What is Tommy John Surgery?

Tommy John Surgery, formally known as ulnar collateral ligament (UCL) reconstruction, is a surgical procedure used to repair a torn or damaged UCL inside the elbow. The UCL is a critical stabilizer for athletes involved in repetitive overhead motions, like pitching or throwing. Movement analysis may also help clarify throwing mechanics before and after surgical intervention.

During the procedure, Dr. Lehman will determine if your UCL is reparable or needs replacement. Often, this is determined pre-operatively with appropriate imaging and examination. If replacement is necessary, he replaces the damaged ligament with a tendon graft from the patient’s own body or with an allograft to restore function and reduce pain.

However, with the newest biologics, Dr. Lehman can REPAIR the majority of UCL injuries. He utilizes the “mini Tommy John” technique, whereby the repair is actually augmented by an internal brace using biologic fiber tape, which has ultra high strength.

This returns the athlete to competition substantially faster. For those who may not be a candidate, Dr. Lehman still augments the conventional ulnar collateral ligament reconstruction with an internal brace. This allows the post-operative rehabilitation to progress much more quickly, protecting the repair, thereby returning to sport substantially faster.

With precision-guided techniques and years of experience, Dr. Lehman ensures stability and sets the foundation for a successful return to sport. Retear rates have been extremely low in Dr Lehman’s hands utilizing the internal brace, Mini Tommy John.

Benefits of UCL Reconstruction

When performed by an experienced orthopedic elbow surgeon, Tommy John Surgery offers substantial benefits:

  • Restores elbow strength and stability
  • Relieves chronic pain and weakness
  • Improves throwing biomechanics and velocity
  • Enables return to high-level sports competition
  • High success rate with long-term durability

Dr. Lehman customizes each procedure and recovery plan to meet your personal and performance goals.

Conditions treated with Tommy John Surgery

Tommy John Surgery is primarily performed for:

  • Ulnar collateral ligament (UCL) tears or ruptures
  • Chronic UCL instability from overuse
  • Elbow pain or weakness in throwing athletes
  • Recurrent elbow strain not responding to non-surgical treatment
  • Failed prior UCL repair

Dr. Lehman’s patients include:

  • Baseball pitchers and catchers
  • Football quarterbacks
  • Javelin throwers and overhead throwing athletes
  • Gymnasts
  • Tennis players
  • Wrestlers and MMA Fighters

Our approach to UCL Reconstruction

Dr. Lehman is a nationally recognized sports medicine expert with decades of experience helping athletes return to elite performance. Trusted by MLB teams, college programs, and Olympic athletes, his protocols are science-driven and results-oriented.

At the Lehman Joint and Performance clinic, you’ll benefit from:

  • Advanced imaging and diagnostic accuracy
  • Minimally invasive and efficient surgical techniques
  • Custom graft selection and placement
  • Performance-focused rehab timelines
  • Ongoing monitoring and athlete-specific recovery plans

Your specialist

Portrait of Dr Rick Lehman

Dr. Rick Lehman

Patient Testimonials

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After tearing my ACL, I though my competitive days were over. But Dr. Lehman and the team at U.S. Center for Sports Medicine didn’t just fix my knee, they helped me rebuild my confidence. The personalized rehab was incredible, and I’m back on the field, stronger than ever. I can’t thank them enough!

Sarah M., Collegiate Soccer player

The Tommy John Surgery procedure

What to expect during and after Tommy John Surgery

Your consultation will include a detailed medical history, physical exam, and high-resolution imaging to confirm UCL damage. Dr. Lehman will assess your suitability for surgery or biological intervention, including PRP injections and autologous stem cells. He and his staff will outline your options.

If surgery is suggested and scheduled, Dr. Lehman will walk you through the timeline, answer questions, and develop a plan tailored to your sport and goals.

When the UCL is repaired, Dr. Lehman will augment the repair with an internal brace using the ultra high strength biologic tape. If you have a failed UCL repair or reconstruction, the damaged UCL is replaced with a tendon graft, often harvested from your forearm, hamstring, or another source. This still will be augmented with an internal brace using ultra high strength biologic tape to stress relieve the graft through rehabilitation.

Most patients return home the same day. Your elbow will be protected in a brace initially, and pain is controlled with medication and cold therapy.

Rehab begins shortly after surgery and follows a carefully staged protocol completely overseen by Dr Lehman and his staff. Most athletes begin light throwing at 3-4 months and certainly sooner with the augmented “Mini Tommy John” procedure. Return to full competition typically occurs at 4-6 months with a Mini Tommy John, and 9 to 12 months post-operatively with a conventional reconstruction (UCL replacement with an internal brace, Mini Tommy John).

Regular follow-ups track your healing, strength, and readiness to return to sport. Dr. Lehman will adjust your rehab plan as needed to ensure a safe and successful recovery. All of your post-operative rehabilitation is monitored with video analysis of your throwing or overhead sport.

Why choose Dr. Rick Lehman for Tommy John Surgery?

  • National leader in UCL reconstruction
  • Trusted by elite baseball players and NFL athletes
  • Over 30 years of experience in orthopedic sports medicine
  • Custom recovery plans designed for performance and longevity
  • Two state-of-the-art surgical and rehab facilities in Menlo Park and St Louis

Frequently asked questions

Tommy John Surgery repairs the ulnar collateral ligament (UCL), which stabilizes the elbow during overhead throwing motions. It replaces the damaged ligament with a healthy tendon graft.

Dr. Lehman repairs the UCL using ultra-high-strength suture material augmented with a biologic fiber tape as an internal brace. The procedure is done under general anesthesia.

The Tommy John Surgery procedure typically takes 60-90 minutes from start to finish. This includes preparation, anesthesia, and the UCL repair/reconstruction itself. Most patients go home the same day, as it is commonly performed as an outpatient procedure. Dr. Lehman uses precise, minimally invasive techniques to ensure optimal results and minimize surgical time.

When performed correctly with the internal brace with ultra-high-strength biologic tape, followed by a structured rehab program, Tommy John Surgery can provide long-lasting, often permanent results. Most athletes return to their sport within 6-9 months and enjoy years of high-level performance. Many professional pitchers have extended their careers by a decade or more after successful UCL surgery. However, longevity depends on proper recovery, throwing mechanics, and overall elbow health.

Initial recovery involves about 3-4 weeks in a brace to protect the elbow. Most athletes begin physical therapy in 7-10 days, and light throwing around 2-4 months, with full return to competition typically achieved by 5-6 months post-surgery. The exact timeline depends on your sport and position. For example, baseball pitchers may require a longer recovery than position players or athletes in less demanding throwing roles due to the high stress placed on the elbow.

Cold therapy is used in the early recovery phase after Tommy John Surgery (UCL reconstruction). It helps reduce pain, control swelling, and speed up healing, often minimizing the need for medications.

At the Lehman Joint and Performance clinic, we offer several cold therapy options based on your level of activity, goals, and recovery timeline:

  • Cold Compression Therapy Units, such as Game Ready, Breg Polar Care Wave, DonJoy Iceman.
    • Combines consistent cold therapy with gentle pneumatic compression
    • Offers 360-degree joint coverage and uniform cooling
    • Especially beneficial for athletes recovering from UCL reconstruction
    • Typically used 3–5 times per day for 20–30 minutes during the first 7–10 days post-surgery
  • Cryo Cuff / Gravity-Fed Cold Systems, such as Aircast Cryo Cuff
    • Passive cold therapy using a cuff and gravity-fed cooler
    • Ideal for elbows, knees, ankles, and shoulders
    • Requires ice and water changes every 6–8 hours
    • Cost-effective and easy for home use
  • Gel Packs & Instant Cold Packs
    • Useful for quick relief from soreness or flare-ups
    • Convenient but less consistent compared to advanced systems
  • Cold Water Immersion / Contrast Baths
    • Occasionally used for elite athletes under supervision
    • Alternates cold and warm baths to stimulate circulation and reduce inflammation

Dr. Lehman will help you choose the most effective option to support your recovery and return to performance.

Ideal candidates are overhead athletes with confirmed UCL tears, especially those who haven’t improved with physical therapy or injections. Baseball pitchers are the most common patients, but football players, javelin throwers, and gymnasts can also benefit.

No. While it’s most commonly associated with baseball, Tommy John Surgery benefits any athlete who places repetitive stress on the elbow, including football quarterbacks, javelin throwers, gymnasts, wrestlers and tennis players.

In some cases, non-surgical treatment may be appropriate, especially for partial UCL tears or less severe injuries. Options include:

  • Rest and activity modification
  • Physical therapy to strengthen surrounding muscles and improve mechanics
  • Platelet-Rich Plasma (PRP) injections and stem cell therapy to promote ligament healing
  • Bracing to support the elbow during recovery

These approaches can be effective, particularly in non-throwing athletes or those with early-stage injuries. However, for high-level throwers or complete ligament tears, Tommy John Surgery is often the most reliable solution for full return to sport. Dr. Lehman will evaluate your injury and guide you to the best treatment plan for your goals.

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Trusted by many

Rodney
6 months ago
He done my right shoulder after a bad wreck and that was in the early 90s until this day I've yet to have any pain he's the best orthopedic surgeon in st,Louis he takes care of the st.louis blue's hockey players he knows what he's doing,I'm going to try to get back to him now for my left shoulder after surgery my doctor here , well let's say 2yearsand2 months ltr I can't pick up anything with it I need a real pro ..
Darrell L.
11 months ago
It's been 28 years since I reluctantly followed the advice of the company nurse where I worked and made an appointment with Dr Lehman, which I had to drive an hour to see. It took a month and a half to actually get in to see him. My first visit, it seems more x-rays were taken than the previous 3 years being "cared for" by a butcher that I had been seeing because I destroyed my left knee in a motorcycle accident. Dr Lehman literally put his money where his mouth was when he convinced me to opt for reparative surgery, rather than complete knee replacement at the ripe old age of 25. Surgery was scheduled, again, it took a month and a half to get in.
Why did all of this take so long, you might ask... Because he IS that good! That's how many people are waiting to see him!
Thank you Dr Lehman for working your magic on me and affording me the quality of life that I have been able to enjoy for all these years.
Very regretfully, I have taken your help for granted and probably overworked it a bit too much, and now likely will have to have more work done. Even more regretfully, as I have relocated, it may no longer be feasible for me to return.
Kama T.
1 year ago
Dr. Lehman is one of the few doctors who puts your goals for mobility or athletic performance at the top of your treatment plan. I thought I would have to choose between 'bleeding edge of orthopedics' and 'decades of experience', but Dr. Lehman is the best of both. Thanks to him and his network of top therapists, I have come back from tough injuries and stayed strong enough to compete as an endurance athlete into my 50s.
Diane W.
2 years ago
Kevin B.
5 years ago
This office is one of the best offices in the country, HANDS DOWN!!!! The staff are very professional and can deal with a high volume of people!! Always getting people in to take care of their concerns!!! They are very detailed and so so kind!!!! Dr. Lehman is “The Best”, this man treats every single patient as if they were worth a million dollars to him!!!!! He deals with the general pubic and everyday working people the same way he deals with pro athletes!!!! What a Great Surgeon!!! His expertise is hard to match!!! My son is playing Division 1 football because Dr. Lehman repaired his knee!!!! Also, He just repaired my knee!! He and his staff ensured that I had a smooth prep, great surgery, and great follow up/discharge instructions. They made sure that me and my son got back to performing duties for life at high levels!!!!I highly recommend Dr. Lehman and his office. “WHAT A GREAT GROUP OF PEOPLE”.
jonathan S.
7 years ago
Dr Lehman is simply the best! You May have to wait awhile in his office but it is worth the wait to see the best!

He takes the time to explain things so you are comfortable and understand. I think this is why the wait. He is a genuinely sincere nice man. Who wants the best for you.

I am very active, he has always got me fixed back up!

You won’t find a better doctor or person!!
Byron S.
7 years ago
The office is great. it is obvious that doctor Lehman has done many famous athletes, the walls are covered with autographed shirts. The staff is competent and Karla is dedicated to her patients. A delight to work with
Shirley Y.
8 years ago
daniel R.
9 years ago
The quality of care & professionalism is worth my 250 mile Drive. I tore both rotator cuffs in September of 2016, at age 54, not good, but thanks to Dr Rick & Dr Shana, I'm back riding Harley's, swimming & playing golf . I'm feeling better than I did at 35! The Team at US Sport medicine will make you feel like an All American Superstar !!!
Much Mahalo

Book your Tommy John Consultation with Dr. Lehman today!

Don’t let a UCL injury sideline your career. Contact the Lehman Joint and Performance Clinic today to explore whether Tommy John Surgery is right for you.