Post TJ Expectations


I pitched through consistent elbow pain for the better part of two years sitting 86-89. My doctor had diagnosed me with a strained UCL and said as long as I managed the pain I could keep pitching.

I used Acupuncture, icy hot and just about any other trick I the book to make my elbow feel normal, but no matter what I did it still felt terrible.

I went to Ken Akizuke, the San Francisco Giants’ orthopedic surgeon for a second opinion in February. Within seconds of looking at my MRI he told me the UCL was torn, and I had been pitching with it for over a year.

It’s been 5 months since my surgery now and I’m out to 105 feet in my throw get program. Throwing and arm strength have always been actual for me; I could get to 330 feet with the pain.

Anyone have experience with a similar situation/advice on what I should expect velo-wise on my return?


Yes actually I had an almost identical case as yours. First thing is get out of your head that because it was torn for so long and you still threw hard that you think youre gonna be at 90 when you come back. Had that belief in my head for a long time. Not the case. I’m 7 months post op now and its still a grind. Some days the balls flys out with no effort and other days its a chore and is dull and achy and feels like youre throwing it 45MPH. Very hard. Take this time to learn from what you’ve done wrong in the past and build on it. I heard a pretty cool quote on MLB network the other day about how you dont ever learn to pitch until youve been hurt, couldnt agree anymore with that quote. Get in the weight room, get your legs to look like tree trunks. Nit pick your mechanics. Stop worrying about how hard youre gonna throw with a new elbow, because theres gonna be some days when you feel so good and feel like you can let it rip, thats when you can get yourself in trouble. There will be a time to see how the new and improved you is, but early on in the rehab throwing progression is NOT the time to test it. Good luck. PS Don’t be upset if you can’t long toss/throw like you could before. You were just split open and drilled into only a few months ago. It’s a much longer process than just the rehab time and the time frame from which they clear you.

TJS 2/24/16


Sorry to hear about your TJ experience.

One thing that I see athletes often overlook in the recovery process is lateralizing our training away from the arm. Unfortunately you can’t throw the way you’d want to right now. Fortunately, you can improve yourself physically away from the arm.

I would prioritize improving the functionality of other areas & joints - increase control of range of motion, tissue capacity and aerobic fitness.

TJ surgery affects the elbow, but is a breakdown in the complex biological system that is your body. Improve the other components of that system (hips, spine, shoulder etc) and improve your overall resiliency!!!


Update: it’s been almost 6 months and I’m throwing out to 135 feet. The inside of the elbow feels great and is never sore or anything after throwing. However, I have been getting some forearm tightness high up on the outside of my arm, about where the forearm turns into the bicep. My therapists massage it out and it eels great but it’ll still come back periodically throughout a week. It’s not triggered by throwing either, just random times.


Good to hear man. Just keep on the course and don’t let the highs get too high and the lows too low. If you have a serious question about pain or your comeback. Call your doctor. Everyone has a take but it’s best to hear from the guy who cut you open with the medical degree.

Keep with the updates!


Update 2: almost 7 months now, and my surgeon is keeping me at 150 for awhile. Increasing the pulldowns and intent on those pulldowns is what I say being emphasized at this point. It’s easy to toss it at this distance, here is a (low quality) video
My pulldowns right now are about 80 MPH at 60-70% effort. If I try to do anything above that, the forearm gets sore so I’ll probably stay at this intent level until I feel I can push it more too.
My lifting is becoming less restricted as well. The only hard no’s from my surgeon are heavy presses and big overhead lifts. Never really went to open heavy on bench or military press anyway, so not a concern really.


Nearing the 8 month mark now and gradually increasing the intensity. Still only going out to 150, and pulling down after that with another shorter round after that. About 75% effort(still just using the body, not really exerting effort from the arm), between 85-90. Today is the first day my elbow has felt legitimately sore after throwing. Will probably take it a little easy throwing Saturday and Tuesday to see how my arm responds. Hopefully the soreness is nothkng and it is still acclimating to throwing with someintensity. The forearm pain I see gone and I’m cleared to open up the lifting more. I’ve been able to do more expanded workouts for 3 weeks now and have gained 4 pounds, and it feels great to be able to more.

Not sure if the soreness is concerning, but everything else is going in the right direction at this point. My goal is to be full speed by May, which will be 13-14 months, and I feel I am well on the way to getting there.


I don’t think the soreness is anything to be worried about, as long as it subsides. Just watch for any inflammation around your elbow or anywhere in your arm that wasn’t there prior to throwing. Keep working man, glad to hear you are making progress and keep us updated.


The reason that most people come back stronger from TJ is because they have never had their body prepared correctly in the first place…so obviously after a strenuous 12 month rehab where you constantly have to strengthen everything that goes into throwing you will put your body in the best shape possible to be able to stay at your peak.

So if you didn’t have a good work ethic before surgery then you will probably see some spikes in velo. If you had a good routine and your body was in shape then you will return to normal.

But the biggest thing is being able to identify how and when you got hurt. Mentally there are obstacles that one has to climb…typically UCL injuries don’t pop up out of nowhere…they started with some type of pain that one continuously pitched through without really knowing they were doing damage.

It is learning to peel back layers of yourself and shave off memories of pain attached to a baseball and throwing it. It can be done but it is a daily struggle to understand you are healthy and there isn’t going to be anymore issues.


8 months and 5 days today. Saw my surgeon in San Francisco and told him about my forearm issue and he gave me a cortisone shot and I’m taking a couple days off throwing. Both he and by physical therapy team in Sacramento say whenever this goes away, I can progress to flatgrounds. Neither of them are concerned at all, which is a good sign. Doctor said the shot will expedite the healing process in my forearm(which is apparently just a big know in the muscle) which was probably taking place already. It will help my therapist when he Grafts the forearm again on Thursday when I go back and hopefully he will get it all they way out once and for all. Highly optimistic at the moment.


9 months now, and I have progressed to throwing flatgrounds. 20 fastballs at 50-60% effort. Boring, mundane, but a big step towards being back.

The catch play has gotten really boring as I am not allowed to go further than 150 feet. Pulldowns have progressed a little as I am throwing those at 80%. A question I have is why I have to throw flats at such a low effort level compared to my pulldowns. It seems like a sizable gap in effort and because of that it’s tough to get a feel for my mechanics right now because it feels like I’m babying it.

I go back to physical therapy Friday, so hopefully they let me increase the effort on flatgrounds.

Also please look at my post regarding chest exercises and hopefully you have some input. Looking to add muscle and my chest clearly has room to grow, any help appreciated.


Hows things going now James?