Immediately after surgery

1. Wear a sling
2. No brace is necessary
3. Follow up with Dr Qeli for the initial wound check within 1-3 days after surgery
4. Call with any problems. Pain usually peaks on day 2 after surgery, and it should be getting better each day after that.

Weeks 1

1. Arm is in postoperative splint
2. Gentle finger motion as allowed by pain
3. Pain management

Weeks 2 and 3

1. Postoperative splint is removed during week 2
2. Start physical therapy
3. Elbow is placed in hinged brace
4. Brace is worn at all times, except during supervised physical therapy
5. Range of motion (ROM) allowed by brace at first is from 30 degrees short of full extension to 90 degrees of flexion
6. AVOID STRESSING THE ULNAR COLLATERAL LIGAMENT

Week 4

1. Advance ROM allowed by brace to 25-95
2. AVOID STRESSING THE ULNAR COLLATERAL LIGAMENT

Week 5

1. Advance ROM to 20-105
2. AVOID STRESSING THE ULNAR COLLATERAL LIGAMENT

Week 6 ####

1. Advance ROM to 15-115
2. Discontinue brace at the end of the week 6 after surgery
3. AVOID STRESSING THE ULNAR COLLATERAL LIGAMENT

Weeks 7 – 12 after surgery ####

1. Start shoulder and forearm strengthening
2. AVOID STRESSING THE ULNAR COLLATERAL LIGAMENT

3 months after surgery ####

1. Additional strengthening
2. May place shoulder in 90 degree abduction and external rotation
3. May do gentle throwbacks (20-30ft, no wind-up)

4 months after surgery ####

1. Progressive gradual return to throwing
2. Easy wind-up
3. Up to 50 ft

5-6 months after surgery

1. Up to 60 ft
2. No more than 50% speed

7-8 months after surgery

1. Up to 150 ft
2. 50% - 66% of maximum speed

9-10 months after surgery ####

1. Throwing at 75% of speed
2. Simulate a game situation
3. Expect up to 1 year to return to competitive throwing