The New Tommy John: The Rise of the Internal Brace - #AMR386

Ten weeks to start throwing after UCL surgery sounds like a miracle timeline, until you’re the clinician staring at a stiff elbow, a deconditioned arm, and a protocol that assumes the athlete is further along than reality. We’re seeing more internal brace UCL repairs and fewer “classic” Tommy John reconstructions, and that shift is changing how baseball pitchers, gymnasts, and other overhead athletes move through rehab. We talk through what’s actually different about the internal brace procedure, why surgeons became so optimistic early on, and why many athletes still aren’t truly ready to throw at week 10 even if they’re technically cleared. Readiness means more than ligament stability. We dig into the practical stuff that decides outcomes: restoring extension early without creating inflammation, building real strength and arm care habits, and using a plyometric progression before a return-to-throwing program. We also share what we’re watching for clinically, including ulnar nerve irritation from prolonged bracing, motion that never quite “settles,” and the unique posterior-medial elbow pain that can show up with deep flexion or forced extension. Most importantly, we argue for criteria-based rehab over calendar-based rehab. If the athlete has time before the next season, use it to build capacity instead of chasing an artificial milestone. If you work in sports physical therapy, sports medicine, or baseball performance, this conversation will help you spot red flags early and guide internal brace athletes with more confidence.

You can listen to The New Tommy John: The Rise of the Internal Brace - #AMR386 online on Radio and Podcast. Open the player on this page to stream the available audio.

The New Tommy John: The Rise of the Internal Brace - #AMR386 is an episode from The Ask Mike Reinold Show by Mike Reinold.

This episode is 20:00 long.

This episode was published on May 7, 2026.

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