Years ago if a thrower tore their UCL it was the end of their career. However, Dr. Frank Jobe invented an operation that rebuilt the torn ligament by replacing it with a tendon from the forearm. It worked, and has become a well-known surgery among pitchers. The technique has been refined, but the principle has remained the same—a tendon is woven back and forth between the bones (ulna and humerus) of the elbow to fabricate a new ligament. This is not an arthroscopy surgery, but rather an open surgery. Over the years the incision has become smaller.
While all athletes think that they will have fastest recovery ever, the truth is that it takes at least 6 months to resume playing catcher or pitching. There are often setbacks during the journey back to pitching. Many times it takes a full year to return to the pre-injury level of competition. This is because it takes time to build arm strength after so much time off, plus the ligament must continue to mature. Remember, the forces on the UCL while throwing are among the highest ever measured and the ligament and arm must be given ample opportunity to strengthen.In our study of professional baseball players, Dr. Jereb and I found that players who had undergone UCL reconstruction before they were drafted and had recovered enough to get drafted had an 80% chance of playing at least 4 years of professional baseball without serious elbow problems. Another study showed that a high school pitcher has about a 70 – 75% chance of returning to that level of baseball after UCL reconstruction, and major league players had a >80% chance of returning to major league ball after this surgery. Though the recovery time remains long, this is quite an improvement compared to the days before Dr. Jobe invented this surgery. What used to be a career-ending injury is now usually a repairable injury. There seems to be a correlation between throwing curveballs and sliders at a young age (under 14 yrs) and the later need for UCL reconstruction. For years leading baseball doctors have recommended against throwing breaking pitches during the peak growth years, and now there are some studies that strongly support this (Andrews J, AJSM 2004; Chandler J, Professional Baseball Athletic Trainers Society Proceedings 2004). In essence, if your pitchers are throwing curveballs and/or sliders at 12 and 13 yrs of age, they have a higher chance of needing major elbow reconstructive surgery when they are in high school.
For more information, contact Dr. David Lintner in Houston at 713.986.5560. Also, on Dr. Lintner’s website you can find detailed information regarding the postoperative rehabilitation after UCL reconstruction.