Elbow UCL Reconstruction

Week1:

• Elbow is immobilized in the Bledsoe Brace or splint at 75 degrees flexion (7-10 days) with wrist free but in sling.
• Dressing changed at 7-10 days after surgery

Week 2:

• Begin active range of motion in the brace.
• Brace adjusted to 30 degrees (locked) extension to full flexion
• May begin grip strength in brace

Week 4:

• Discontinue the use of the Bledsoe Brace
• Shoulder and elbow ROM, PROM, AAROM, AROM, advance as tolerated
• Begin muscle strengthening exercises for wrist, forearm, elbow and shoulder
• Advance strengthening as tolerated (avoid aggressive weight-lifting until 12 weeks after surgery, especially chest flies or other lifts that directly stress the ligament
• Valgus stress on the elbow is avoided until at least 2 months after surgery
• Total body conditioning/ aerobic training may begin

Month 4:

• May begin an interval-throwing program progressing from 45 ft up to 180 ft.
• Pitchers are not asked to throw past 120 ft, infielders are not asked to throw past 150ft.
• The player may progress from one distance level to the next when the following criteria are met:
  • There is no pain or stiffness while throwing
  • There is no significant pain or stiffness after throwing
  • Strength is good throughout the final set with little fatigue
  • The throwing motion is effortless and fundamentally sound
  • Accuracy is consistent and throws are online
• For Pitchers, the mound program begins at the completion of the 120 ft level.
  • The catcher is initially moved forward, but throwing with a pitching motion is reserved for the mound
  • No flat ground pitching is allowed

Months 9-12:

• Return to competition is permitted when the following conditions are met:
  • Trunk, scapula, shoulder and arm muscle strength and balance have returned to normal
  • There is no pain while throwing
  • Throwing balance, rhythm, and coordination have been reestablished