TJ Question

I'm not a Dr., but I would say to get a second opinion. TJ surgery will put your son down for close to a year. Ligaments have no pain receptors, so the pain is coming from something other than his UCL.

He may need surgery, but he also may not. I would definetely get a 2nd opinion before you jump into that.

I thought TJ surgery was tear repair. So, how would that help a 'strain'?

Something doesn't make sense here. I agree with bballman, 2nd opinion.

Go to this link to ask for a referral to a Dr. trained by ASMI. ASMI and Dr. Andrews do pretty close to all the MLB surgeries and are very experienced in this.

http://asmiforum.proboards.com/index.cgi?

Let them know where you live and they will let you know who has been trained by them near you.

Good luck to you.

My son who is a D1 pitcher had a very similar history last year. He has been very meticulous about his arm care since he was a kid so needless to say we were initially shocked when we were told of his injury. He developed acute arm pain after throwing. The initial impression was a UCL strain with no apparent tear or disruption. He did rest and rehab for six weeks, but continued to have discomfort when he resumed throwing. At that point the recommendation was a UCL reconstruction e.g. Tommy John. He is now well into his rehab and should return to pitching early this coming spring. Catching his injury early avoided the additional trauma of a partial or complete tear. His UCL was spared in surgery and the longus was grafted to it. There is data to support the notion that the arm retains motor memory when the UCL is retained, which seems to be the case for him post surgery. We were fortunate to have a very talented surgeon available and he had no complications and very little discomfort post surgery. He says at this point his arm has never felt better. Assuming no unforeseen complications he should return 100%. The good news, relatively speaking, is it is a pretty straight forward procedure as opposed to having a shoulder worked on for example. Nonetheless it still is surgery and complications can occur. Feel free to PM me if you have any questions.

Thanks to all for your replies thus far. We have seen 2 separate orthopedists thus far...sorry if I wasn't clear on that earlier.

bballman - thanks for that link! I hadnt seen that before. I posted a topic looking for a referral.

carmelpitcher - that sounds exactly like what we are going through. Thanks for sharing.

quote:

...There is data to support the notion that the arm retains motor memory when the UCL is retained...

I have never heard of this. Where did you get the study or data (or, perhaps, you can point me to a website). Very interesting.

It's possible the MRI wasn't very clear. They may go into the elbow surgically to get a better idea of what is actually wrong. Or you could have a doctor who is familiar with the elbow trying to read that MRI. Second doctor may be telling you there is more damage done that a "strain" since it hasn't gotten better...

Could also potentially be a tear of the proximal wrist flexor tendons..

Hi BB13

Came across that when I did a literature search prior to my son's procedure. Can't say specifically which article at this point. His surgeon was also aware of it when I brought it up during his pre-surgical consultation.

Cubbie23-

I know exactly how you feel right now. My son was diagnosed with a UCL Sprain during his sophomore year of HS as well. Rest & Rehab was recommended for the six week period and he was able to return to the outfield afterwards, but he still felt discomfort on the mound and did not pitch that season. In fact, the initial diagnosis was made in late January after pitching in a showcase. He didn't pitch in another game until October, nearly nine months later. We probably should have received a second opinion back then........

Fastforward over three years later and my son will be 12 weeks Post-Op UCL reconstructive (TJ) Surgery this Monday. He felt a pop over the summer while pitching for his summer collegiate team. His surgeon suggested that surgery was more than likely needed three years prior when he was sixteen years old (Sophomore Year HS) due to the long recovery period to return to pitching.

Best wishes to your son, I hope everything turns out okay. As carmelpitcher suggested, don't hesitate to PM me either regarding the process early on and what to expect. I've PM'd JH on a few occasions regarding my son and what to expect during the different portions of the recovery period...and I know there are a few others that have had son's go through this recently. Who knows, we may end up with a TJ Fraternity on the HSBaseballWeb!?

Cubbie - 6 weeks with PT should show some improvement the situation if it's s strain. Still I would go for 3rd or 4th opinion before surgery. My son felt the pain when he was 11, but the ortho surgeon said son was lucky as his bone was still soft and gave way to the ligament; shut him down for 6 to 9 months and did an MRI to be sure and he was fine. Catching and pitching is a bad combination. I saw another player who had a year layoff when he was 13/14 year-old due to arm issue, he catch and pitch the same time. For that reason, son just catches may be once a year for an inning or so, just to experience what it is like to be a catcher; he was able to gun down a runner on 2nd base caught stealing in the big field. It was fun but not worth the risk in the long run. Wish your son speedy recovery with or without surgery.

I read these posts and most are eerily similar to our son's scenario. . . especially, for us, your most recent post bsbl247. Our son just had his TJ surgery this past Friday in Cincinnati. The Dr. (Timothy Kremchek) said pretty much exactly what you were told . . . that our son had a "severely injured arm which probably dates back to some HS arm pain he said he had in June 2010" and we can't help but wonder now as we we look back how this all ties together. Cubbie23, he just recently had gone through what you indicated about your son verbatim. He rested his arm, went through a regimented throwing program precisely as outlined and ended up having the exact same sharp pain in elbow upon throwing 120 feet at 70% capacity he had back in the summer which essentially made my son feel like he wasted all the time from when he injured it in mid-July (finished it off is probably more accurate) and his surgery late October. I'm no doctor but I have learned that words like elbow sprain or strain are actually other ways to say torn ligament (at least sprain is). Lastly, we also learned that you can see very good and well respected ortho's who utilize the exact same MRI's, MRA's, X-rays, ultra-sounds, etc. yet can come up with very different courses of treatment or plans of action. Our own experience pretty much ended up quite simply coming down to our son saying "Dad, I know my arm and it's messed up". He told us that after we were told he did not need TJ Surgery when, as we walked to the car and as parents were very happy, that"they're wrong, I know it" but he religiously did what they told him was the route he needed to take (just as he had done the previous TWO other times he had MRI's and all the tests done which also came back indicating he didn't need surgery) and eventually had some sort of episode which triggered another round of MRI's, X-rays, etc. again) until this time when exploratory surgery was in the least suggested and it was only then that it became black and white that he had a complete UCL tear. Dr. Kremchek leaned back during the procedure and looked directly over at us while we were seated in the viewing area (they are set up where you can actually watch the surgery taking place live as well as also see it up close and personal on a TV screen hanging in the viewing room whose camera zooms you right in on the operation as if you were performing some of the required functions of a nurse or assistant) and, at the precise time we were told the day before he would learn of the extent of what the damage - if any - was to our son's elbow "HE WAS RIGHT! YOUR SON WAS SO SURE . . . HE TOLD ME HE KNEW HIS ARM WASN'T RIGHT AND HE PERSISTED AND HE IS NOW VINDICATED. TELL HIM THAT IT WILL BE NOW! I got emotional then and just got emotional now typing that as he WAS right, he DID persist and now he can start the road to being able to see where his dreams can take him again.