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.

If you were diagnosed today and Spring break is two months away, not sure why you would wait. In my opinion the sooner the better. Pre-planning with all involved, teachers, coaches, trainers etc...will make the process much more manageable. Son had the surgery on a Friday and was back in class Monday morning with one arm in a sling/brace (lefty thrower and writer) and the other arm bandaged. First day or two he had classmates help him with notes until he could start taking them on his laptop, and then got pretty good at writing right handed. As far as rehab, this was strictly set up by the Doctor, Coaches and trainers so they were able to set his schedules around his school.
I realize everyone is different and the approach could be different as well. This is just how our situation worked best.

Good luck!

How's your son doing, Danny?

quote:

Originally posted by Tx-Husker:
How's your son doing, Danny?

Putting in the hard work that will hopefully allow him two more years of competing and having fun.
Keeping fingers crossed. Thanks for asking.

Sent you a PM Tx.

OH BBmom,

Sorry to hear it was a complete tear but at least you now know and can take the steps necessary to get back on the field. I would think that the Indians surgeon would be an excellent doctor to perform the surgery. Personally I wouldn't wait for break to have the surgery for two reasons. My son is only 15 and had the surgery on a Thursday, that Friday (Christmas eve of all days) he was hurting a bit but by that Saturday (Christmas)he was back to his old self. He did have the next week off but could have gone to school if he had to. He had the tendon out of the wrist on the same arm he throws with and he was able to write with it easily when he got back to school. I think your son would likely handle it well as well. Schedule it on a wed or Thursday if possible and he can have the weekend at home to recoup. The second reason while not as important, is that it takes 10-12 months to get back to game readiness. You'll want everyday possible between now and then to rehab and be ready for next season. I know the "politically correct" answer would be to miss as little of school as possible and in a perfect world that is what you'd shoot for. But your son is already missing a year of ball and I'm sure he doesn't want to miss a chunk of next season as well rehabbing because he took 6-8 weeks to have the surgery over spring break which pushed his rehab schedule well into the season. I know that isn't the supposed "right way" to look at it but I think as a student athlete it is a realistic way to look at it. Just my opinion is all.

I hope it all works out well for your son!!! I would think touching base with the coach and his staff would be a good idea. Rehab starts within the first couple of weeks so the training staff there at the school should be able to assist with that. I would think an email to the coach asking if he thinks a sit down meeting would be a good idea or not would not be a bad idea. Mind you son is only in high school but we've kept him on the loop since day 1. And the school trainer is assisting my son with his limited rehab each day after school. so the school is involved with the process.

Redsox,

Thank you for the good wishes. I too would like to have the surgery as soon as possible. His appointment with the surgeon is on the 13th. We won't know until then how soon the surgery can be scheduled. I guess we are at the mercy of the doctor's schedule. My son is adamant that he will only miss one season. He is determined to be back for next season.

I did email the coach after son told him about the injury. He had been texting the coaches to keep them informed, so it wasn't a total shock to them.

Please keep up the posts with your son's progress. I wish the best for him and hope he has a successful recovery.

I made the suggestion regarding surgery spring break, because I thought that most are returning to school and isn't going to classes what it is all about, in the end, their education? This can also be a great opportunity to take summer classes and concentrate on school.
He won't have to miss another season, but chances are next season regardless he will NOT have a full load. I am not sure that people understand that this is a very long process, and even after surgery, it takes a LONG time to recover accuracy on the mound. Plus it will be his first season of college pitching. Summer 12 should be the goal for getting on the mound and really grinding it out, but then he can have lots of credits under his belt and paid for (depending on the scholarship).
JMO, true it has to be done, I would think that you would discuss the option with the coaches as to when they feel it would be best, depending classes, etc.

quote:

Originally posted by TPM:
isn't going to classes what it is all about, in the end, their education?

Absolutely!

So it's a moot point at this time. Doctor does not want to operate until he rehabs for six weeks, says there's a 50/50 chance it will heal on its own. Anyone out there have success with this method?

I would be surprised if it "heals itself." Ligament has a very small healing chance. And with it being a "complete tear" I would all but rule out it healing itself. On the other hand, the surgeon may be waiting for the bone bruise and tendon damage to possibly heal first...

I would say at this point you have two choices: follow this surgeon's plan or get another surgeon to take a look.

Good luck.

we were told that a significant or full tear would more than likely not ever heal enough to pitch, but being that he was 18 the doctor said he would understand and do what ever he could if we wanted to try 6 months rest and rehab first...also mentioned PRP therapy but said he had not really had any success with it on the UCL. We decided on surgery and after surgery was finished he told us we made the right choice because it was completley torn and never would have healed enough on its on for him to pitch competitively in college.

by the way the it seems the Yankees have just signed Soriano who is a member or the TJ club since 2004.

OHBBmom

We went through that with my son. Surgeon wanted to see if rehab would help before doing the surgery. This is when we found out how weak his shoulder really was and that it likely helped lead to his breakdown. The 6 weeks of rehab did strengthen his shoulder but did nothing for his UCL. After the surgery it was apparent that all the rehab in the world wouldn't have helped as it was torn in two places. The only good is the shoulder was stronger going into the surgery then it would have been.

Red,
It's funny you mention the weakness in the shoulder. My son is a college senior. Because of where he's at school, he is very, very strong and in great shape. When the Mets team Dr. saw him, he said the decelerator muscles in his back, behind his shoulder, were exceptionally weak for a person of his size and velocity and quite likely contributed significantly to his problem.

So, even as a senior, with three years of hard work underneath his belt, there can be deficiencies in training and preparation.

quote:

Originally posted by OH BBMom:
So it's a moot point at this time. Doctor does not want to operate until he rehabs for six weeks, says there's a 50/50 chance it will heal on its own. Anyone out there have success with this method?

Who is assuming responsibility for injury? School?
If this is under your private insurance it could be a protocol they require to consider operation, as TJS may not be considered necessary. If the school were handling it, they's get it done.

Just a thought as to why he wants to rehab other than what bulldog has suggested.

quote:

Who is assuming responsibility for injury? School?
If this is under your private insurance it could be a protocol they require to consider operation, as TJS may not be considered necessary. If the school were handling it, they's get it done.

Just a thought as to why he wants to rehab other than what bulldog has suggested.

That's something to think about too TPM! I hadn't really, but it's possible that your personal insurance won't cover it. If the injury occurred during a school practice, it's possible that the athletic department's insurance may cover it. The thing is that at least where I went to school, the athletic department's insurance was secondary. It did not kick in until the athlete's personal insurance made payment.

If this is the case, have the kid talk to the team's athletic trainer. S/he would know how to go through that whole process...

Sorry I haven't responded in a while, I've been a little under the weather.

I also misunderstood what we had been told about our son's elbow. (I hear good pain meds will do that.) Evidently, the plan is to rehab for 6 weeks. Because the doc will be at spring training in 6 weeks, and son's team will be in Fla., they are going to go a little longer with the rehab. If the rehab goes OK, son will start a throwing program, possibly leading to pitching this season. My first reaction was, "What?!?" My son latched on to this right away, because in his mind it gives him a chance to play this year. Doctor said that dozens and dozens of ML pitchers pitch without a UCL. Anyone else ever heard of this?

BTW, whenever we got back to school, son found out that he had made the 25 man roster for the #1 ranked DIII. Not too bad for a freshman.

Interesting thread. My 15 year old son goes under the knife wednesday morning for his torn UCL. The UCL is all but totally gone and the previous two orthopedists both diagnosed "tendonitis". He is a sophomore so he will miss this season and the summer but it would have been worse had it torn next year.

His problem was lack of development in the shoulder muscles, tiring out and dropping his arm, etc. Number of innings and pitch counts were never an issue. He is 6'4" and still growing so I wonder if that had anything to do with it as well.

Anyway best of luck to all the players undergoing this procedure and parents, be sure to get multiple opinions!

I took my son to his physical therapy appointment yesterday. It was a month and a day (32 days) after his surgery. He has nearly full range of motion in his arm with very little pain left. All the steri-strips have fallen off and the incision is almost totally healed over. He had the deep tissue massage with ultra sound for the first time. They also added 2lb weights to some of the exercises and added bands to some as well. The head therapist was quite pleased with his progress and told him he must be a fast healer...lol. I told him he's had a lot of practice healing over the years . He goes back in two weeks and likely will lose the brace at that time if all goes well. I know it is extremely early in the whole rehab schedule but it is nice to see he is right on schedule!!

DPelite99

sorry to hear about your son's upcoming surgery tomorrow!! I hope it goes smoothly for him!
Your situation sounds eerily similar to my son's right down to the age, although my son is an inch or so shorter..lol.

Good luck with it and keep us posted.

Here is an update on my son's treatment.

His rehab was going so well that the trainer called the doctor and said that son would be able to throw sooner than expected. He has had no pain at all with rehab. He will be allowed to begin a throwing program on 2/11. If all goes well, he will be able to pitch by the end of the program. Not sure yet how long that will be. I guess we will know in a few weeks what will happen this year.

Redsox and OH BBmom,

It's very good hearing about the fast recovery for both your sons. I know inside the emotions and hope that you have for your sons, and the roller coaster you all have been on during this time.

I suppose the one thing that has always been said on here about post-TJS is to not rush getting back. It could be detrimental. I'm sure you both already know this.

Best wishes to you and your sons over these next few weeks and months.

YGD

Well I took my son to see the Physical Therapist yesterday. He is at 6 1/2 weeks post-op. Therapist was impressed with son's recovery to date. The brace is gone now, no need for it. son has full range of motion with just a hint of discomfort when he bends the arm to touch the back of his shoulder. This is common and due to the slight swelling still in the elbow. We are now in the first "boring stage" (PT's words) as it is another 8 weeks or so of doing light rehab (bands, 1 and 2 lb weights on some exercises)before considering the throwing program. We knew that was the schedule and that even if the wound is healing well outside it will still take some time for the inside to heal well. Now it is time to get the arm, shoulder, wrist etc... prepared to support the elbow when it is time for the throwing program. Son was happy to lose the brace and looks forward to putting in the work to be ready for the next phase in two months. We don't go back for another 4 weeks now. Tomorrow is the follow up with the surgeon and hopefully he too will be pleased with the progress. so far so good

One good thing has come from all this it seems. School coaches are pushing proper arm care. Son went to the team workout over the weekend at the indoor facility and before anyone could take time on the mound they had to warm up using the bands and doing several of the throwers 10 exercises to properly warm up. Made son feel good that maybe his set back will be used to make sure others don't follow in his footsteps! In prior years there was no set warm up procedures..you did your own thing if anything more then throwing the ball around some before taking the mound. Nice to see that the coaches are being more proactive.

My son is now nearing the 7 month mark post TJ surgery. So far other than alittle feeling of weakness he says his arm feels good and better each time he throws and is now throwing from 110 to 150ft. He is justabout ready to throw off the mound at 1/2 to 3/4 speed at 45 and 60 ft. 1st week says 30 throws at 45 ft then 10 throw at 60 ft. Does anyone have any advice or experience they would like to share about this stage of the rehab?

To the TJ patients,

After 10 months and 15 days, son was able to jog back out to the mound and get an inning in against the Houston Cougars. While I would love to report a three up three down all on K's, in reality, he has a lot more work to do to get back to where he was, but just seeing him out there able to compete after all the hard work was a blessing. At this point (coaches might disagree ), results are irrelevant, progression and remaining healthy are the goals for the foreseeable future. While son admitted that it was/is a bit awkward, and location was probably the most difficult part, he was thrilled to be able to get back out there. Today son states arm is sore, but nothing unusual. Hopefully with continued hard work and some good luck along the way, the progression and health will continue. Good luck to all who are or will be going through the process.
As for the results:
1 inning
1 hit
1 walk
1 K
1 run

It was a fantastic feeling!

Danny,

That is awesome news!! 10 1/2 months is pretty good time in getting back on the mound. Hopefully the feel for pitching comes back to him. Just getting back out there must have been a scary yet awesome feeling for him...and you too!

You hear of many who have....did he pick up any velocity after the surgery?

son is a long way away from taking a mound again...he is doing well but is only 8 1/2 weeks post surgery. Just doing the rehab till he can touch a ball again likely in April or early May.

I hope Adam has a great season..we will be watching from afar here in NH.

quote:

Originally posted by Danny Boydston:
To the TJ patients,

After 10 months and 15 days, son was able to jog back out to the mound and get an inning in against the Houston Cougars. While I would love to report a three up three down all on K's, in reality, he has a lot more work to do to get back to where he was, but just seeing him out there able to compete after all the hard work was a blessing. At this point (coaches might disagree ), results are irrelevant, progression and remaining healthy are the goals for the foreseeable future. While son admitted that it was/is a bit awkward, and location was probably the most difficult part, he was thrilled to be able to get back out there. Today son states arm is sore, but nothing unusual. Hopefully with continued hard work and some good luck along the way, the progression and health will continue. Good luck to all who are or will be going through the process.
As for the results:
1 inning
1 hit
1 walk
1 K
1 run

It was a fantastic feeling!

Congratulations. Heres to continued succuss and good health. Keep us posted.

Thanks redsox and hisbiggest.

As you know, it's a long and hard journey for both the parents and the player. We have been fortunate to have a smooth rehab (knock on wood), and hopefully with more encouraging news right around the corner, the excitement and fun has returned for us and the lefty.

Again, thank you both for your comments and well wishes!!

Danny

son is at 7 months post op now and worked off the mound for the 1st time yesterday....stretched out with some long toss to warm up and then threw off the mound 30 pitches at 45ft and 10 at 60ft at 50% or so. Told me today no soreness at alland he will get another session in tomorrow before the pitching coach leaves with the team for their weekend games. Was wondering if anyone at this point got a biomachanical evaluation when they started to throw again or have any other tips or suggestions for this stage?

Fan,

finally throwing off the mound...even for 10 pitches he must have been pumped! glad to hear no pain from it!!

I wonder about the bio mechanical evaluation as well. As no one really noticed a problem with son's mechanics last year prior to the injury, it makes me leery to go right back to those mechanics without having them checked out. Does one coming back from TJ usually have his mechanics looked at by a 3rd party if you will to look for issues..obviously the surgeon or Physical therapist won't have the answers. I'm interested in others opinions.

hisbiggestfan:

Send me an email & I will try to suggest
a few throwing programs to consider.

Your son is near a 12 day throwing cycle
(2 days on, 1 day off and repeat 4x)

SENT!

Son is 3 months post-op as of yesterday. Still doing his rehab as instructed. We head back down to Boston for the visit with the Physical Therapist on the 4th. Hoping to find out when the throwing program starts up at that time.

Baseball season started on Monday (tryouts) up here in NH. Son went to all three for Varsity as if he was healthy. While he obviously could not participate he assisted in shagging balls, doing soft toss with his right (off) hand and other things to just help out. He will now do his rehab during practice time with the team and sit close to the coaches on the bench during games and get to learn the game from a different perspective. It is killing him not being able to participate though...lol. He can't wait for March 2012!!

quote:

Originally posted by hisbiggestfan:
SENT!

Please send me your email (vs a PM)

To all,

Long time stalker of this site, 1st time contributor. My son had TJ on 1/21, and I have been following all the comments here about different stages of recovery etc. Want to thank you all for your comments. Parallelling my son's recovery with others described here is making me feel a bit better about the whole ordeal. Slow at first, the monotony of rehab, dealing with the starting of a season without them playing....it is frustrating, but part of the process if our kids want to continue playing. My son is a hs soph, so better this year than the next 2, but is there ever a good time? Anyways, I want to personally thank all the contributors on here, for giving me an insight i might not have otherwise had. It is much appreciated!

bigmacsx4,

Welcome to the boards! Too bad your first post had to include your son having had TJ. But you are correct that if you had to lose a season in high school the sophomore season is probably the best. At least that is what my son and I like to say..lol.

Son is in his 14th week post-op and we go back to the physical therapist on Monday. Hoping we can see that start of the throwing program in the not too distant future. All depends on his strength test for his shoulder. Not sure about your case but the more we reflect the more it seems to have been a combination of a very weak shoulder and trying to impress too much by throwing too often at max effort. Live and learn I guess.

Did they re-route the ulnar nerve when they did the surgery? Just curious as I had read that in the East that is normal to do it while in there but out west it was not the norm.

Hope everyone who is in the different stages of rehab from Tommy John are doing well and on the road to coming back stronger then ever!!

I have one of my athletes who is currently in the beginning stages here. She heard/felt a "pop" while stretching about 10 days ago. She is a high school softball player. I evaluated her the day after the incident I believe and my evaluation concluded that she had sprained her ulnar collateral ligament. We won't really know the extent of the damage until the results from the MRI come back. She got the MRI done on Tuesday.

I realize it's quite nerve-wracking for parents waiting on the results of their kid's MRIs and such. I didn't realize it'd be nerve-wracking for me as a healthcare professional to wait on these kinds of things. But I am anxious to find out the results just as much as others would be. Part of that is that I have a certain amount of credibility riding on these results. It was my evaluation that has led to the MRI and I would be upset if I was completely wrong. But I guess that's why we have the technology-- to confirm or rule out the results a clinician is able to get using his/her hands...

Went to the physical therapist yesterday for a check up. The good news is the elbow is doing fantastic and the nerve seems to be settling in nicely. His shoulder is still a bit weak and seeing that he really won't be competing again till next March he decided it was best to do another month of just rehab to strengthen that shoulder even more before starting the throwing program. He said that if we didn't know about the shoulder weakness coming in that he would have cleared him no problem to start the throwing but where we do know how weak his shoulder was and that it likely played a big part in the injury in the first place it was better to err on the side of caution and really get it strong prior to starting throwing. Son was a bit bummed but understood he had the time to do so and he certainly doesn't want to go through this again or worse a shoulder injury. So another 4 weeks of rehab and we go back on the 29th at which time he should be cleared to throw.

Redsox8191, yes, a weak shoulder, according to the surgeon, was definitley a major contributing factor in the elbow injury. I noticed during that game he had "dropped down" a bit, and was probably throwing harder than he ever had right before the injury.

He is now almost 3 months from surgery. Dr appt 2 days ago, now he starts working on shoulder and core strength. These parameters must be met before he starts soft toss, hopefully in a couple more weeks. That would put him on week 14, which from what I have been told is normal.

One comment I do have, get a 2nd opinion! We went to two highly recommended surgeons... see my comments:

Surgeon#1---After looking at the MRI, torn UCL on the back side (no percentage, full or partial?). What caused the problem? No ivestigation. No other testing. Let's get surgery scheduled, pull a tendon from the hamstring and get it done.

Surgeon# 2---After looking at the MRI, torn UCL on the back side. 100% tear. What caused this problem? Time for a shoulder test......weak right shoulder (big, strong kid, also qb for football team), but, we need to rehab the shoulder, get it right, shoulder and elbow mechanics, along with core strength. 1st part, repair UCL with tendon from same arm....less down time, if tendon available, than rehabbing 2 different body parts. 2nd part, what caused the stress on the elbow in the first place, and how do we remedy that defect? 3rd part, how do we tie surgery, rehab, and expectations together?

My personal thanks to Dr Trey Green, University of Washington Sports Medicine, for the surgery and aftercare you are providing to my youngest son. Also thank you for the diagnostics for my 2nd son, who, after 2 years of D-1 college ball, decided against TJ surgery and will now work towards his degree. Your professionalism, understanding and compassion are to be commended.

Thank you, and I hope this helps anyone who needs some info.

If anyone in my neck of the woods, should, God forbid, know of anyone needing this type of surgery, I would personally recommend Dr Green.

son saw doctor today he is 10 and a half months post TJ surgery and after a little setback is now clear to start throwing all breaking pitches. Doc also said to start cranking up the fast ball and wants him to start breaking pitches at low effort and progress to normal effort as he gets the feel for each pitch. Says he should be pitching to live batters in 4-6 weeks. Crossing my fingers for no more set backs!

hisbiggestfan,

That is awesome news!!! hope the setbacks are behind him and he keeps progressing!!

Son is STILL in a holding pattern...working on his shoulder strength. Still not at an optimum level and they don't want to proceed forward till it is 100% ready to go. As far as the elbow goes the surgery was excellent and it seems to be in great shape. Goes back next week and praying we get to start the throwing program! Been 5 1/2 months post surgery so really itching to get going...lol. His HS team is in the semi finals and it is killing him not being able to compete with his teammates!

FINALLY he can start his throwing program!!! Went to the Physical Therapist and finally past all his shoulder strength tests. Been 24 weeks post surgery. Elbow has been ready for sometime but the shoulder was still too weak. Now that the shoulder is strong he can start throwing. Typical program to start I believe. 20 throws with an arc from 45ft a short rest and then 10 tosses from 60ft with an arc. He has been cleared to do everything but throw a baseball hard on a line. He is excited to have moved on to this next step, as is his dad I might add!

quote:

Originally posted by hisbiggestfan:

YAY! Good luck with this next step. He is on his way back..time will go alittle faster now as he moves into the throwing program.

Saw a kid from my local high school pitched in the 3rd place game at state this weekend... he had Tommy John in June of last year. He pitched a total of 3 innings all year and 2 of them came in his start on Saturday. He missed most of the season due to trying to rush back. TAKE YOUR TIME.

There is no issue with rushing. He won't pitch competitively until next March. That is the goal...to take our time and have him ready for tryouts in March. That is 9 months away. so plenty of time to do it right.

He will start throwing for the next 6 - 8 weeks and then shut it down for a month (happens to be going away for the month...so worked out well) He will be checked after that month and if his shoulder is still stable and the elbow is still doing awesome, he will fire up the throwing program for good and progress from there till throwing full bullpens with no restrictions by March 2012.

They have handled him with kid gloves from the start, they won't change that now.

Just a relief that he can begin throwing again. Looking forward to playing catch tonight...even if only 30 tosses!

Well son is up to throwing at 75'. We start out at 20 tosses at 45' and then 10 tosses at 60'. We break for 5 or 10 minutes (I forget how long..he tracks it) and then 10 more tosses at 75'. when we were throwing on Monday he was saying how good it felt to actually throw the ball without any pain or discomfort in the elbow. He feels strong which is good but is doing the right thing and keeping it light for now. No need to push it now. We go back to see the Therapist on Monday to make sure everything is going well. Continues his band and weight work on the off days. Shoulder feels strong now too. Then again it should as we are taking the ultra slow approach here..just started throwing program at about 6 months post op.

hope everyone else who is in recovery or just coming out of recovery is doing well!!

Sucked to hear on the new broadcast that "JH" from here needs Tommy John himself.

redsox,

Pleased to see your son is throwing again. My 2013 has been given the OK for light pitching from the mound. HS coach is putting him on the team and he will maybe see an inning or two before the end of Fall.

Still have his trainer, HS Coach, Surgeon and his pitching coach all talking and keeping each other apprised. If you can get a "team" approach like that I would advise it. We dodged a bullet last week when his travel coach wanted him to start too early. Focus is on varisty for the spring.

Good Luck with the continued rehab!

Well here is an update...

Son went away for the month of August so we shut down the throwing. Went to see the therapist on Monday and his shoulder is still not where he'd like to see it. The smaller muscles are still too weak. I have been trying to back off and let son take ownership of his rehab work but obviously that isn't working (dang ADD gets in the way.. ) so I am now assisting him manage his rehab for the time being. He was rushing through his workouts and using poor form which led to the large muscles taking over. those muscles are fine...the elbow is fantastic..it is the smaller shoulder/arm ones that still need the work. so I re-arranged my schedule (divorced parents) so I have him M/W/F. We are restarting his throwing program at week 3 (up to 75ft) and afterwards we go and do his workouts. Therapist showed me what to look for in regards to his form etc. So hopefully at the next appointment there will be an improvement. We shall see!!! Still have plenty of time till end of March and the start of the season. but we are losing the ability to throw outside fast!


DPELite99,

glad to hear things are going well for your son!! Hopefully by March both of our boys are ready to conquer the season!!!

New Update!!

Since son's last visit we really concentrated on doing the exercises with proper form and it has really paid off. He is a lot stronger and working the proper smaller muscles. His left shoulder is now about 95% as strong as his right. Should be at 100% by next visit in 6 weeks. We had also been doing the long toss part of the throwing rehab and were up to 110ft. No issues and he feels really strong. I on the other hand need a shoulder replacement I think...my arm is now officially a rag..lol.

After the excellent visit with the PT we are now cleared to FINALLY add flat ground work for the next 3 weeks and then MOUND work for the following 3 weeks. Just fast balls at 70-80% effort. First round was last evening and he did great and was excited. Asked him on a scale of 1-10 how excited and he said 8...was saving 10 for the mound work...lol.

So it has been a little over 9 months post-op and we are finally seeing a light at the end of this long tunnel. When we go back in 6 weeks they will shut him down for 2-4 weeks and work backwards from the start of our HS season here in NH (around March 21st) to get him prepared for the season. Want to rest his arm some before that starts.

So looking forward to 2012!!!!

quote:

Originally posted by redsox8191:

I on the other hand need a shoulder replacement I think...my arm is now officially a rag..lol.

If you want to save "your" arm, have your son throw out of a bucket and you just catch. No need to kill your arm, especially at longer distance. Lots of experience with this from catching my sons long tosses.

Great to hear your son is on the road to recovery!

Well for the first time in about 14 months my son pitched off of a mound (10 1/2 months post op) Wednesday evening. He was nervous even though he had had no set backs during long toss or flat ground work. He got on the hill and threw....and felt awesome! Nice easy mechanics throwing at about 75% or so and popping the glove. He was throwing about as hard as he was when he injured the elbow. Had a catcher there from Fresno State who offered to catch him for me (thankfully...getting old and eyes aren't so good..lol) and he was impressed by what he saw. His control was surprisingly good and his fastball still had its normal movement. Needless to say it was a very exciting day for him and me! We throw one more time on Sunday and then see the PT next week to discuss a shutdown period for rest and then the plan to have him ready to go in mid March for the start of his baseball season.

Been a lot of hard work and a few set backs with shoulder strength but we can finally see the light at the end of the tunnel!!!!

It's great to hear the news. That's a long road he's traveled good luck to both of you on the rest of the journey!

All,
Some of you may or may not know about the passing of the gentleman that started this thread about his son's Tommy John surgery, "redsox8191." His real name is Mark Robert and he resided in Nashua NH. I also live in NH and although never met Mark in person, we were introduced through this website in the Northeast forum.

Mark was aware that my son had played on a summer team that helped him get a D1 scholarship. He so much wanted for his rehabbing son Mike to have the same fate. I helped put Mark and his son in touch with the program director and Mike was picked for their U17 team.

We would continue to swap emails and update each other on our son's progress. My son is in his Senior year of High School, and Mike is in his Junior year.

The irony of all ironies is that I had intended to reach out to Mark last Monday. My son heard the dreaded pop and needs Tommy John surgery. I wanted to learn from his experience and was unaware until today that he did a great job of documenting it here.

When I logged into the Northeast forum to contact Mark, somebody had just posted his obituary...Mark died on April 30th after a very brief battle with cancer.

If one thing was clear about Mark it was his dedication and love for his son and the game of baseball. That is something I think all of us on this site can relate to.

My son is going to have his surgery done by the same surgeon that did Mark's boy's on May 31st. Thanks to Mark's documentation, he's given me a local blueprint to follow. I truly hope that Mike Robert fulfills his Dad's dream as I trust Mike is watching his progress from a higher view.

http://www.nashuatelegraph.com.../mark-a.-robert.html

LJ Sandwich, thanks for sharing this story. It puts things in proper perspective about how fleeting life is. Good luck to you and your son.

I am speechless and very sad, I did correspond several pm's with Mark before and after his son's surgery.

His last post was at the end of March. My sincere condolences to his family and friends.

Could you be so kind as to post this in general forum, he was a regular contributor to the HSBBW.

quote:

Originally posted by TPM:
I am speechless and very sad, I did correspond several pm's with Mark before and after his son's surgery.

His last post was at the end of March. My sincere condolences to his family and friends.

Could you be so kind as to post this in general forum, he was a regular contributor to the HSBBW.

I'd be happy to.