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Ulnar Collateral Ligament (UCL) Injury

What is the UCL?


The UCL is a key ligament on the inner side of the elbow that stabilizes it during throwing and overhead motions.


What is This Condition?


A UCL injury occurs when the ligament is stretched or torn. It is especially common in throwing athletes such as baseball pitchers.


What are the Symptoms?


  • Pain on the inner side of the elbow during throwing

  • A “pop” or sudden pain at the time of injury in some cases

  • Loss of throwing velocity or control

  • Weakness or instability when the elbow is stressed

  • Swelling or bruising after an acute tear


What Causes It?


  • Repetitive overhead throwing, especially with poor mechanics or overuse

  • Sudden injury from a forceful throw or collision

  • Chronic stress from sports like baseball, javelin, or gymnastics


How is It Diagnosed?


  • Exam: tenderness along the inner elbow, pain with valgus stress testing

  • MRI (with or without contrast): shows ligament damage

  • Ultrasound: sometimes used dynamically during stress testing


How is It Treated?


Non-surgical:


  • Rest, activity modification, and anti-inflammatories

  • Physical therapy to strengthen the forearm, shoulder, and core

  • Pitching mechanics evaluation for athletes


Surgical:


  • UCL reconstruction (“Tommy John surgery”): ligament is replaced with a tendon graft

  • UCL repair with internal brace: an option for certain types of tears, especially in younger athletes


Learn more from AAOS (OrthoInfo):

https://orthoinfo.aaos.org/en/diseases--conditions/ulnar-collateral-ligament-ucl-injury/

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