Elbow UCL Reconstruction Rehabilitation Program
0-7 DAYS
- Splint is worn for one week.
- No valgus stress to the elbow.
- Full active forearm pronation and supination ROM.
- Full active wrist radial and ulnar deviation ROM. Gentle stretching of wrist and fingers is okay.
- Active and active assistive wrist flexion and extension ROM exercises.
- Full active shoulder ROM – flexion, abduction, internal and external rotation.
1-4 WEEKS
- Discontinue splint at one week.
- Sling may be worn for one more week, if necessary.
- Two weeks post-operation, begin a Total Body Conditioning Program after incision is closed (starting earlier runs the risk of getting perspiration in or on the wound, increasing risk of infection).
- Gradually achieve full elbow ROM.
1-2 MONTHS
- Athlete should have full ROM at the elbow, wrist, forearm, and shoulder.
- One month post-operation, add light weights for resistive elbow and forearm exercises (i.e. elbow flexion and extension, forearm pronation and supination).
2-3 Months
- Continue active, resistive exercises for the entire extremity, including the rotator cuff.
- Continue lower body and trunk conditioning program.
3-4 MONTHS
- If there is no swelling and the athlete has full, pain free elbow ROM at fourteen weeks post-operation, the athlete may begin easy tossing (no wind-up), start with 25-30 throws, building up to 70 throws and gradually increase the throwing distance.
- Note: The Throwing Program is performed 3-4 times per week. Apply ice after each throwing session to help decrease the inflammatory response to microtrauma.
# of THROWS |
DISTANCE (ft) |
20 |
20 (warm-up phase) |
25-40 |
30-40 |
10 |
20 (cool down phase) |
4-5 MONTHS
Continue the Throwing Program by tossing the ball with an easy windup on alternate days.
# of THROWS |
DISTANCE (ft) |
10 |
20 (warm-up phase) |
10 |
30-40 |
30-40 |
50 |
10 |
20-30 (cool down phase) |
5-6 MONTHS
Continue increasing the throwing distance to a maximum of 60 feet.
Continue tossing the ball with an occasional throw at no more than half speed.
# of THROWS |
DISTANCE (ft) |
10 |
30 (warm-up phase) |
10 |
40-45 |
30-40 |
60-70 |
10 |
30 (cool down phase) |
6-7 MONTHS
During this step, gradually increase the distance to 150 feet maximum.
Phase 1
# of THROWS |
DISTANCE (ft) |
10 |
40 (warm-up phase) |
10 |
50-60 |
15-20 |
70-80 |
10 |
50-60 |
10 |
40 (cool down phase) |
Phase 2
# of THROWS |
DISTANCE (ft) |
10 |
40 (warm-up phase) |
10 |
50-60 |
20-30 |
80-90 |
20 |
50-60 |
10 |
40 (cool down phase) |
Phase 3
# of THROWS |
DISTANCE (ft) |
10 |
40 (warm-up phase) |
10 |
60 |
15-20 |
100-110 |
20 |
60 |
10 |
40 (cool down phase) |
Phase 4
# of THROWS |
DISTANCE (ft) |
10 |
40 (warm-up phase) |
10 |
60 |
15-20 |
120-150 |
20 |
60 |
10 |
40 (cool down phase) |
7-8 MONTHS
Progress to throwing off the mound and ½ to ¾ speed. Try to use proper body mechanics, especially when throwing off the mound.
- Stay on top of the ball.
- Keep the elbow up.
- Throw over the top.
- Follow through with the arm and trunk
Phase I
# of THROWS |
DISTANCE (ft) |
10 |
60 (warm-up phase)) |
10 |
120-150 (lobbing) |
30 |
45 (off the mound) |
10 |
60 (off the mound) |
10 |
40 (cool down phase) |
Phase II:
# of THROWS |
DISTANCE (ft) |
10 |
50 (warm-up phase) |
10 |
120-150 (lobbing) |
20 |
45 (off the mound) |
20 |
60 (off the mound) |
10 |
40 (cool down phase) |
Phase III:
# of THROWS |
DISTANCE (ft) |
10 |
50 (warm-up phase) |
10 |
60 |
10 |
120-150 (lobbing) |
10 |
45 (off the mound) |
30 |
60 (off the mound) |
10 |
40 (cool down phase) |
Phase IV:
# of THROWS |
DISTANCE (ft) |
10 |
50 (warm-up phase) |
10 |
120-150 (lobbing) |
10 |
45 (off the mound) |
40-50 |
60 (off the mound) |
10 |
40 (cool down phase) |
9-10 MONTHS
At this time, if the pitcher has successfully completed the above phase without pain or discomfort and is throwing approximately ¾ speed, the pitching coach and trainer may allow the pitcher to proceed to the next step of “Up/Down Bullpens”. Up/Down Bullpens is used to simulate a game situation. The pitcher rests in between a series of pitches to reproduce the rest period in between innings.
Up/Down Bullpens: (1/2 – 3/4 speed)
Day 1
# of THROWS |
DISTANCE (ft) |
10 warm up |
120-150 (lobbing) |
10 warm up |
60 (off the mound) |
40 pitches |
60 (off the mound) |
REST 10 MINUTES |
20 pitches |
60 (off the mound) |
Day 2
Off
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