Intended for licensed physical therapists coordinating care with Dr. Vasileff. Defer to the operative note and the surgeon’s office for patient-specific direction.

Elbow

UCL Repair with Internal Brace

Post-operative protocol · Dr. Chris Vasileff, MD

For the treating physical therapist. This protocol is a guideline; progression is criteria-based and individualized. Defer to the operative note and the surgeon’s office for patient-specific direction.

Elbow Ulnar Collateral Ligament Repair Rehabilitation Protocol

Sling for 2 weeks.

Phase 1 – Maximum Protection Phase (0-10 days)

Week 1 Reduce Inflammation

Immobilization in hinged brace/posterior splint at

90° of elbow flexion

Ice and modalities to reduce pain and

inflammation

Begin passive, progressing to active wrist and

hand range of motion

Begin hand strengthening

Light Cardio

Phase 2 – Progressive Stretching and AROM (10 days to 6 weeks)

Week 2-3 Brace setting 30° to 100°

Active elbow flexion and extension 30° to 100°

Increase intensity of wrist and hand strengthening

Begin rotator cuff strengthening avoiding valgus

stress

No IR

Scapular strengthening exercises

Proprioception drills emphasizing neuromuscular

control

Week 3-4 Brace setting 15° to 110°

Increase range settings, 5° of extension and 10°

of flexion per week, progressing to full by week 6

Continue with gradual progression in ROM as outlined in week 2

Week 4-5 Brace setting 10° to 120°

Begin light biceps and triceps strengthening

Continue with progressive rotator cuff and scapular strengthening avoiding valgus stress

Week 5-6 Brace setting 5° to 130°

Phase 3 – Strengthening Phase (Weeks 6-10)

Week 6-8 Discontinue brace, modalities as needed

Restore full elbow ROM with terminal stretching

Resisted biceps, wrist, and hand strengthening

Proprioception and neuromuscular control drills

Manual resistance and PNF patterns with

proximal stabilization

Week 8-10 Continue with terminal stretches

Advance rotator cuff and scapular strengthening program

90-90 strengthening

Initiate Gym Routine – avoidance of valgus stress

Initiate 2 handed plyometrics, if ready

Week 10-12 Continue with advanced cuff, elbow and

forearm strengthening

Plyometric progression of 2 handed to 1 handed, starting low and moving to overhead

Return to Sport prior to return all ROM, strength, endurance and

functional requirements of sport must be met

Contact Sports - 16+ weeks per MD clearance, braced

Throwing – 12-16 weeks per MD, met all ROM

Hitting – 10-12 weeks per MD, 2-3 weeks prior to or after starting ITP

Tennis – low strokes 10-12 weeks, serves 12-16 weeks

Questions about a protocol? Contact Dr. Vasileff’s office at (704) 865-0077.