Tuesday, June 19, 2012

Rehabilitation after UCLR: 2-6 Weeks Post-Op

During this phase of rehabilitation after UCLR, elbow range of motion (ROM) is increased gradually (i.e.5 degrees/week). The goal of this phase is to regain full ROM by the week 6, especially extension, control pain/inflammation, and retard muscle atrophy. Shoulder and scapula strengthening exercises can be initiated in this phase as well as some forearm exercises such as grip exercises and wrist exercises. It is more common to use the muscle splitting technique than cutting the forearm muscles to reconstruct UCL, however, aggressive forearm strengthening targeting the wrist flexors/forearm pronators using heavy weights should be avoided in this phase. If the forearm muscles are cut, any forearm flexor strengthening should be avoided at least 6 weeks after surgery. Some of the shoulder and scapular exercises can be found on our website (Note that some of these exercises may not be allowed in some protocols). Also note that any strengthening exercise should be done pain-free. All of the rehabilitation exercises (ROM and strengthening) are to be progressed based on tissue healing and athletes' tolerance.    

Thursday, June 7, 2012

Rehabilitation after UCLR: Immediate Post-Op

Ulnar collateral ligament injuries are very common in baseball pitchers and some other over head athletes such as javelin throwers. When athletes tear their UCL, surgical reconstruction of the injured ligament is often needed to restore stability of the medial elbow. There are several approaches to surgical methods including fixation method. Also, post-surgical rehabilitation protocol may vary depending on the surgeon. We will discuss general rehabilitation process for UCLR, however, please note that protocols may vary depending on who the surgeon is.

Immediate Post-Op (Week 1-2)

The goals of this phase are to protect reconstructed graft and graft site, to decrease inflammation, and to retard muscle atrophy. The athlete's elbow will be put in a splint right after surgery for about a week. Then, he/she will be fitted to an elbow brace with range of motion (ROM) usually limited from 30 degrees of extension to 100 degrees of flexion. The athlete may start doing wrist flexion/extension active range of motion (AROM) exercises and grip exercise.

Schematic view of reconstructed graft using end button