UCL Injuries

Overview

The ulnar collateral ligament (UCL) is the most commonly injured ligament in throwers. This ligament connects the inside of your upper arm (humerus) to the inside of your forearm (ulna) and helps support and stabilize your arm. Injuries of the UCL can range from minor damage and inflammation to a complete tear of the ligament.

• Often there is a popping sound when the ligament ruptures
• Pain with swelling
• Loss of full range of motion
• Inability to throw at full speed or loss of ball control
• Elbow stiffness or inability to straighten the elbow
• Numbness or tingling in the ring and little fingers and hand
• Clumsiness and weakness of hand grip

Diagnosis

The diagnosis can be made by a physical examination. Other tests which may help your doctor confirm your diagnosis include X-rays and MRI. An MRI can be helpful if there is doubt as well as to look for damage to other structures within the elbow.

Treatment Options

Depending on the type of tear and the patient's sport, an athlete can often return to play with non-operative treatment. Therapy and brace are used to rehab the tear and allow for return of strength and motion. If surgery is necessary, UCL reconstruction is performed arthroscopically with minimal incisions and low complication rates.The ruptured ligament is removed, and then tunnels (holes) in the bone are drilled to accept the new graft. This graft which replaces your old ligament is taken either from various parts of your body or a donor. There are advantages and disadvantages of each which your surgeon will discuss with you. The graft is prepared and passed through the drill holes in the bone. The new tendon is then fixed into the bone to hold it into place while the ligament heals into the bone (usually 6 months).

Physical Therapy

Following surgery, bracing is required for several weeks, and a slow, progressive rehabilitation is important to allow for a successful outcome. Overhead motions and throwing are typically possible after three months, and competition is typically allowed approximately 6-9 months after surgery.