Timing of Return to Batting Milestones Following Ulnar Collateral Ligament Reconstruction in Professional Baseball Players

Objectives: Ulnar collateral ligament reconstruction (UCLR) is a common procedure in professional baseball position players. Timing of return to hitting following UCLR is unknown. The purpose of this study was to determine the time to return to batting milestones after UCLR as well as the effect of UCLR upon batting performance in professional baseball players. The authors’ hypothesized that position players would return to batting in an in-season game prior to fielding in an in-season game and hitting performance would remain unchanged following UCLR Methods: All professional position players who underwent UCLR between 2010-2018 were included. Time to batting milestones following UCLR was analyzed. Batting performance before and after UCLR was compared and analyzed. Results: Overall, 141 UCLRs (96% performed on the dominant arm) in 137 position players were included (86% minor leaguers). Four players underwent revision, all within one year of the primary UCLR. With regard to position, catchers and shortstops were over-represented. With regard to batting side, 57% batted from the right and 12% batted as switch-hitters, and thus 76% of surgeries were on the lead arm. While 91% of players were able to return to any throwing at all, there was a progressive gradual decline during the rehabilitation progress such that 77% were able to return to hitting in a real game and 75% were able to return to fielding in a real game. The first dry swing occurred at 150±49 days after surgery, first batting practice occurred at 195±58 days after surgery, and first hitting in a real game occurred at 323±92 days after surgery. However, players generally saw a decrease in their utilization, with fewer at bats (p<0.001) translating into fewer hits (p<0.001) and runs (p<0.001). Conclusion: Professional position players begin swinging at 150 days following UCLR while they do not hit batting practice until 195 days and do not hit in a real game until 323 days following UCLR. Players saw a decrease in hitting utilization following UCLR. [Figure: see text]