Ulnar Collateral Ligament (UCL) TEARS
The ulnar collateral ligament of the elbow is the most important stabilizer of the elbow joint. It is on the inner side of the elbow and connects the upper arm bone (the humerus) with the forearm bone (the ulna). Overhead throwing puts excessive stress on the UCL and with repetitive overuse the ligament suffers microtears, stretches and frays, and degenerates leading to injury and UCL tears. UCL tears are frequently chronic and degenerative but may also be acute or an acute injury on top of a chronic, degenerative tear.
About UCL tears
Most of these injuries are found in the dominant elbow of throwing athletes, particularly pitchers, javelin throwers and other overhead athletes. However, UCL injuries in the non-throwing athlete also occur. Combat sports like MMA, contact sports like football and hockey, and tumbling sports like cheer leading and gymnastics all place heavy loads on the elbow. Sometimes the UCL can be torn by a fall on an outstretched arm.
UCL injuries and reconstructions are on the rise in young amateur athletes suffering UCL injuries as they participate in competitive sports compromising elbow stability. UCL injuries used to be career ending injuries until the Tommy John surgery.
What are the symptoms of a UCL injury?
swelling and bruising on the inside of the elbow
elbow pain and stiffness
the inability to completely straighten the affected arm
tingling in the ring and baby fingers
weak grip strength
instability and loss of performance in the thrower's elbow
How is a UCL tear diagnosed?
Dr. Johnston will review your medical history, discuss your symptoms and your level of athletic participation. He will conduct a physical exam to test elbow stability, evaluate range of motion and strength using special tests. He will order x-rays to evaluate bone health, and an MRI to view the soft tissues including the UCL. With this information he will make his diagnosis and recommendations for treatment.
What are the treatment options?
Treatment depends upon the type of tear. Partial tears can often be managed without surgery with rest, support, anti-inflammatory medications, and physical therapy. Platelet - rich plasma injection is another nonoperative treatment that may help reduce recovery time and potentially avoid surgery in partial tears when combined with physical therapy and a rehab program. With nonoperative management most throwing athletes with a partial tear can return to competitive throwing in 3-4 months.
Patients with complete tears and patients who fail extensive conservative management for a partial tear are candidates for surgical UCL reconstruction.
Surgical repair with Tommy John Procedure
Clinical studies report excellent outcomes for UCL Reconstruction surgery for both recreational and elite athletes. The Tommy John Procedure is the gold standard surgery to reconstruct the torn UCL. It provides excellent results with return to play between 80-90%. Time to return to play varies with most elite athletes, especially professional pitchers, needing 15-18 months to return to their previous level of play.
If you or a loved one suffers with an elbow injury, contact Dr. Peter Johnston with offices in southern Maryland to schedule consultation. Dr. Johnston is a board - certified shoulder and elbow specialist who treats elbow conditions including trauma, arthritis, and instability. joint problems with both arthroscopic and open approaches. Dr Johnston is an expert in Tommy John UCL reconstruction surgery. He cares for the young and the aging athlete in and around.
