Jock Doc

When a baseball pitcher tears this ligament, it usually means ‘Tommy John’ surgery

Q. My son is a high school senior and a pitcher who has had a sore elbow for the last six weeks. He has pain on the inside part of his elbow when he throws and he has lost at least 10 mph on his fastball. He was referred to an orthopedic surgeon, who ordered an MRI that showed a high grade partial tear of his UCL. The doctor told him to rest his arm and do physical therapy. My son wants to know whether he can pitch again this season and will he have trouble pitching in college?

A. The UCL (ulnar collateral ligament) is a major stabilizer of the elbow in the throwing athlete. It is also known as the “Tommy John” ligament after the famous baseball pitcher who had one of the first successful surgeries to reconstruct this ligament.

The UCL can tear from an acute event or be injured over time from chronic repetitive stresses. Most elite pitchers with an UCL tear of this magnitude will need reconstructive elbow surgery to return to pitching at a competitive level. The success rate for this surgery is usually good but it requires a year post op to return to pitching. If your son wants to pitch in college, I recommend you return to your orthopedic surgeon for further evaluation and discussion. Depending upon the recommendations, you may want to consider a second opinion.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to