By Asuan Farrell, SPT
What is the UCL?
The UCL or Ulnar Collateral ligament, is located on the inside our elbow and goes from our humerus to the ulna bone. This ligament is important for resisting movements such as elbow extension, and valgus stress which is when our elbow goes in toward our body.1
UCL Injuries and Risk Factors
Injuries of the UCL commonly occur with overhead athletes where there is repeated stress of high forces. These injuries are seen in gymnastics, javelin, softball, and notably baseball.2
Among specifically baseball players, a few factors that place these athletes at such an increased risk of UCL injury may include lack of shoulder internal rotation with the arm at 90 degrees, fastball pitch velocity, changeup velocity, and curveball velocity.3
Treatment Options
Many athletes who experience a UCL injury are encountered with choosing between conservative or surgical treatment to manage their injury. Each option has its benefits however, there are many components to consider when choosing which would most apply to the specific individual. With conservative methods such as Physical Therapy, this intervention would be most beneficial to athletes who have more of a partial than complete tear, and those who participate at the professional level as conservative methods have been shown to have faster recovery rates.4 On the other hand surgical management of this injury, also known as “Tommy John Surgery”, may be the more applicable choice for those who have a complete tear of their UCL, however,
there is a 10 to 16-month recovery period seen with this option.4
References
1. Cinque ME, Schickendantz M, Frangiamore S. Review of Anatomy of the Medial Ulnar Collateral Ligament Complex of the Elbow. Curr Rev Musculoskelet Med.2020;13(1):96-102. doi:10.1007/s12178-020-09609-z
2. Zaremski JL. Elbow ulnar collateral ligament injuries in overhead athletes: An infographic summary. Sports Health: A Multidisciplinary Approach. 2022; 14(4):527-529.doi:10.1177/19417381221098622
3. Reiman MP, Walker MD, Peters S, Kilborn E, Thigpen CA, Garrigues GE. Risk factors for ulnar collateral ligament injury in professional and amateur baseball players: asystematic review with meta-analysis. J Shoulder Elbow Surg. 2019;28(1):186-195.doi:10.1016/j.jse.2018.08.018
4. Cascia N, Picha K, Hettrich CM, Uhl TL. Considerations of conservative treatment after a partial ulnar collateral ligament injury in overhead athletes: A systematic review. Sports Health: A Multidisciplinary Approach. 2019;11(4):367-374.doi:10.1177/1941738119853589
