6 Keys to a Successful Tommy John Rehab

Baseball pitchers have a higher risk than ever to sustain an elbow injury leading to the need for Tommy John surgery. In one recent study, between 2002-2011 the rate of Tommy John surgeries tripled. While having a successful Tommy John surgery is important, more crucial is a thorough plan for a successful Tommy John rehab.

We have discussed in the past the importance of having a plan to try to reduce your risk of sustaining an arm injury. In fact, we have a free online mini-course that you can access here to learn everything you need to know about keeping your arm healthy during baseball season.

But, despite everyone’s best efforts, sometimes injuries happen, and we’re here to remind you that rehab is important. If you recently had (or are soon having) Tommy John surgery, here are 6 keys as you approach your rehab:

1. Attention to Detail in the Early Stages

The first few weeks after Tommy John surgery are pretty boring, but really important. You’ll be in a brace that protects the new repair and limits your range of motion. Your elbow will be pretty sore, and you won’t be able to do much. Your physical therapy sessions will be boring but really impactful in the long run. You need to:

• Reduce swelling
• Keep your surgical site clean and dry so you don’t get an infection
• Gradually regain your range of motion
• Get your elbow working like an elbow in your day-to-day life (not working for your sport, quite yet)

It isn’t fancy. These will not be your favorite rehab sessions, and you won’t get a lot of likes on Instagram posts. But, it is crucial to your overall rehab, and it sets the stage for a successful outcome and faster progress when you are ready.

2. Target Your Deficits

Tommy John rehab is a grind, and it’s a long process. People typically say it’s a 12 month recovery, but the MLB average is returning to the mound at 14 months, with some players taking 18+ months.

If all you do is think about your elbow for the next year, you will be bored, frustrated, and you will miss a huge opportunity to improve your body besides your elbow while it heals:

• Do you want to gain weight? 
• Do you need to get stronger or faster?
• How is your thoracic spine or hip mobility?
• How strong is your throwing shoulder?
• How good is your single leg squat?

Rather than looking at the rehab as a setback, look at it as an opportunity to improve. Identify your weaknesses and attack them. The goal is that you never have another lengthy time out of competition, but while you have it, focus on yourself and your own improvement to prevent it from happening again.

3. Build a Team

You need support to get through Tommy John rehab. You can’t do it by yourself and one professional cannot support you by themselves. 

Even if you go to the best surgeon in the world, your outcome won’t be great without a solid rehab program.

The best rehab program won’t help you throw harder if your mechanics suck and put a lot of excess stress on your elbow.

No matter how hard you lift, you need adequate nutrition to reap all the benefits from your workouts.

Your mental health and confidence are crucial to your recovery.

Every athlete is different, but we feel it is important to have a team that could include a surgeon, strength coach, athletic trainer, physical therapist, dietitian, sport psychologist and pitching coach. Each professional has their own role and area of expertise that can best support the athlete as they go through the Tommy John rehab process. 

4. Train Hard!

You had surgery on one limb. You likely have three other limbs that you can train! As soon as the stitches are out and the risk of infection is low, it is time to get after it in the gym.

You may have to modify exercises to protect your elbow, but you can train your legs, improve your conditioning, strengthen your core, and even train your other arm, as 10-15% of your strength improvements in that arm will carry over to your surgical arm! 

This is a great opportunity to build a foundation that can carry you for years. Specifically targeting body composition changes, adding muscle mass, and targeting maximum strength gains can be areas of opportunity during this time frame. You have no competing interests. You don’t have to manage fatigue or soreness because of games or competition. Take advantage of the opportunity and get after it!

5. Build Your Throwing Program with the End in Mind

A common mistake we see in Tommy John rehab is not following a throwing program, or starting a throwing program with no clear goal for a finishing point. For example, in Wisconsin, we wouldn’t want a player to “finish” their mound progression in November. They would be physically ready for competition, but there are no games to be played.  In that situation, we would recommend either starting throwing a little later or slowing down the long toss progression to have them “finish” the mound progression in January or February so they would be ready to start the season with their teammates with no throwing restrictions.

The throwing program is key. It is one of the most important aspects of the Tommy John rehab process and you need to have a solid plan that lines up with your specific baseball schedule. 

6. Find an Outlet

In case I haven’t said it enough, Tommy John rehab is a long, hard process. You will need an outlet. Up until this point, your free time was taken up by baseball, your relationships were with your teammates and your focus and motivation to improve were largely driven by baseball.

You need to shift that focus and motivation to attacking your rehab. However, you will still need an outlet. You need a hobby, something else to look forward to and have fun with throughout the process. Something that you can use to take a break and “unplug” from the daily grind of the rehab. 

This looks different for everyone; we’ve seen players get really into fishing during the summer or dive deep into Pokémon in the winter. Wherever your interests lie, find an outlet for yourself throughout the rehab process. 

If you’d like to learn more about Tommy John rehab from a first hand experience, check out this podcast with Ben Heller, a MLB reliever that returned to The Show after his Tommy John rehab.

If you are a baseball player dealing with an elbow injury or going through Tommy John rehab, learn more about how we help baseball players recover, or reach out to set up a free consult today!