TJS rehab

TPM, I can only speak for my son. He had TJ surgery 12/16/15. He threw his first bullpen pitch from the mound on 10/20/16. He was scheduled to throw off the mound a couple weeks earlier but had some setbacks with arm pain so it pushed him out a couple weeks. So in his case, it was almost 10 months to the day. One other issue with him that may have delayed his timing is he had his ulnar nerve transposed 4 months prior to the UCL surgery. I believe he is healing a little slower due to more scar tissue than normal having been opened up twice in 4 months. 

The word "exactly" makes your question problematic.  Just about any milestone in TJ rehabilitation depends on:

a. the rehab protocol set by the doctor - and those protocols do vary depending on the doctor

b. how the patient responds to rehab - a lot of other variables come into play here, including age, whether it's the first TJ or a repeat, overall fitness level, scar tissue development, etc.  In short, throwing off a mound is near the end of the process and there are a lot of potential setbacks along the way.

This is why they tell you that complete recovery generally takes 10-18 months... or longer.

I don't have my son's protocol handy.  I didn't make a copy before he gave it to his team's trainer.  But he started light throwing with a tennis ball at about 10 weeks post-op.  He has another follow-up exam on the 22nd (14 weeks), and if he continues to progress he should be cleared to start throwing a baseball after Thanksgiving (15 - 16 weeks).  Throwing off a mound is still a long way off.

My son's approximate program. He basically had no issues in his rehab.

light tossing began 5 1/2 months after surgery

off the mound 10 months after surgery

Threw to live batters 11 months after surgery.

YMMV

ps: I think that when your surgery takes place would also affect your program. No need to get fully ramped up only shut it down for several months for your off season. in other words, a person that has surgery in December may have a difference schedule than one that had surgery in April or August.

Thanks all.

Mrbumstead, the impression I got was your son would begin the throwing phase a little sooner than I am familiar with, approximately 18+ weeks. 

Also is light throwing post up with a tennis ball the Protocol?

Thanks

10-11 months for mine.  Late July surgery, pitched relief in summer ball.

What were some pitch count limits that were prescribed by Docs for the initial outings/months??  Were they strict or a range or "see how it feels"?

Start with 60-75 and progress to no more than 100 in first season back

no more than 100 innings in first year back, includes Fall, Spring and Summer

I've got 2 kids in our program dealing with this right now. One is about 8 months removed, and one had the surgery a week ago. The one that is farther along is on track to throw his first bullpen at about 10.5 months, simply because that's when the rest of the pitchers start working in January, no point in rushing for no reason. He likely would be ready at 10 months.

He didn't do any work with  a tennis ball fwiw.

One used a tendon from his wrist, the other used a patella tendon. Same doctor. Interested to compare their recoveries with that variable and see if there's a difference. 

TPM posted:

Thanks all.

Mrbumstead, the impression I got was your son would begin the throwing phase a little sooner than I am familiar with, approximately 18+ weeks. 

Also is light throwing post up with a tennis ball the Protocol?

Thanks

As I said, there seems to be a lot of variation in protocols.  His came from Dr. Cain at Andrews.  

I think the calendar may play into his situation as well.  For him, 18 weeks is right before Christmas, while he's home from school for the holidays.  Assuming there's no increased risk involved and Dr. Cain agrees, I think the trainer is wanting him to start throwing under her supervision before he heads home for the break.  The other alternatives are to have him start throwing while he is at home (either alone or under someone else's supervision), or wait another month until he gets back to school after the holidays.

One way or another, this should get ironed out when he goes back to Dr. Cain in a few weeks.

I don't know if the tennis balls are specifically in the protocol.  From what I remember from reading it, the protocol gave more of a framework for the rehab (milestones to be achieved before moving forward, what types of activities and exercises were to be performed, objectives for that segment) rather than a recipe of specific exercises, weights, reps, etc.  (This isn't to say it wasn't detailed.  IIRC it was about 10 pages long.)

From what he described to me, the tennis ball throwing is very short distance and very low velo (basically just tossing it against a wall ~10 feet away), with the objective being to regain the feel of the throwing motion before he actually picks up a baseball.

Speculating here - I think regaining his body control through the throwing motion from the ground up may be one of the trainer's concerns before he picks up a baseball. He's a late bloomer and just turned 18 over the summer. As a result, he has REALLY filled out over the past year.  And since he's 6-7, "really fill out" has equated to gaining 65-70 pounds in a little less than a year.  (Some of that is due to post surgical inactivity before he was cleared to do anything remotely strenuous, including running; but most of it is just his "man muscles" finally showing up.)  I know that gaining that much weight sounds kind of ridiculous.  But that's what happened.  And I don't think Letterman would describe him in the same manner as he did Terry Forster many long years ago. (As it happens, a pretty good picture of my son at a community service project last week appeared on the team web site the other day.  He's the one smack dab in the middle of the photo with all the afternoon glare on the side of his face. http://www.abac.edu/wp-content...2012/11/SUNP0014.jpg)

Balance and body control are common struggles for young, tall pitchers anyway (and has been for him).  Adding 60-70 pounds to that equation compounds that; everything feels different than it did a year ago, and he really didn't have time to completely adjust to it during spring and summer before the injury.  So I think the tennis ball thing may be less about the 15 pounds between his shoulder and fingertips than it is the 245 pounds on the other side of this shoulder.  But like I said, that is just me speculating.

RedFishFool posted:

Start with 60-75 and progress to no more than 100 in first season back

no more than 100 innings in first year back, includes Fall, Spring and Summer

Interesting and thanks for sharing.  That is actually not much more than what a normal pitch limit would be and progress to during the season...maybe 15% below the norm, I would estimate.

MrBumstead posted:

TPM posted:

Thanks all.

Mrbumstead, the impression I got was your son would begin the throwing phase a little sooner than I am familiar with, approximately 18+ weeks. 

Also is light throwing post up with a tennis ball the Protocol?

Thanks

As I said, there seems to be a lot of variation in protocols.  His came from Dr. Cain at Andrews.  

I think the calendar may play into his situation as well.  For him, 18 weeks is right before Christmas, while he's home from school for the holidays.  Assuming there's no increased risk involved and Dr. Cain agrees, I think the trainer is wanting him to start throwing under her supervision before he heads home for the break.  The other alternatives are to have him start throwing while he is at home (either alone or under someone else's supervision), or wait another month until he gets back to school after the holidays.

One way or another, this should get ironed out when he goes back to Dr. Cain in a few weeks.

I don't know if the tennis balls are specifically in the protocol.  From what I remember from reading it, the protocol gave more of a framework for the rehab (milestones to be achieved before moving forward, what types of activities and exercises were to be performed, objectives for that segment) rather than a recipe of specific exercises, weights, reps, etc.  (This isn't to say it wasn't detailed.  IIRC it was about 10 pages long.)

From what he described to me, the tennis ball throwing is very short distance and very low velo (basically just tossing it against a wall ~10 feet away), with the objective being to regain the feel of the throwing motion before he actually picks up a baseball.

Speculating here - I think regaining his body control through the throwing motion from the ground up may be one of the trainer's concerns before he picks up a baseball. He's a late bloomer and just turned 18 over the summer. As a result, he has REALLY filled out over the past year.  And since he's 6-7, "really fill out" has equated to gaining 65-70 pounds in a little less than a year.  (Some of that is due to post surgical inactivity before he was cleared to do anything remotely strenuous, including running; but most of it is just his "man muscles" finally showing up.)  I know that gaining that much weight sounds kind of ridiculous.  But that's what happened.  And I don't think Letterman would describe him in the same manner as he did Terry Forster many long years ago. (As it happens, a pretty good picture of my son at a community service project last week appeared on the team web site the other day.  He's the one smack dab in the middle of the photo with all the afternoon glare on the side of his face.  http://www.abac.edu/wp-content...2012/11/SUNP0014.jpg)

Balance and body control are common struggles for young, tall pitchers anyway (and has been for him).  Adding 60-70 pounds to that equation compounds that; everything feels different than it did a year ago, and he really didn't have time to completely adjust to it during spring and summer before the injury.  So I think the tennis ball thing may be less about the 15 pounds between his shoulder and fingertips than it is the 245 pounds on the other side of this shoulder.  But like I said, that is just me speculating.

Ok, thanks for the explanation.

For my son he first started throwing about 16 weeks after surgery - plan is / was 16 weeks on flat ground. end when he could throw 200 feet on a line. that ended at exactly 16 weeks, then he started throwing off mound - that is 13 weeks and he is ending week 1 this week. The last 3 weeks he can pitch "live" to hitters in a indoor cage (we are in Ohio so that will be the only option). 13 weeks would be end of January. That is about 2 1/2 weeks before season starts, so at that point he will continue to pitch to gain strength, location, velocity, endurance. Supposedly at this moment he should be available for first weekend. He projected as either #1 or 2  starting pitcher at moment and will be on a strict pitch count for a while. No idea what those numbers are as of yet.

He would pitch in his first game action 11.5 month after surgery if all goes according to plan.