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Why is it called Tommy John Surgery?

Tommy John is a retired pitcher who played Major League Baseball (MLB) from 1963 to 1989. His MLB career includes playing for the Cleveland Indians, Chicago White Sox, Los Angeles Dodgers, New York Yankees, California Angels and Oakland Athletics. While playing for the Los Angeles Dodgers in 1974, Tommy injured his ulnar collateral ligament and became the first person to undergo ulnar collateral ligament (UCL) reconstruction surgery. When the surgery turned out successful and Tommy John returned to the MLB, the surgery was named after him.

Ulnar Collateral Ligament

The ulnar collateral ligament (UCL) is located on the inside of the elbow and attaches the upper arm (humerus) to the forearm (ulna). It’s one of two ligaments connecting the ulna and radius in the forearm to the humerus in the upper arm. The radial collateral ligament (RCL) and UCL are thick pieces of tissue that connect these bones and run along the inside and outside of the elbow. The UCL is responsible for stabilizing your elbow during a throwing motion and has to be able to withstand a great amount of stress. Repetitive motion can cause deterioration of the ligament, commonly in sports like baseball and javelin throwing.

What causes UCL injury?

The UCL is the major stabilizer of the elbow and repeated motion can cause it to break down and wear away over time. If Tommy John Surgery is recommended, it usually means overuse caused the UCL to fray, tear or become loose. The arm and elbow will not be able to be used without extreme pain if the UCL is loose.

A fall on an outstretched arm can also cause stretching, fraying and small tears in the UCL.



If you are experiencing pain on the inside of your elbow and participate in a sport with a lot of overhead motion, such as baseball, gymnastics or volleyball you may have damaged your UCL. Symptoms of a torn UCL include:

  • Pain on the inside of the elbow
  • Decreased stability
  • Tingling in your ring and pinky
  • Irritation or discomfort of your funny bone (or ulnar nerve)
  • Unable to throw at full ability
  • Swelling on the inside of your elbow
  • Weak hand grip

UCL Reconstruction

Athletes who have an unstable or torn UCL, and who do not respond to nonsurgical treatment, are candidates for surgical ligament reconstruction, or Tommy John Surgery.

Most ligament tears cannot be sutured (stitched) back together. To surgically repair the UCL and restore elbow strength and stability, the ligament must be reconstructed. During the procedure, the Raleigh Orthopaedic elbow surgeon replaces the torn ligament with a tissue graft. This graft acts as scaffolding for a new ligament to grow. In most cases of UCL injury, the ligament can be reconstructed using one of the patient’s own tendons. The graft is then attached to the ulna and the humerus with buttons or screws. To give the grafted tendon extra strength, it is often attached to any remnants left of the original UCL.

If UCL reconstruction is performed, it may take 6 to 9 months or more to return to competitive throwing.

If you’re considering surgery for a UCL injury, schedule an appointment at Raleigh Orthopaedic today to learn more about treatment options and to find out whether you are a good candidate for this type of surgery.


About Raleigh Orthopaedic Surgery Center

Raleigh Orthopaedic Surgery Center is the first and only orthopedic surgery center in the Triangle to specialize exclusively in orthopedic surgery. Raleigh Orthopaedic surgeons are board-certified with advanced training in their respective sub-specialties, performing more than 9,000 outpatient orthopaedic procedures on an annual basis. Click the button below to watch a video and learn more about Raleigh Orthopaedic Surgery Center.With our care, we are with you the entire way and keep you enjoying life even during injury. 

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