(S/P Tommy Johns Surgery) a surgical graft procedure where the ulnar collateral ligament in the medial elbow is replaced with either a tendon from elsewhere in the patient's body (palmaris longus,gracilis, or plantaris) or tendon from a cadaver

Max Protection Phase (1 week)

Mod Protection Phase (4-8 weeks)

Min Protection Phase (9 weeks)

Reduce Symptoms

Posterior splint (20-90)

Progress to hinged brace

Modalities

Cryo

Compression

Exercise

ROM hand and wrist

Isometrics of shoulder/wrist and elbow, excluding shoulder ER

Education

Avoid values stress

No shoulder ER

Ball squeezes

Weighted 4 way wrist

Shoulder ROM

Exercise

Education

Gradual increased in ROM, 20 degrees/week, discontinue hinged brace at week 6

Blackburn exercise without resistance moving towards resistance

By week 6 initiate Thrower's Ten Program

Per protocol possibly move to light resistance/strengthening exercise for the elbow, shoulder, wrist

Scar Tissue Massage

ROM/Stretching elbow, wrist, shoulder

Exercise

Supported Bicep curls

Prone rows

Chair Pressup

Progress Thrower's Ten Program

Diagonal patterns

Increase weight/resistance/reps

Progress pushups

Plyometrics

Soccer Throws

Rebounder

Sport specific training

Throwing drills

Tennis serves

Medicine ball