Adam Seidl, MD - Board Certified Orthopaedic Surgeon - Shoulder and Elbow Specialist

Adam Seidl, MDBoard Certified Orthopaedic SurgeonShoulder and Elbow Specialist

Ulnar Collateral Ligament Reconstruction Throwing Progression

PHASE I: Early ROM & Protect Repair (0 to 6 weeks)

  • Splint and postop dressing remains in place for the first week.
  • Sutures will be removed by surgeon in 10-14 days.
  • Night splint (60 degrees flexion) is to be worn at during day and night (after the initial dressing removed)
  • Initiate elbow exercise program 5 times per day:
    • Passive and active elbow ROM to full flexion
    • Elbow extension to 30 (with forearm pronated)
    • Forearm pronation/supination ROM with elbow at 90 degrees flexion
  • Grip and wrist/hand AROM immediately.
  • Avoid terminal 30 degrees extension, perform supination ROM only with the elbow flexed to 90 degrees.
  • PHASE II: Full ROM and function (>6 weeks)

  • Discontinue night splint.
  • Advance ROM:
    • Full elbow and forearm ROM
    • Terminal elbow extension performed with the forearm neutral or pronated until 3 months.
  • Initiate elbow and forearm strengthening.
  • Avoid varus forces across the elbow until 3 months postop.
  • Avoid activities creating axial load to involved extremity until 3 months postop.
  • 4 Months

    • Advance rotator cuff strengthening
    • Avoid Isokinetic internal rotation strengthening until 6 months
    • Soft toss 30 to 40 feet with no windup, 10 to 25 minutes per session, 3 days per week
    • Ice post throwing

    5 Months

    • Increase tossing distance to 60 feet with no windup, 15 minutes per session, 3 days per week
    • Ice post throwing

    6 Months

    • Isokinetic rotator cuff strengthening as tolerated
    • Easy windup added to throwing, limit distance to 60 feet, 50% effort, 15 minutes per session
    • Ice post throwing

    7 Months

    • Throw with 50% effort, 60 to 90 feet, 20-30 minutes, 3 days per week

    8 Months

    • If cleared by physician, advance to 70 % effort throwing for 30 minutes, 3 days per week

    9-12 Months

    • Advance throwing effort to 80% at 9 months from the mound, 30 minute max
    • Increase to 90-100% at 10 months
    • Focus on pitching mechanics
    • No competitive pitching until full progression tolerated well and minimum 11 months post surgery

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    Location Map

    • Orthopedics - University of Colorado Hospital

      1635 Aurora Ct
      4th Floor
      Aurora, CO 80045

    • UCHealth Lone Tree Clinic

      9548 Park Meadows Dr
      Lone Tree, CO 80124

    Credibility Logos

    • The American Board of Orthopaedic Surgery logo
    • American Academy of Orthopedic Surgeons logo
    • American Shoulder And Elbow Surgeons logo
    • Western Orthopaedic Association logo
    • Alpha Omega Alpha
    • Moon Shoulder