UCL Reconstruction — Elbow UCL Reconstruction

UW Health Sports Medicine · UW Health Sports Rehabilitation; UW Health Sports Medicine physician group

Weight-Bearing

N/A (elbow surgery)

Key Restrictions

Week 1: hard brace at 90°; Week 2: brace 30°-100° (rehab ROM 15°-110°); Week 3: brace 20°-100° (rehab ROM 15°-110°); weeks 4-6: brace opened to 0°-110°, rehab ROM to 0°-130°; brace discontinued 6-8 weeks; no valgus stress throughout; no running/jumping until Phase IV (75% speed week 16); ice 15-20 min after rehab; RTS competitive throwing 8-12 months

Timeline & Phases

Phase I (0-3 wks): immobilized at 90° then hinged brace, sub-max shoulder isometrics wk 2, walking/bike in brace; Phase II (usually 4-8 wks): brace ROM progressions, near full ROM by wk 9-10, no running/jumping; Phase III (usually 8-12 wks): full ROM by wk 10, first testing at wk 12; Phase IV (usually 12-16 wks): arm >45° ABD strengthening, 2-hand plyometrics, throwing mechanics education, running/sprinting 75% at wk 16, interval throwing program after wk 16 testing (90% LSI); Phase V (usually 20-24 wks+): mound progression 26-30 wks, testing at 6 and 12 months, RTS competitive throwing 8-12 months

Notes

Tommy John surgery for UCL tears in overhead/throwing athletes. Docking or figure-8 tendon graft technique. Flexor muscles split (not detached). Ulnar nerve may be rerouted anteriorly if irritated. RTS competitive throwing 8-12 months; not all athletes return. Updated 3/2018. Copyright 2018.

Surgeon / Author

UW Health Sports Rehabilitation; UW Health Sports Medicine physician group

Published

2018-03