Finally had his Tommy John Surgery

What a Christmas present. Best wishes for a speedy and successful recovery!!

How old is your son and at what level? I'm curious if he feels there may be a particular cause and if so, will he make any changes mechanically or in his conditioning as he returns? Also curious about what you think about the injury and recovery?

Again, all the best in the New Year!

P.S. Looking for big things from your Sox's this year!

Prime9,

He is 15 and is a sophomore in high school. It would appear that there were a couple of things that lead to the breakdown of the UCL. Testing of his left shoulder (he is a LHP) revealed that it was extremely weak. This likely lead to his arm tiring quickly and a breakdown in his mechanics (dropping his elbow). The second contributing factor was that he had a 7mph jump in his velocity of the prior year. He worked with a pitching coach over the winter which greatly improved his mechanics along with a 2-3" growth spurt. (went from throwing mid 70's (75 - 76) to low to mid 80's (82 -83)) He also threw max velocity often trying to impress the coaches etc... One thing it likely wasn't was overuse. His innings were monitored and rarely threw 7 innings or more in a week. Pitch counts were below 100 as well, usually well below. So basically it was a very weak shoulder and big growth spurt that lead to the carnage..lol.

We will likely work with a pitching coach when he gets to that point to confirm that his mechanics are sound. He will definitely be doing exercises like the throwers 10 for the rest of his pitching days. He took his physical gifts for granted and didn't put in the extra work needed as a pitcher, figuring that having come out of basketball season and working with the pitching coach was enough. He didn't put in the effort with warming up properly either so we will create a routine with the physical therapist for the future.

My only thoughts are first and foremost that it sucks that it happened in the first place but if it had to happen occurring in the summer of his freshman year was probably the best timing for a high school pitcher. He established himself in the coaches eyes as a freshman, will miss his sophomore year but should be good to go for his junior and senior years. He will also be able to participate in the summer of his junior year for travel teams and hopefully get on the recruitment trail. Will be a long 15 months till he pitches to a batter competitively again though!!

Glad to hear the surgery is over and successful. He should get the splint off and the stitches out on his next visit and go into the mechanical brace. My son was surprised that he started out at 120 degrees flexion and 30 extention...much more open then he expected it to be...he thought he would start out at 90 degrees..so he was alittle nervous when the dr set it and said your good to go and walked out. He made me get the dr to come back in and check it because he thought he made a mistake lol. He got used to it pretty quickly and becuase he started college about 4 weeks after surgery the doctor had him wear it all the time for 3 months and then had him wear it whenever he went out to class or practice just as a reminder that he still had limitations. He is now 3 weeks into his throwing program and throwing at 60ft. So far so good. No pain just a little soreness but dr says all normal stuff. Next hurdle will be throwing off the mound in late Feb. Good luck to your son with his rehab.

Hisbiggestfan - I figured he'd likely get his brace then. When did physical therapy actually start for him? He must be pumped to be at 60' with his throwing. I hope things continue to go well for him!!

He started therapy the day after he got out of the splint with passive range of motion excercises done by the therapist.

Best of luck to both of your sons for a speedy and successful recovery.

My son (college freshman) was working out on the 22nd. He felt a little soreness in his elbow, but finished his throwing. Thursday morning he woke up and told me he needed to go to the doctor. The pain had gotten worse. We finally got an appointment for today with a sports medicine clinic. The doctor took one look and said "UCL". We have an MRI scheduled for the 4th to confirm. We are all pretty devastated. He has never had any arm or elbow problems in his pitching career.

It is uplifting to hear some good news about this type of injury. Can you tell me how soon after the diagnosis your surgery was performed?

my son went to the 1st doctor on june 11 had an mri on the 15th was diagnosed with a signifcant tear on the 17th first doc suggested 4 to 6 months rest and rehab with 50/50 chance of reinjuring it when pitching resumed. Went for 2nd opinion on july 10th and Dr recommended UCL surgery if son wanted to pitch in college. Had surgery July 26th. Turned out he had a complete tear so surgery was the only way he would have been able to pitch again and is now in 3rd week of throwing program. So to answer your question from 1st appointment to surgery date was about 6 weeks but only 2 weeks between 2nd opinion doctor doing the surgery

quote:

He also threw max velocity often trying to impress the coaches etc... One thing it likely wasn't was overuse.

BINGO. UCL injuries are not an overuse injury. Ligament injuries are almost always acute injuries-- one incident causes it. Rotator Cuff injuries are more often chronic injuries-- overuse.

Throwing max velocity so often is a likely cause for injury. Throwing over 85MPH is a risk factor for elbow injuries big-time..

Thank you for the information. It's nice to know this was not an overuse injury, son threw a lot of innings last year. He said he felt a little discomfort around the middle of his workout, specifically while throwing changeup, his other pitches didn't seem to bother it. The worst pain he had wasn't until well after he finished his workout.

OH BBMOM...best of luck with the MRI...maybe it wont be worst case scenerio. Your son is the same age as mine. He is also a freshman in college and will have to red shirt this season and hopefully will be ready this time next year. No summer ball either he will just work with his pitching coach and come back slowly over the fall and winter next year giving him about 18 months before he gets back on the mound in real games. He will start throwing off the mound at 50 percent right around the time his team will leave for their 1st preseason trip. The rehab road back is not easy and a little lonely, but hopefully he will make it all the way back for the next season. Best Wishes to you and your son. Keep us posted.

OH BBmom - Son's injury to surgery time was likely the longest in recorded time...lol. He got to the point where he couldn't pitch anymore due to pain (thought it was tendonitis..silly us!!) back around the 15th of august. Went to the local Ortho Dr that Monday and he did an MRI and discovered the tear. Got a second opinion two days later at MGH and they confirmed the diagnosis. With son only being 15 Dr OH took a very conservative tact. Had son go for an MRI with the dye to get a really good picture of what he was dealing with and put him on a rehab program to strengthen his shoulder before surgery. The MRI showed damage to the cartilage in the elbow so he wanted to correct that first. Had that surgery in October. Had to let that surgery heal and FINALLY had his TJ surgery on December 23rd. So it took 4 months to finally have the surgery.

Being from New England our HS baseball season doesn't start till late March so he will have 15 months of rehab and recovery before he throws his first competitive pitch. Hopefully by then he will be healthy and going strong. Come summer time he will be 18 months out and should be able to participate in summer ball hopefully playing down in GA at the WWBA events.

Good luck to your son!! If it is a torn UCL I bet you'll have your surgery much quicker then my son did, by about 3 months or more! Don't be afraid to seek a 2nd opinion with a good quality surgeon, obviously Dr Andrews would be nice but isn't very practical being in OH. I'm sure the Reds or Indians surgeons are quite qualified. Son had the Orthopedic Dr from the Red Sox perform his surgery. He studied under Andrews and works on studies with him. For this area I don't think I could have got better short of flying to Atlanta to see Andrews himself.

Keep us posted!!

Thank you for all of the pep talks! As you can imagine, our house has not been a very happy place to be these last few days. Before leaving for Christmas, son's coaches had individual meetings with each player to discuss what was expected of them during the coming season. He was told that he was one of 6 or 7 pitchers that would be competing for a spot in the 5 man rotation. He was very excited, and probably wanted to show up in mid-season form. Don't know if this could have caused injury. Guess it really doesn't matter what caused it, at this point.

We are very happy with his doctor. We chose to take him to the sports medicine center at Akron Children's Hospital, about a 40 minute drive from where we live. He had been there a few years ago for a shoulder injury that was healed with therapy and rehab, hasn't had one problem since. Hopefully we will have some good news in a few days.

my son had tj in 06. things worked out for him. but the one difficult thing, keeping him up mentaly. they don't tell you how, you have to figure it out yourself. there can be many blue days.

good luck to you and your son's, things will be fine i'm sure.

hisbiggestfan - you were right on with my son's 1st appt with the doctor after the surgery. They removed the splint and took out the stitches. Wounds were healing well and they put steri-strips on them which he is to keep on till they fall off on their own. He now has the brace and it was set at 90 degrees. Pretty much the same as the splint. The good part is it can come off when showering. That was a pain in the butt as it was my son's left arm which at his house was the inside wall of the shower so he couldn't hang it outside the curtain. Had to tape trash bags over it to shower. Now he can shower normally but remembering not to use that arm.

He heads to the Physical Therapist on Monday to start that up. Not sure how much he can do right off but I'm looking forward to taking him later on that week. I'm hoping a Sox player or Bruins player will be coming or leaving as he is the PT for each team..lol. Be a kind of cool benefit to meet a player.

1 Week down and 64 weeks to go till High School baseball starts up in 2012!!!

quote:

Originally posted by redsox8191:
hisbiggestfan - you were right on with my son's 1st appt with the doctor after the surgery. They removed the splint and took out the stitches. Wounds were healing well and they put steri-strips on them which he is to keep on till they fall off on their own. He now has the brace and it was set at 90 degrees. Pretty much the same as the splint. The good part is it can come off when showering. That was a pain in the butt as it was my son's left arm which at his house was the inside wall of the shower so he couldn't hang it outside the curtain. Had to tape trash bags over it to shower. Now he can shower normally but remembering not to use that arm.

He heads to the Physical Therapist on Monday to start that up. Not sure how much he can do right off but I'm looking forward to taking him later on that week. I'm hoping a Sox player or Bruins player will be coming or leaving as he is the PT for each team..lol. Be a kind of cool benefit to meet a player.

1 Week down and 64 weeks to go till High School baseball starts up in 2012!!!

Where will he be doing the PT? In the Nashua area?

Catching coach (Coach Weaver I presume )

He is starting down at Mass General with their lead physical therapist Scott Waugh. He will lead and monitor his physical therapy. At first we will go there and then he will assign what needs to be completed and that will be forwarded to the physical therapists here in Nashua. I believe his mom has coordinated it with the same group that supplies the trainer for North (Performance Rehab). In fact I believe that during the school year he will perform some of it with the trainer for North right after school. It is my understanding that we will meet with Scott at MGH probably once a month at least to check progress and to get info for the next stage of rehabilitation.

So basically it will be administered by MGH and a good chunk performed here in Nashua with Performance Rehab.

Mike Reinold (www.mikereinold.com) from the Boston Red Sox I believe also does some work out of MGH. He is the head athletic trainer and physical therapist with the Red Sox. He spent at least a year or two down in Alabama working with Dr. Andrews and the American Sports Medicine Institute.

Bulldog

I am sure that they work together at MGH as well as with the Sox..

Here are their official titles off of the Red Sox website:

Head Athletic Trainer/Asst. Dir. of Medical Services - Mike Reinold

Physical Therapist - Scott Waugh

Scott Waugh is also the Clinical Director for the Sports Physical Therapy Service at MGH.

So needless to say I feel like his rehab is in good hands .

And yes I did totally screw up the spelling of his name originally (Wahl vs Waugh)!!

Should be good to go

Here's part of Mike's bio from his website..

quote:

Michael is currently the Head Athletic Trainer and Assistant Director of Medical Services of the Boston Red Sox Baseball Club. He had previously spent the last 4 years as the Rehabilitation Coordinator and Assistant Athletic Trainer. He is also the Coordinator of Rehabilitation Research and Education of the Department of Orthopedic Surgery, Sports Medicine Division, of Massachusetts General Hospital at the MGH Sports Center in Boston, MA. In addition, Michael is Adjunct Faculty at Northeastern University in the Doctorate of Physical Therapy program. Michael was formerly the Facility Director of Champion Sports Medicine and the Coordinator of Rehabilitative Research & Clinical Education at the American Sports Medicine Institute in Birmingham, AL.

He might know a thing or two here and there I'd love to work with him for awhile myself..

I actually just posted a link to Mike Reinold's Injury Prevention Program for Youth Baseball Players off of the MGH site in the Pre-high school forum. If that leads to one kid conditioning his arm properly to avoid a serious elbow or shoulder injury then I will feel good! Kicking myself for not starting my son on a program when he was young enough to listen to me...instead of always having to point out "I told you to do that but you wouldn't listen to dad"!! You think he'd learn by now!! Worth trying to warn other dads and players...

RedSox,
The rearview mirror is fraught with all kinds of betterment. Focus ahead or it will eat us up.

You can lead the horse to water, but you can't make him drink.

Your son's story sounds very familiar....my son tore his UCL during the summer after his freshman year. After an initial misdiagnosis (and a few wasted weeks undergoing rehab that only worsened his condition), I brought him to Dr. David Lintner in Houston. His Tommy John surgery was in September of 2009. No pain afterwards,in fact, never took a pain pill aside from Aleve. He was in his brace 5 days post-op and began his first session of therapy that day. I drove him to therapy two times a week for 4 months, then dropped to once weekly for 4 more. He began a throwing program in January, so approximately 4 months post-op. Much to our surprise, they started him on a modified pitching program in April, just 7 months post-op. Of course, this was all done under the supervision of his surgeon and the rehab staff. They were surprised at how quickly he was progressing.

He was actually released for position play (LF,2B,or 1B)about mid-way through the season; however, his HS coach opted to have him sit the season out.(Prior to his injury, he was an OF/P.)
He was released to pitch from the mound in games this past summer under a strict pitch count (2 innings/20 pitches per inning max). Needless to say, HS coach was cautious, so he didn't get much mound time. He played fall ball this year on a great team and was able to get some decent (but modified) mound time. I'm a mom, so I was sure to let his fall team coach know what his limitations were and watched like a hawk to make sure they were followed.

Biggest drawback from the surgery has been trying to overcome the perception (in his mind) he has been "passed up" during his extensive rehab. He was finally able to show the coaches his speed, agility, and arm strength are still better than most players on the team, injury or no injury. The one downside has been his bat. It is evident that the loss of the at-bats he missed during sophmore season are almost impossible to overcome. Coach has basically decided he will be a pitcher only at this point, which is really his best shot at playing college ball anyway.

On a good note, his speed has increased since surgery. He was throwing 82-83 before the injury and is now throwing 87-88 (currently a junior). I believe it has mostly been due to the increased strengthening of his shoulders and back from all of the rehab work.

Everyone comes back at a different pace. My son still gets frustrated, as he feels he should be further along now than he is. I have to keep reminding him this is not a race. Staying healthy is the key. Good luck to you and your son during recovery!

Best of luck to all of your sons. Keep us posted on progress.

TPM

quote:

On a good note, his speed has increased since surgery. He was throwing 82-83 before the injury and is now throwing 87-88 (currently a junior). I believe it has mostly been due to the increased strengthening of his shoulders and back from all of the rehab work.

I have heard this being the case. And I think you are absolutely right on about a lot of it being due to the strengthening activities. I did a presentation back in September on shoulder and elbow injuries in baseball players and this topic came up in discussion. It was brought up that some parents were having their kids have Tommy John even though their ligament was perfectly fine! For this reason-- velocity is often greater post-surgical.

Just do the exercises!

What Doctor would do tommy john surgery on a healthy UCL, I cant believe there is even 1 that would do it? That just seems unbelievable to me!?!

People are crazy! Easy to think it was the surgery that "improved" the arm instead of the nearly year worth of intense rehabbing to strengthen the arm, shoulder and surrounding muscles. Plus you add in all the bullpens and tweaking of mechanics as well. Of course that is the real reason why there seems to be an increase not the replacement of the UCL (though if it was trashed it would likely help a bit having a fresh replacement).

In my son's case we are hoping for a bump in velocity but know if it comes it will be due to the rehab work and the natural maturation process from 15 to 17 yrs old by the time he pitches in a game again. Son was also 82-83 while hitting 85 on occasion before tearing apart his UCL. He'd be tickled pink to be hitting 87-88 after his surgery and rehab his junior year.

Well, today is the day of the MRI. It seemed like it would never get here! Now we have to wait until Thursday afternoon to get the results. I wonder how many ulcer prescriptions and sleep aids these guys give out!

I want yall to know that even if Tommy John surgery hasn't come up for our particular player(knock on wood) this is a very valuable thread that many posters like myself are following closely. Please keep updating your various son's progress and your individual approaches to handling this temporary setback. Good Luck and full recovery to all!

OH BBmom,

I hope the results come out positive either way. If not torn then hopefully right into rehab to get it back to normal, if torn I hope it is an obvious tear and they go right to surgery so your son could be ready for next season and not waste precious time trying rehab first.

Hopefully he can get a redshirt year if surgery is needed and not lose a year of eligibility.

Keep us posted!

fonvib2012 your sons time table sounds very simular to my sons. He had the surgery july 26th. He also has gone to PT twice a week for 5 months now and will go down to once a week soon when the spring semester starts up. He is now tossing at 60 ft and if all goes well will start working at 50 percent off mound by the end of feb which will be 7 months and just as his team is getting into its season. That will be the hardest part for him I think, when his team starts to play games and he will hopefully be feeling good, but will not be playing or traveling with his team. I just keep telling him that this time next year he will be getting ready to start his first college season and it will go faster than he thinks and if he keeps up all the hard work hopefully he will be a better pitcher than he was before he tore his UCL. Its just very hard to get an 18 year old who hasnt played in a game since june and wont pitch in a real game for 18 months that it will go faster than he thinks, but so far so good and we are greatful that so far his rehab has been all positive and good.

I was wondering if your sons had their ulnar nerve moved during TJS.

i believe a muscle splitting technique was used so ulnar transposition was not necessary to get to the UCL

Redsox,
Thank you for the words of encouragement. His tests included an MRI with contrast, so hopefully we get a definite result. I know it's silly to try and guess what the problem is until we hear about the test results, but my son has had conflicting symptoms. His pain started as a little soreness that gradually got worse, even after he stopped throwing. He never felt the big "pop", or had any loss of velocity, he just felt the pain. He had no swelling or bruising. Tomorrow will be 2 weeks since the initial incident, and he still has some pain, however.

One thing I do not know much about is if it is a partial tear. The doctor mentioned repair, not reconstruction, during our initial meeting. Has anyone had experience with a UCL repair? I understand this can be an arthroscopic procedure.

Sorry I dont know anything about repairing a UCL. My sons diagnosis was significant tear and his choices were rest and rehab for 6 months or TJS and as it turned out doctor said we made the right choice in not waiting because when he went in the UCL was completely torn and would not have healed itself.

OH BBmom

My son's symptoms were the same. He never had a "pop" he did have a couple of pitches when looking back he knows that is when he tore it as there was discomfort after. We honestly thought it was tendinitis when he first went to the local orthopedic doctor. To say we were shocked to hear it was a torn UCL (he actually tore it in two places..lol) would be understating it! The MRI with the dye is actually what showed not only the torn UCL but cartilage damage as well leading to the first surgery to repair the cartilage and take out a bone chip. As funny as it sounds to say...hopefully it is just a tear and he can have the surgery and start getting ready for next season.

TPM

My son had the ulnar nerve moved during his surgery. doctor said it is routine to do so now with the surgery, at least in these parts. Dr Andrews teaches doing it as part of his TJ surgery procedure now so that there are no problems in the future. Son's nerve would catch at times so it would have been moved either way.

Fonvib2012

Luckily son's coach has been excellent through this. He will keep son close and have him do his rehab with the team once the season starts and will be instrumental in helping son have throwing partners during the off season. While he did lose the opportunity to move into the varsity rotation as a sophomore this season (a rarity at our school) coach has enough pitching for this season to get by. Coach needs him more for his junior and senior year so he will be sure to keep a close eye on him and his rehab. Heck he is even now tutoring him before school in geometry to help pull his grade up. He will likely let him suit up for the games this season and chart pitches during the game. Keep him feeling a part of the team.

quote:

Originally posted by TPM:
I was wondering if your sons had their ulnar nerve moved during TJS.

Yes, my son had his ulnar nerve moved during the procedure.

OH,
Google repair of UCL and you will find info, not that common of a procedure.

Well, we just got back from the doctor's and found out that he has a complete tear, also a bone bruise and damage to the tendons. I guess if you are going to injure something, you might as well do it right!

I want to publicly thank the doctors and staff at the Akron Children's Hospital Sports Medicine Clinic. They took a very difficult situation and made it bearable for us. They scheduled an appointment for us at the Cleveland Clinic with the Indians team physician for consultation and surgery. It is a comfort to know that your child is in good hands.

His coaches have texted him several times already telling him to keep his chin up and that there will be a spot waiting for him when he is recovered. I think that went a long way to ease his mind.

I did have one idea that I would like some opinions on: our consultation is scheduled for the 13th. I had the idea of meeting with his coaches whenever we take our son back to school so that we could explain what will be done regarding surgery and rehab; find out what he needs to do to keep up with schoolwork; and for my son to find out what part he can play in the upcoming baseball season. Does this sound like a reasonable request? My thought was that after a meeting like this, everyone would be on the same page.

Thank you again for all of the kind words and encouragement.

I am sorry to hear the news.
You might want to consider the surgery over spring break, this will make it easier for him, not to miss too many classes and then they will be able to monitor him and do all of the stuff that is required post op and rehab until end of school term. He will then be well on his way towards his rehab and hopefully be ready for next season.
Best of luck.