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