Expert Orthopedic Care

UCL Injury & Tommy John Surgery

Comprehensive treatment for Ulnar Collateral Ligament (UCL) injuries. Dr. Daniel Feghhi provides advanced surgical reconstruction (Tommy John surgery) and rehabilitation to help athletes return to competition.

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Board Certified
Fellowship Trained
15+ Years Experience
Applying Ice Pack Gel Against Elbow Pain
Understanding the Condition

What Is a UCL Injury?

The Ulnar Collateral Ligament (UCL) is a crucial ligament on the inner side of the elbow that provides stability during throwing motions.

UCL Function

The UCL resists valgus stress (inward bending) on the elbow, which is especially important during overhead throwing motions in baseball and other sports.

Tommy John Origin

Named after baseball pitcher Tommy John, who was the first to undergo this groundbreaking reconstructive surgery in 1974.

Common in Athletes

Primarily affects baseball pitchers, but also occurs in javelin throwers, quarterbacks, volleyball players, and gymnasts.

Risk Factors for UCL Injuries

High-volume throwing, improper mechanics, inadequate rest, and year-round pitching without rest are major contributors to UCL tears in young athletes.

Recognition & Diagnosis

Symptoms & Diagnosis

Recognizing the signs of a UCL injury early is crucial for successful treatment and return to sport.

Common Symptoms

Inner Elbow Pain

Pain and tenderness on the inner side of the elbow, especially during throwing.

Decreased Throwing Velocity

Noticeable loss in pitch speed or throwing distance.

Elbow Instability

Feeling of looseness or "giving way" in the elbow joint.

Stiffness & Reduced Range of Motion

Difficulty fully extending or bending the elbow.

Numbness or Tingling

Ulnar nerve symptoms radiating into the hand and fingers.

"Popping" Sensation

A distinct "pop" at the time of injury, often accompanied by immediate pain.

Diagnostic Methods

Physical Examination

Dr. Feghhi will perform the "moving valgus stress test" and assess elbow stability, range of motion, and pain points.

X-Rays

Used to rule out fractures, bone spurs, and assess for loose bodies in the elbow.

MRI Scan

Provides detailed images of soft tissues, confirming UCL tears and determining tear location and severity.

Valgus Stress X-Ray

A specialized X-ray that applies stress to the elbow to measure joint laxity and assess ligament integrity.

Treatment Options

Treatment for UCL Injuries

Dr. Feghhi offers comprehensive treatment options from conservative management to advanced Tommy John surgical reconstruction.

Conservative (Non-Surgical) Treatments

Rest & Activity Modification

Complete rest from throwing to allow the ligament to heal naturally.

Anti-inflammatory Medications

NSAIDs to reduce inflammation and manage pain during recovery.

Bracing

A hinged elbow brace to limit valgus stress during healing.

Physical Therapy

Structured rehabilitation to strengthen surrounding muscles and improve mechanics.

Surgical Treatment: Tommy John Surgery

UCL Reconstruction

The classic Tommy John procedure using a graft to reconstruct the damaged UCL.

  • High success rate (85-92%)
  • Uses autograft or allograft
  • Outpatient procedure

UCL Repair

Direct repair of the ligament when the tissue quality is good enough for reattachment.

  • Faster recovery time
  • No graft needed
  • Best for acute tears

Internal Bracing

A newer technique using a suture-button device to augment the repair.

  • Accelerated rehabilitation
  • Stronger initial fixation
  • Less invasive
Recovery Timeline

What to Expect After Surgery

Recovery from Tommy John surgery is a gradual process that requires patience and dedication to the rehabilitation protocol.

1

Weeks 0-4

Protection Phase

  • Full arm immobilization
  • Sling for comfort
  • Wrist/hand exercises
  • Gentle shoulder exercises
  • No elbow motion
2

Weeks 4-8

Early Motion Phase

  • Begin elbow range of motion
  • Remove brace progressively
  • Gentle strengthening
  • Eccentric exercises
  • Modalities for healing
3

Weeks 8-16

Strengthening Phase

  • Progressive strengthening
  • Core and hip mobility
  • Shoulder stabilization
  • Biomechanical analysis
  • Simulated throwing
4

Months 4-12+

Return to Sport

  • Progressive throwing program
  • Pitch count management
  • In-season monitoring
  • Return to competition
  • Continued maintenance

Important Recovery Notes

Full recovery to competitive throwing typically takes 12-18 months. Rushing the process significantly increases the risk of re-injury. Dr. Feghhi will monitor your progress through regular evaluations before clearing you to return to sport.

Common Questions

Frequently Asked Questions

Get answers to the most common questions about UCL injuries and Tommy John surgery.

How long does it take to recover from Tommy John surgery?

Can I pitch again after Tommy John surgery?

What's the difference between UCL reconstruction and repair?

Can UCL injuries be prevented?

What age is most common for UCL injuries?

How do I know if I need surgery?

Ready to Return to the Game?

Don't let a UCL injury end your athletic career. Schedule a consultation with Dr. Daniel Feghhi today and get expert treatment to return to competition.

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Our Locations

Visit Our New Jersey Offices

Dr. Feghhi sees patients at multiple convenient locations throughout New Jersey.

Dover

400 W Blackwell St
Dover, NJ 07801

(973) 328-1200

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East Brunswick

East Brunswick, NJ

(732) 333-8700

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Elizabeth

Elizabeth, NJ

(908) 400-5990

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Hackensack

Hackensack, NJ

(201) 968-0230

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Wayne

Wayne, NJ

(973) 987-3040

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