ULNAR COLLATERAL LIGAMENT TEAR                            KANDIL NOTES

INTRODUCTION

  • An elbow ulnar collateral ligament (UCL) tear is an injury to the ligament on the inner part of the elbow that provides stability to the elbow joint

  • A UCL tear can occur suddenly after a trauma like an elbow dislocation or can occur gradually over time, as often seen in overhead athletes

  • Most UCL injuries occur in baseball players, especially pitchers

  • This a repetitive overuse injury

  • Can be associated with inflammation of the ulnar nerve leading to numbness and tingling of the small and ring fingers

  • CAUSES

  • Most common risk factors include

  • Exceeding youth pitch count guidelines

  • High pitch speed

  • SIGNS AND SYMPTOMS

  • Pain and tenderness on the inner part of the elbow, over the elbow UCL

  • Lower pitch speed

  • Lower pitch accuracy and control

  • TREATMENT​​

  • First line of treatment is a period of rest and pitching holiday

  • Avoid throwing for 6 full weeks

  • After 6 weeks and if symptoms are completely resolved, may begin a course of physical therapy (PT) to strengthen the muscles on the inner part of the elbow. In addition, work on shoulder and core strengthening and improve throwing mechanics

  • After PT, begin return to throwing program

  • High level athletes that fail conservative management may be candidates for Tommy John Surgery

  • Tommy John surgery is the reconstruction of the UCL using soft tissue graft to reinforce and strengthen the inner part of the elbow

  • 90% return to pre-injury levels with newer surgical techniques

PREVENTION

  • Adhere to pitch count guidelines

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