Private UCL Repair (Tommy John Surgery)

Tommy John surgery costs, aftercare considerations, procedural steps. Find the right surgeon that fits your needs below, serving Canadians in major cities like Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec.
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Le fondateur de Surgency, le Dr Sean Haffey, souriant
Révisé et approuvé par le Dr Sean Haffey
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À titre informatif seulement, ne constitue pas un avis médical ou juridique. Veuillez consulter votre médecin ou votre chirurgien.

Comment fonctionne Surgency

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Décidez où aller

La chirurgie privée au Canada nécessite généralement de voyager hors de sa province. La première étape consiste donc à décider où.
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Notre application facilite la recherche de chirurgiens par spécialité et par emplacement.
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What is Tommy John surgery?

Tommy John surgery is a procedure to fix a torn ulnar collateral ligament (UCL) in your elbow—the ligament that helps keep the joint stable during throwing. Think of the UCL as a sturdy strap on the inner side of your elbow. Repeated high‑speed throws (like pitching) can fray or tear it, causing pain, instability, and loss of power.

During surgery, the doctor usually replaces the damaged ligament with a tendon graft taken from somewhere else (often your forearm, hamstring, or a donor). Small tunnels are drilled in the upper arm bone (humerus) and forearm bone (ulna). The new tendon is threaded through these tunnels and secured so it can act like a new ligament. Sometimes, if the tear is in a good spot, surgeons can repair it directly and reinforce it with an “internal brace.”

Why do people get Tommy John surgery done privately?

Délais d'attente plus courts

  • For throwing athletes, time matters.
  • Private centres can often schedule consultation and surgery sooner, reducing time away from sport, school, and scouting windows.

Choix et contrôle

  • Choose a surgeon with high-volume UCL reconstruction experience and strong return-to-play outcomes.
  • Sélectionner l'emplacement de la clinique (souvent à l'extérieur de la province).
  • Plan surgery around season timelines, exams, and family schedules.

Tranquillité d'esprit

  • Know who will operate, when it will happen, and the step-by-step plan (graft choice, internal brace, throwing progression).
  • Clear timelines reduce anxiety and help coaches, trainers, and families coordinate rehab.

Prévenir une détérioration supplémentaire

  • Function and performance: Limits months of elbow instability, pain, and shutdown from throwing; preserves velocity and control potential.
  • Joint and tissue health: Ongoing instability can irritate cartilage/ulnar nerve and strain the flexor-pronator mass; earlier stabilization can curb secondary damage.
  • Surgical complexity: Repeated partial tears and scarring can complicate later reconstruction.
  • Mental load: Shortens time living with uncertainty, lost roster spots, and disrupted training.
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Pourquoi choisir Surgency

Pour les Canadiens qui souhaitent une chirurgie en quelques semaines, et non en quelques mois

Surgency est une ressource gratuite, offerte par un médecin canadien du système public, pour vous aider à trouver le bon chirurgien selon vos besoins.
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How do I get a private Tommy John surgery in Canada?

  1. Confirmez votre diagnostic. La plupart des patients commencent par consulter un médecin de famille ou un spécialiste qui confirme que la chirurgie est conseillée. Un chirurgien privé peut également confirmer le diagnostic si nécessaire.
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  2. Faites des recherches.
    • Vous pouvez trouver des chirurgiens à Vancouver, en Colombie-Britannique; Calgary, en Alberta; Toronto, en Ontario; et Montréal, au Québec sur notre application, et consulter leurs qualifications ainsi que les tarifs.
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  3. Planifiez une consultation initiale. La plupart des chirurgiens proposent des consultations en clinique et en ligne.
    • Les consultations sont généralement fixées en quelques jours ou quelques semaines.
    • Remarque : prévoyez des frais de consultation entre 150 $ et 350 $.
    • Nous vous recommandons de prendre 2 à 4 consultations avec différents chirurgiens afin de mieux comprendre vos options.
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  4. Consultation. Le chirurgien examinera votre état, vos symptômes et tout traitement ou diagnostic antérieur, comme des radiographies ou des IRM.
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  5. ‍Après la consultation. Le chirurgien examinera ensuite votre dossier et vous proposera des options chirurgicales (et non chirurgicales) en fonction de vos besoins; il passera en revue les risques et les résultats attendus; et présentera les options de tarification et de planification.
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  6. Planifiez la date de votre chirurgie. Une fois que vous aurez confirmé la procédure et le paiement, la clinique fixera la date de votre chirurgie – généralement dans un délai de quelques semaines.

Tommy John surgery steps: what to expect

Surgery time is about 60–120 minutes (most are ~90 minutes). Plan on several hours for check-in, anesthesia, and wake-up before going home.

Étapes de base :

  • Check-in and marking
    • You meet the team, review the plan, and the surgeon marks the elbow.
  • Anesthésie
    • You get general anesthesia (asleep). Many also get a nerve block to numb the arm after surgery.
  • Positionnement et préparation
    • You’re positioned safely, the arm is cleaned, and sterile drapes go on.
  • Diagnostic look
    • Through small incisions, the surgeon looks inside the joint (arthroscopy or open assessment) to confirm the injury pattern.
  • Graft harvest (if using your own tendon)
    • A small tendon (often hamstring or forearm) is taken, cleaned, and prepared. If using donor tissue, it’s prepped instead.
  • Bone tunnels
    • Tiny tunnels are drilled in the ulna and humerus at precise spots where the UCL attaches.
  • Graft passage and fixation
    • The tendon graft is threaded through the tunnels in a figure-8 or modern fixation pattern and secured with buttons/screws. Tension is set to match normal ligament tightness.
    • Some cases use an “internal brace” (strong tape) to reinforce the repair.
  • Check stability and close
    • The surgeon tests elbow motion and stability, then closes the incisions and applies a dressing and brace.
  • Recovery instructions
    • You wake up, get instructions for the brace and early movement, and head home the same day.

What can I expect from the Tommy John surgery recovery process?

Everyone's recovery process looks different. This is to give you a general idea of what to potentially expect. Consult your surgical team and take rehab seriously—the more consistent you are, the better your outcome.

Semaine 1

  • Not fun: soreness, swelling, stiff elbow.
  • Goals: control pain/swelling, protect the graft, start gentle safe motion.
  • Activities: sling/brace as directed, ice/elevate, move fingers/wrist/shoulder, gentle elbow motion if cleared. Wound care.

Semaines 2 à 4

  • Still annoying, slowly improving.
  • Goals: increase elbow range of motion (ROM), reduce swelling.
  • Activities: regular physio; brace adjustments; forearm rotation and elbow bends/straightens within limits; light daily tasks (typing, eating) if comfortable.

Semaines 5 à 12

  • The grind phase.
  • Goals: near-full ROM by ~8–10 weeks; begin light strengthening.
  • Activities: progressive exercises for forearm, biceps/triceps, shoulder/scapula; grip work. No throwing.

Months 3–4

  • Building a base.
  • Goals: stronger arm and shoulder; good mobility and control.
  • Activities: more resistance, cardio/conditioning, movement quality drills. Still no throwing unless cleared.

Months 4–5

  • Return-to-throw start (if milestones met).
  • Goals: pain-free light tosses, clean mechanics.
  • Activities: structured interval throwing program—short distance, low effort.

Months 6–9

  • Progress throwing.
  • Goals: increase distance/effort; add position-specific work.
  • Activities: bullpen-style progressions for pitchers; field drills for position players.

Months 9–12+

  • Return to competition (timing varies).
  • Goals: full strength, endurance, and command.
  • Activities: game-speed throwing once cleared by surgeon and physio.

Des signaux d’alarme à tout moment

  • Fever, wound redness/drainage, calf pain/swelling, chest pain/shortness of breath, new numbness/weakness—contact your care team.

How much does private Tommy John surgery cost in Canada?

In Canada, private clinics in charge between $10,000 to $25,000.

In the U.S., you can expect to pay CA$13,500 to CA$34,000.

Les coûts varient énormément selon l’emplacement, l’expérience du chirurgien, le type d’établissement, la portée des traitements potentiels, la complexité du problème et les services inclus (certaines cliniques offrent tout compris, tandis que d’autres facturent séparément l’anesthésie, les soins de suivi, etc.).

For more information on cost, see here.

Ce qui est inclus

Most quotes for private Tommy John cover:

  • Surgeon fee (and assistant if used) and anesthesiologist/general anesthesia.
  • Frais d’établissement (temps en salle d’opération, soins infirmiers, fournitures, équipement d’arthroscopie).
  • Soins de récupération immédiatement post-opératoire et suivis matinaux de routine (vérification de la plaie, retrait des points de suture).
  • Les instructions de base pour l’écharpe et la réadaptation initiale (varient selon la clinique).

Ce qui n'est généralement pas inclus :

  • Pre‑op consults and advanced imaging beyond basics (MRI, MRI‑arthrogram).
  • Braces/splints or special implants beyond standard supplies.
  • Unexpected overnight admission or ER visits; additional imaging for complications.
  • Formal physiotherapy/occupational therapy beyond initial guidance.
  • Médicaments post-sortie (antidouleurs, anti-nausées).
  • Travel and accommodation if out‑of‑province.
  • Frais pour la gestion des complications ou les réopérations au-delà de la période globale habituelle (selon la politique).

Options d'assurance et de financement

  • Assurance maladie privée : Certains régimes peuvent couvrir une partie des coûts, comme les frais d'hospitalisation. Il est important de vérifier directement votre police d'assurance.
  • Plans de financement : De nombreuses cliniques proposent des options de paiement mensuel pour vous aider à étaler les coûts. Apprenez-en davantage sur vos options de financement ici.‍
  • Crédit d'impôt pour frais médicaux (CIFM): Il s'agit d'un crédit non remboursable qui réduit vos impôts lorsque vous payez de votre poche des dépenses médicales admissibles. Apprenez-en davantage sur la façon de demander le CIFM pour les chirurgies privées.

Choisir un chirurgien et une clinique

Choosing your surgeon is one of the benefits of going the private route. Here’s what to consider and the key questions to bring to your Tommy John consultation.

Ce qu'il faut rechercher

  • Expérience et volume d'interventions
    • Ask how many UCL reconstructions (and UCL repairs with internal brace) they perform per year, primary vs revision, and for throwers vs non-throwers.
  • Qualifications et formation
    • Confirmez leur permis d'exercice auprès de l'ordre provincial des médecins (par exemple, le Collège des médecins et chirurgiens de l'Ontario, le Collège des médecins et chirurgiens de la Colombie-Britannique, le Collège des médecins et chirurgiens de l'Alberta).
    • Look for FRCSC-certified orthopaedic surgeons with fellowship training in sports medicine/upper‑extremity or shoulder & elbow, and experience with overhead athletes.
  • Sécurité
    • Renseignez-vous sur les taux d’infection, les retours imprévus, les taux de raideur, les délais de retour au sport.
  • Technique et anesthésie
    • Reconstruction vs repair with internal brace—why for you?
    • Graft choice: autograft (palmaris longus, gracilis) vs allograft; pros/cons, expected strength, donor‑site morbidity, and cost implications.
    • Tunnel/anchor technique and fixation method; how they protect the graft during early rehab.
    • For throwers: evaluation of kinetic chain (shoulder, scapula, trunk, hips) and how that factors into rehab.
  • Accréditation de l'établissement‍
  • Intégration de la réadaptation‍
    • Access to elbow‑savvy physiotherapy, clear phased protocol, and communication with your local physiotherapist if you’re traveling.

Questions to ask during your Tommy John consultation

Chirurgien et plan chirurgical

  • How many UCL reconstructions/repairs do you perform yearly?
  • What are your return-to-play (RTP) rates and average time to RTP by competition level?
  • What are your last 12–24 month rates for infection, nerve issues (ulnar neuropraxia), stiffness, graft failure, and unplanned re-operations?
  • Do you recommend reconstruction or repair with internal brace for me—and why?
  • Which graft (palmaris, gracilis, or allograft) do you prefer in my case? How does graft choice affect recovery and cost?
  • Will you perform elbow arthroscopy or ulnar nerve procedures if needed? How would that change risks, rehab, and price?
  • Anesthesia plan (regional block + sedation vs general) and pain-control strategy (nerve block duration, multimodal meds).
  • Is this outpatient same-day? Any chance of overnight stay? What criteria decide that?
  • Do you have a transfer agreement with a hospital if an emergency occurs?

Rétablissement et suivi postopératoire

  • What’s my timeline to: brace weaning, full elbow ROM, start strengthening, start interval throwing, flat-ground work, bullpens, and live competition?
  • What are the specific criteria to progress between phases (ROM, strength ratios, pain-free milestones, biomechanics)?
  • Do you provide a written return-to-throw program? How will you coordinate with my local physio/athletic trainer and coach?
  • What red flags should prompt a call or ER visit (fever, wound drainage, calf pain/swelling, shortness of breath, new numbness/weakness)?
  • Qui est mon contact post-opératoire (téléphone direct/courriel)? Temps de réponse typique? Combien de suivis sont inclus et quand?

Coûts et logistique

  • What exactly is included in my quote (surgeon, anesthesiologist, facility fees, graft/implants, nerve block, imaging review, immediate post-op care, scheduled follow-ups)?
  • What could add cost (allograft upcharge, additional arthroscopy time/procedures, ulnar nerve decompression, brace, extra imaging, complications/re-operations)?
  • If intra-op findings require added procedures, how do you handle consent and pricing in the moment?
  • If I’m traveling from another province, which follow-ups can be virtual? Will I receive the operative note, graft/fixation details, and the full rehab plan for my local team?

Tommy John surgery frequently asked questions

How do I know if Tommy John surgery is right for me?

Tommy John surgery fixes a torn or badly damaged UCL (ulnar collateral ligament) in your elbow. That ligament helps keep your elbow stable when you throw.

You might be a candidate if

  • You’re a thrower (baseball/softball pitcher, javelin, quarterback) with inner-elbow pain that won’t go away
  • Your elbow feels unstable or “gives way,” or you hear/feel a pop with loss of velocity/control
  • You’ve tried rest, pitch count changes, physical therapy, and maybe an injection, but you’re still having pain or can’t return to throwing
  • MRI shows a high-grade tear, especially if it didn’t improve after 3–6 months of structured rehab

Common reasons people get Tommy John surgery

  • High-grade or complete UCL tear
  • Repeated throwing injuries with ongoing pain, loss of velocity, or control despite rehab
  • UCL didn’t heal after months of non-surgical treatment
  • Sometimes a UCL repair with “internal brace” is possible if the tear is in the right spot and fairly fresh

Quand ce n’est peut-être pas juste

  • Mild sprains/partial tears that can heal with rest and a solid rehab program
  • Pain that’s actually from something else (flexor/pronator strain, nerve irritation, shoulder mechanics)
  • You haven’t completed a proper throwing-specific rehab and workload change yet
  • Active infection or medical issues that make surgery unsafe

Ai-je besoin d'une référence?

No, you do not need a referral for private Tommy John surgery in Canada. You can book a consultation directly with a surgeon, and they will review your condition, symptoms, and any previous treatments or diagnostics.

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How do I prepare for Tommy John surgery?

Prehab and health tune-up

  • Pre-surgery exercises: gentle range-of-motion and light strengthening for shoulder, scapula, core, and lower body. Keep wrist/hand moving if comfortable. A strong kinetic chain protects your new UCL.
  • Quit nicotine: Stop smoking/vaping/chew at least 4+ weeks before surgery—nicotine slows healing and raises infection/nerve risk.
  • Medications: Share all meds/supplements. You may need to pause blood thinners (aspirin, warfarin, DOACs), certain NSAIDs, and some herbal supplements—in coordination with your surgeon.
  • Fitness and nutrition: Light cardio, balanced diet, good sleep, and hydration are important. Protein and fibre help.
  • Medical clearance: Labs or other checks may be needed depending on age/health.

Préparation à domicile

  • One-handed living: Your arm will be in a splint/brace early on. Set up essentials at counter height. Open jars/containers, stock easy meals/snacks.
  • Declutter and safety: Remove tripping hazards (cords, rugs, clutter). Keep pathways clear. Consider shower chair and non-slip mat.
  • Comfort station: Ice packs/cold devices, pillows to elevate arm, basket for meds/chargers/water near your favourite chair/bed.
  • Clothing: Loose, front-opening shirts; elastic-waist pants; slip-on shoes. A sling-friendly zip hoodie is ideal.

Soutien et logistique

  • A helper: Arrange a ride home and someone to stay 24–48 hrs. Have a backup contact for a couple of weeks.
  • Work/school/sport: Plan time off. Desk work/school may resume in days, but lighter loads. No throwing until cleared; expect a long staged return-to-throw plan.
  • Daily tasks: Arrange help for lifting, pets, groceries, chores for first 1–2 weeks.

Surgery-day details

  • Fasting: Follow anesthesia instructions exactly (no food after cutoff; clear fluids allowed).
  • Pain plan: May get nerve block numbing arm for 12–24 hrs. Fill pain meds in advance. Have acetaminophen ± NSAIDs ready.
  • Nausea/constipation: Ask for anti-nausea meds if needed. Stool softeners/fibre recommended—pain meds cause constipation.
  • Skin prep: Follow antiseptic wash instructions night before and morning of surgery. Don’t shave operative arm.
  • What to bring: ID, meds list, loose top, sling (if provided), small pillow for ride.
  • Jewelry/nails: Remove rings/bracelets; avoid heavy nail polish/acrylics on operative hand.

Pratique post-opératoire

  • One-handed routines: Practice dressing, showering, meal prep, phone/computer use with non-operative hand.
  • Car practice: Rehearse getting in/out and fastening seatbelt with one arm.
  • Sleep setup: Test positions on back or non-operative side with pillows supporting forearm and wrist.

What are the risks if I delay or don't get Tommy John surgery?

Your situation depends on your pain level, how unstable your elbow feels when throwing, what imaging shows (partial vs full UCL tear, tissue quality, bone bruising), your sport/position, season/timeline, and how well non-surgical care works (rest, pitch count changes, physio, PRP). Discuss specifics with your surgeon.

Main risks of delaying or not having Tommy John surgery (when symptoms are significant/persistent)

Progressive pain and loss of performance

  • Increasing inner-elbow pain with throwing, loss of velocity/control, and needing more time to “warm up.”
  • Night or next-day soreness that lasts longer, plus growing reliance on pain meds or ice just to play.

Instability and re-injury

  • The ligament may not heal if torn in ways unresponsive to rest/rehab; valgus “gapping” can worsen with continued throwing.
  • Repeated micro-tears can lead to complete rupture, sometimes at worst times (showcase, playoffs).

Joint and nerve problems from ongoing stress

  • Cartilage wear and bone spurs on inside/back of elbow (valgus-extension overload) causing catching or locking.
  • Ulnar nerve irritation (ring/small-finger numbness, weakness, grip fatigue) that may be harder to settle.
  • Flexor–pronator tendon strain from compensating for weak ligament.

Lower quality of life and mental impact

  • Frustration, anxiety about every pitch/throw, avoiding practices/games.
  • Sleep disruption from pain; loss of identity for competitive athletes.

Deconditioning and altered mechanics

  • Long breaks without plan weaken shoulder/scap/core; returning too fast with poor mechanics raises risk of shoulder/wrist injuries.

Harder return later

  • More inflammation, spurs, or nerve irritation can prolong recovery and limit progression in throwing programs, even after surgery.

Effets nocifs liés aux médicaments

  • Prolonged NSAID/opioid use raises risks (stomach/kidney issues, dependence) and does not fix ligament damage.

Quand l'observation attentive peut être raisonnable

  • Mild symptoms with preserved performance and no instability on exam.
  • Non-operative plan: structured rest from throwing, pitch/throw count changes, kinetic-chain strength (shoulder/scap/core/hips), technique cleanup, possible PRP for partial tears.
  • No progressive loss of velocity/control, no frequent “giving-way” feeling, nerve symptoms absent or improving.
  • Clear, time-boxed trial (e.g., 6–12 weeks) with re-evaluation before return-to-throw.

Quand il ne faut pas tarder

  • Pain or a “pop” with clear instability and inability to throw without symptoms.
  • Recurrent “giving-way,” loss of velocity/control despite proper rest and rehab.
  • Worsening ulnar-nerve symptoms (numbness/tingling/weak grip) or locking/catching from spurs/loose bodies.
  • Imaging shows high-grade tear or poor tissue quality, and a full, sport-specific non-operative trial has failed.
  • Repeated breakdowns when trying to return-to-throw despite careful ramp-up.

What are the risks involved with Tommy John surgery?

Your individual risk depends on your health, elbow anatomy, the size/location of your UCL tear, whether you’re getting a reconstruction or repair with internal brace, the graft choice (your tendon vs donor), surgical technique, and how well you follow rehab. Discuss your specific risks with your surgeon.

Courants et généralement temporaires

  • Pain, swelling, bruising; sleep trouble early on
  • Nausées dues à l'anesthésie; constipation due aux analgésiques.
  • Temporary numbness around incision(s) or from nerve block
  • Stiffness and tightness in elbow/forearm during first weeks

Moins courants

  • Blood clots (DVT/PE) — uncommon for upper limb but possible; early walking and prevention help
  • Infection (skin/portal or deeper around graft/tunnels)
  • Wound healing problems or hematoma (blood collecting under the skin)
  • Nerve irritation/injury near elbow (ulnar, median, or branches like medial antebrachial cutaneous) causing numbness/tingling or weakness — usually temporary, sometimes longer
  • Persistent stiffness or limited range of motion if scar tissue forms or rehab is delayed/overly aggressive
  • Graft site soreness (if using own tendon from forearm, hamstring, or big toe extensor)
  • Syndrome de douleur régionale complexe (SDRC) — condition de douleur/sensibilité peu commune

Procedure-specific risks

  • Reconstruction (traditional Tommy John): graft stretch/failure if overloaded too soon; tunnel pain/irritation; graft protection needed for many months
  • Repair with internal brace: risk of re-tear if tissue quality poor or rehab too aggressive; not every tear pattern fits
  • Ulnar nerve issues: some need nerve decompression/transposition; risk of ongoing numbness if nerve was irritated

Rare mais important

  • Deep infection requiring further surgery and antibiotics
  • Lasting nerve problems with weakness or numbness
  • Vascular injury (very rare) around elbow
  • Graft failure or recurrent instability/pain with throwing, needing revision surgery
  • Ongoing pain or inability to return to prior performance despite healing
  • Heterotopic ossification (extra bone) causing stiffness
  • Shoulder or kinetic-chain problems if mechanics and strength not restored properly during rehab

Comment réduire les risques

  • Follow pre-op instructions (stop nicotine, manage meds, antiseptic wash)
  • Protect repair/reconstruction: wear brace as directed, avoid lifting/valgus stress
  • Start approved motion and therapy on schedule—neither too soon nor too late
  • Keep wounds clean/dry; watch for redness, drainage, fever
  • Follow a structured, criteria-based return-to-throw program; don’t “test” max velocity early
  • Maintain shoulder, scapula, core, lower-body strength and clean throwing mechanics

Signaux d’alerte à appeler

  • Fever, chills, increasing redness, warmth, or drainage from incision
  • Severe pain not controlled by meds, sudden swelling, worsening stiffness
  • New or worsening numbness/weakness in hand/fingers
  • Calf pain/swelling or shortness of breath (possible clot)

When can I return to sports or active hobbies after Tommy John surgery?

Your return to normal activity and sport will depend on your unique circumstances.

In general, you can expect basic arm movement within 2-3 months, retuning to limited throwing within 5-6 months, and full recovery within ~12 months.

Consultez toujours votre chirurgien et votre physio pour obtenir des conseils.

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PARCOURIR LES CHIRURGIENS

Browse Accredited Private Surgeons for UCL Repair (Tommy John Surgery)

Les chirurgiens de Surgency sont vérifiés :

✓ Diplôme de médecine reconnu
✓ Permis d'exercice canadien (LMCC)
✓ Permis d'exercice médical provincial actif
✓ Certification du conseil (FRCSC/ABMS)
Alberta
Accepte les patients de toutes les provinces, y compris l'Alberta
Tanner Dunlop
MD, FRCSC
Icône de localisation du chirurgien
Edmonton, AB
Anglais
Accepte les patients adultes

Chirurgien orthopédiste comptant 9 ans d'expérience, spécialisé en chirurgie des membres supérieurs (du coude à la main), en arthroscopie et en médecine sportive.

VOIR PROFIL