Most cases of ulnar collateral ligament replacement (UCLr, or “Tommy John” surgery) follow a fairly standard throwing program and rehabilitation program. A sample throwing program once cleared to throw looks something like this: However, not all athletes respond to such a conservative program. It is also our opinion that touching a baseball should show up significantly later in the “throwing program” than what most PT and MDs recommend. For example, in weeks 1-3, many of our athletes will never touch a baseball and instead will do primarily negative/reverse throwing with Driveline PlyoCare Balls. Furthermore, they will generally NOT throw balls at the regulation weight – 5 oz. Their first throws will often be with an overload ball (8 oz) at very low intensities to “feel” the motor patterns they should be building. Touching a baseball and throwing it brings back hundreds of thousands of reps and feelings from throwing a baseball, which is hard to change. This psychological connection is meaningful and is often overlooked! Here’s an example of the intent with an 8 oz. ball for the first week of throwing: Specific Case – Ex-Pro Tennis Player Jeff is a converted ex-pro tennis player (now pitcher) who had an unsuccessful rehabilitation from UCLr. While the surgery left his elbow stable, he lost gross amounts of shoulder external rotation, has nagging biceps irritation, and lost massive ball velocity, going from 88-90 to 78-81 despite completing a full throwing program similar to the one above in this post. He felt rehab was not specific enough to traits that were not common in baseball pitchers, like increased hypertrophy of the upper arm that is seen in tennis players. In cases where pitchers who can still throw with significant ball velocity (80+ MPH) […]
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