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Are There Nonsurgical Alternatives for Tommy John Surgery?

Are There Nonsurgical Alternatives for Tommy John Surgery?

If you hang around a bullpen long enough, you’re likely to hear a story or two about Tommy John surgery, which is the go-to procedure for pitchers who’ve injured their ulnar collateral ligaments (UCLs).

If you find yourself dealing with elbow pain because of UCL damage, you’re wondering whether you can add to the overall Tommy John conversation or whether there’s another way. 

The answer to this is complex and depends upon a lot of factors. Below, Dr. Marc Pietropaoli and the team here at Victory Sports Medicine & Orthopedics review what we’re up against with UCL damage and your treatment options. Spoiler alert — it’s not always Tommy John surgery.

A brief look at elbow anatomy

Let’s start with a basic anatomy review, which helps provide some good background information.

Your elbows are joints where three bones come together, including your:

  1. Humerus (upper arm)
  2. Radius (forearm)
  3. Ulna (forearm)

Keeping three bones connected falls to various ligaments in your elbow, including your ulnar collateral ligament, which is located toward the inside of your elbow.

Evaluating the damage

When you injure your UCL, our first step is to evaluate the degree of the damage, which can be divided into three grades:

As you can imagine, figuring out the extent of the damage will dictate your treatment options moving forward.

Your options for UCL damage

Most UCL injuries are due to repetitive use, so it’s progressive, and catching the problem in the early stages is extremely helpful. If your UCL injury is a grade 1 or grade 2, the odds are very good that we can treat the problem nonsurgically using cold laser therapy and biologics like platelet-rich plasma (PRP) and/or bone marrow aspirate cells (BMAC) injections.

The cold laser is great for encouraging the soft tissue to heal, and we boost this by adding regenerative resources through PRP and BMAC injections.

Another important component is the work you do through physical therapy to strengthen your elbow and maintain flexibility and range of motion.

If your UCL tear is complete, meaning it’s detached from the bone, this damage won’t usually heal on its own, no matter how much time you give it. In these cases, having us reattach the ligament to the bone surgically is a good call.

Through Tommy John surgery, we reconstruct the ligament using a graft (usually from your own body). Our patients who opt for this procedure haven’t responded to conservative measures or need the strength back in their elbows, like athletes.

It would be impossible for us to say here what’s best for your UCL injury, so we invite you to call our office in Skaneateles, New York, at 315-303-8352 or book an appointment with us online.

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