Tears in the collateral ligament of your elbow can be really painful and debilitating. While these tears sometimes heal on their own with months of physical therapy, cortisone injections, and rest, the prognosis is not that great, and most orthopedic surgeons recommend surgery for this ailment. The surgical approach used is colloquially called Tommy John surgery since it was famously performed on pitcher Tommy John. Its formal name is "ulnar collateral ligament reconstruction." Whatever you prefer to call it, here is what you can expect if you decide to have this surgery.

Preparing for Surgery

These days, Tommy John surgery is almost always performed with a local or regional anesthetic rather than under general anesthesia. In other words, you will be awake, although probably sedated, while the surgery is performed. However, your arm will be numb and you won't feel a thing for hours after the surgery is complete. Because the surgery is done this way, little prep is needed. You can typically eat and drink right up until your procedure. If you are on any blood thinners, such as aspirin, your doctor will probably ask you to stop taking them a few days before the procedure. You will probably also be asked to stop smoking and drinking, as these habits can interfere with the healing process.

Going Through Surgery

Your surgeon will likely make a few small incisions in and around your elbow joint. They'll use these incisions to insert small surgical tools. Once they get a good view of the damaged ligament, they will decide whether to simply suture the affected ligament back together, or whether to do a graft. If a graft is needed, they will remove a small portion of a tendon in your elbow and use that to reconnect your ligament. Once this is finished, they'll remove the tools and stitch your incisions closed.

Recovering From Surgery

After your surgery, you will need to wear an elbow brace to prevent you from over-bending the joint as the ligament begins to heal. You'll keep this brace on for a couple of weeks. During this time, you can also take pain relievers and use ice to alleviate inflammation and pain. Once the brace is removed, you can begin physical therapy. Your physical therapist will slowly, over time, work on increasing your range of motion. Most patients are back to normal activities within about three months. If you are an athlete, you can expect to resume your sport within six months.

Tommy John surgery is a rather common procedure, and most orthopedic surgeons have performed it many times. If you have any worries, your surgeon should be happy to address them so that by the time your surgery arrives, you're feeling more sure of what's to come.

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