7: Splint, no valgus stress, full active forearm/wrist/shoulder ROM; Wks 1-4: d/c splint wk 1, sling optional, full body conditioning from wk 2, achieve full elbow ROM; Months 1-2: Full ROM elbow/wrist/forearm/shoulder; light weights from 1 month; Months 2-3: Continue active resistive exercises entire extremity including RC, lower body/trunk conditioning; Months 3-4: Easy tossing (no windup) at 14 wks if full pain-free ROM, 25-30 → 70 throws, 20-40 ft; Months 4-5: Easy windup, increase distance to 50 ft; Months 5-6: Increase distance to max 60 ft; Months 6-7: Gradually increase to 150 ft max (4-phase distance progression); Months 7-8: Off mound ½-¾ speed (4-phase mound program); Months 9-10: Up/Down bullpens ½-¾ speed (game simulation)

Notes

Tommy John surgery; easy tossing at 3-4 months; off mound at 7-8 months; bullpen simulation at 9-10 months; same throwing program progression as UCL repair but ~3 months longer throughout

Surgeon / Author

Kevin Roth MD

Published

2024