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UCL Injury

Injuries of the ulnar collateral ligament (UCL) are the scourge of baseball pitchers, whose overhand throwing places extreme stresses on the elbow. Forever linked with Major League Baseball player Tommy John, UCL injury affects a myriad of athletes including gymnasts, wrestlers, and football players. The severity of an injury to this ligament covers a wide range, as it can tear in various locations, and the tear can be complete or partial.

What causes it?

UCL injury is most commonly developed with long periods of overuse (think lots of pitches, lots of games, not enough rest).

How do you know you have it?

The most common symptoms of a UCL injury are:

  • Pain on the inside of the elbow
  • Sensing a “pop” in the arm
  • Motion limitations
  • Decreased throwing velocity

How we fix it

The OSI upper extremity team is here to listen, discuss your concerns, and examine you for signs and symptoms of an injury to the ulnar collateral ligament. The personalized treatment path will be tailored to the patient, considering factors such as sport, timing of season, and career goals. The following can help determine the best course of action:

  • Physical exam: Your doctor will perform a careful examination of your arm. You can expect a discussion regarding your general health, the nature of your participation in athletics, and the first appearance of your symptoms. Following the medical history, your doctor will check the strength, stability and range of motion of the elbow.
  • X-rays: X-rays can show stress fractures and bone spurs.
  • MRI: An MRI can help assess the severity of the ligament tear.

Nonsurgical Treatment

Most treatment regimens begin with rest. Treatment can continue with the following:

  • Physical therapy exercises/programs to restore strength and flexibility.
  • Corrective throwing mechanics to relieve stress put on the elbow.
  • Anti-inflammatory medications to relieve pain and reduce swelling.

Surgical Treatment

Surgical treatment may be considered if symptoms of pain continue. Options include repair or reconstruction:

  • Arthroscopy
  • UCL reconstruction


There is a high rate of return for athletes after suffering a UCL injury.