One of the common questions I receive from patients in my office centers around delaying surgery in order to finish a sports season or wait until they have a break at work or school. In this Ask Dr. Geier video, I discuss this concept with a serious injury often suffered by baseball pitchers – Tommy John surgery for a UCL injury (Tommy John injury) of the elbow.

Erik writes:

I have a complete tear of the UCL. It occurred two years ago. Originally, I did not plan on getting surgery because I did not think I would play baseball any longer. I have re-evaluated that decision and plan on getting surgery (if affordable).

Is there more damage I can do to the elbow if I play (or wait) any longer before getting the surgery? Would it make the surgery more difficult or less likely to be successful?

Most of us – or at least those of us who don’t pitch in baseball or play overhead sports – can do well without undergoing Tommy John surgery for an ulnar collateral ligament, also called a UCL injury or Tommy John injury. Baseball pitchers have historically not done well with non-surgical treatment for these injuries. Return to sports rates have been unpredictable for athletes with complete tears of the ligament.

While it is difficult to know if a pitcher would do more harm to his elbow, the bigger problem is that it could be difficult to pitch as well as he wants. He might struggle with the location and velocity of his pitches. He could try a course of physical therapy to regain range of motion and strength of his arm and try to return to see how he pitches, and he could undergo UCL reconstruction if the process didn’t get him back to the level of pitching he desires.

Also read:
Ask Dr. Geier – Tommy John injuries
Ask Dr. Geier: Partial UCL injuries of the elbow

Tommy John surgery common among baseball pitchers

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