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Post-Operative Rehabilitation Guidelines for Ulnar Collateral Ligament Reconstruction

Please note that these instructions are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Verma or either Physician Assistant supersede the instructions below and should be followed.

Post-Operative Rehabilitation Guidelines for Ulnar Collateral Ligament Reconstruction

0-4 Weeks:

  • Posterior mold splint and sling until first post-op visit
  • Splint removed and use hinged elbow brace for weeks 2-4
  • Brace at 15 degrees (locked) extension to full flexion
  • May begin grip strength in brace
  • PT begins after splint is removed; PROM full flexion to 15 deg extension

Week 4:

  • Discontinue brace
  • PROM into AAROM and AROM at elbow and shoulder as tolerated
  • Begin strengthening exercises for wrist forearm, elbow and shoulder
  • No aggressive weight lifting until 12 weeks post operatively
  • No chest flies or lifts stressing ligament
  • Avoid valgus stress on elbow until 2 months post operatively
  • Total body conditioning / aerobic training may begin

4 Months:

  • May begin interval-throwing program progressing from 45ft. up to 180ft.
  • Pitchers are not asked to throw past 120ft., infielders not past 150ft.
  • May progress from one distance level to next when following are met:
    • No pain or stiffness while throwing
    • No pain or stiffness after throwing
    • Strength is sufficient throughout the final set with min. fatigue
    • Throwing motion is effortless and fundamentally sound
    • Accuracy is consistent and throws are on line
  • For pitchers, mound program begins at completion of 120ft. level
    • Catcher is initially moved forward, but throwing with pitching motion is reserved for the mound
    • No flat ground pitching is allowed

9-12 Months:

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

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