REHAB PROTOCOL · ELBOW

UCL Reconstruction (Tommy John) Rehab Protocol

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The written protocol Dr. Kelly provides to his patients and their physical therapists in the Tri-Cities. Time frames are guidelines — progression is criteria-based, and your own post-op instructions always govern.

⬇ Printable protocol (PDF)Request an appointment →

Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team's directions. In an emergency, call 911.

0–4 Weeks

PROTECT THE GRAFT

Week 4

MOTION & STRENGTH

9–12 Months

RETURN TO THROWING

0–4 WeeksPROTECT THE GRAFT

•Posterior mold splint and sling until first post-op visit; splint removed and use hinged elbow brace for weeks 2–4
•Brace at 15° extension to full flexion; may begin grip strength in brace
•PT begins after splint is removed; PROM full flexion to 15 deg extension

GOALS Brace per protocol

Week 4MOTION & STRENGTH

•Discontinue brace; PROM into AAROM and AROM at elbow and shoulder as tolerated
•Begin strengthening exercises for wrist forearm, elbow and shoulder
•No aggressive weightlifting until 12 weeks post operatively; no chest flies or lifts stressing ligament
•Avoid valgus stress on elbow until 2 months post operatively; total body conditioning / aerobic training may begin
•Begin Throwers 10 week 8; 5 Months:; may begin interval-throwing program progressing from 45ft. up to 180ft.
•Pitchers are not asked to throw past 120ft., infielders not past 150ft.
•May progress from one distance level to next when following are met:; no pain or stiffness while throwing
•No pain or stiffness after throwing; strength is sufficient throughout the final set with min. fatigue
•Throwing motion is effortless and fundamentally sound; accuracy is consistent and throws are on line
•For pitchers, mound program begins at completion of 120ft. level
•Catcher is initially moved forward, but throwing with pitching motion is reserved for the mound
•No flat ground pitching is allowed

GOALS Thrower's Ten

9–12 MonthsRETURN TO THROWING

•Return to competition is permitted when following conditions are met:
•Trunk, scapula, shoulder and arm muscle strength/balance have returned to normal; no pain while throwing
•Throwing balance, rhythm and coordination have been reestablished

GOALS Interval throwing program

Return to Sport & Discharge Criteria

•Full elbow ROM, strength, and stability
•Interval Throwing Program completed without symptoms before mound work
•Competitive throwing per Dr. Kelly (commonly 9–12 months)

Time frames are guidelines — progress when phase goals are met, per Dr. Kelly and the treating therapist.

When to call

Increasing pain, numbness, redness, drainage from the wound, or fever/chills — call (509) 460-5588. After hours, the answering service can reach Dr. Kelly. If your issue feels emergent, call 911 or go to the nearest emergency department.

Physical therapists

Treating one of Dr. Kelly's patients? Download the printable protocol for your clinic, and call (509) 460-5588 with questions about an individual patient's progression.

⬇ Protocol PDF

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Back on the field starts with a plan.

Fellowship-trained sports medicine care in Kennewick, Richland & Pasco.

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