Ulnar collateral ligament (UCL) injuries, also known as “Tommy John” injuries, occur when there is repetitive stress on the inside ligament of the elbow. The UCL is a ligament that connects the inside of your upper arm to the inside of your forearm, and helps to stabilize the arm.
Causes-
Overuse: repetitive stress on the UCL causing increased stretching and strain on the ligament. This is commonly caused by throwing repetitively, much like a baseball player, or football player, or in overhead sports such as volleyball and tennis
Dislocation: UCL injuries can also happen from elbow dislocation. With dislocation there is a higher risk of ligament rupture or the ligament getting pulled off of the bone. Dislocation often happens from a fall or impact on an outstretched arm.
Symptoms-
Symptoms common to an Ulnar Collateral Ligament injury;
Pain when throwing or performing overhead movements
Pain or tenderness on the inner side of the elbow
Possible numbness and/or tingling in the arm and fingers
Elbow weakness or feeling of instability of the elbow
Minor swelling around the elbow, specifically on the inner side
Elbow stiffness, inability to outstretch elbow
Weakened grip strength
It is important to seek medical attention if you experience any of the symptoms listed above.
Treatment-
UCL injuries can get progressively worse without treatment, it is important to receive treatment via;
Rest
Ice therapy
Nonsteroidal anti-inflammatory treatments (always consult with a doctor)
Anti-inflammatory and pain relieving drugs such as ibuprofen, aspirin, or naproxen
Physical therapy
3-6 months of therapy combined with rest
Range of motion (ROM) exercises and therapy from a Physiotherapist
When ROM is back to preinjury range (minimum 3 months), progressive return to activity can be started. Increasing duration and intensity gradually.
“Tommy John” Surgery (reconstruction of the Ulnar Collateral Ligament)
Predominantly used in acute tears, chronic instability, or when patient has recurrent symptoms after 2 or more attempts at other conservative therapy methods
Prevention-
Some prevention measures that can be taken to reduce the risk of UCL injuries include;
Appropriate warm-up and stretching
Muscle conditioning for the arm, forearm and wrist
Flexibility training for the arm, forearm and wrist
Using proper protective equipment
Bracing of the elbow maybe beneficial, especially in the prevention of re-injury
Reducing the amount of stress on the ligament daily (ie. limiting the number of baseball pitches per game/practice)
