ELBOW INJURIES –
ULNA COLLATERAL LIGAMENT
The most well known and publicized elbow injury; Tommy John surgery, a tear of the Ulna Collateral Ligament. The UCL is the main connector between the upper and lower arm. That ligament endures a lot of stress in the throwing/pitching motion. The higher velocity throwers will create even more stress. Typically that ligament will begin to fray like a rope over time. Eventually the ligament will tear. There are different levels of tears ranging from a small tear, which causes mild to no pain to a full tear which can cause extreme pain. Some players also have multiple tears of the ligament. Players that have full tears in most cases experience a pop, usually on one pitch. There are signs that often occur prior to a full tear of a pop that will concern the player. The player will experience tightness in the forearm and elbow during and after throwing, and in some cases, during everyday non throwing related activities (brushing teeth, washing hair in the shower, or touching their shoulder). Pain in or around the funny bone area of the elbow is typically where most players will experience discomfort or pain. If the tear is bad enough, surgery is recommended to repair the compromised ligament, even if the player is still capable of playing.
The severity of a UCL tear can be determined by an Arthogram more commonly known as an MRI with contrast dye. The results of the MRI will dictate the player’s rehabilitation options. With small tears, alternative treatment options such as Cortisone, PRP, or Stem Cell injections, followed by physical therapy can be effective. Treatment for partial UCL tear varies from player to player base on their pain tolerance and performance. On occasion certain players can pitch effectively and remain asymptomatic (not experiencing pain) with partial ligament tears. For these players UCL reconstruction (Tommy John surgery) is optional and may not be required immediately. Other players with partial tears may experience pain that renders them incapable of pitching effectively. For these players UCL reconstruction is necessary for them to return to competition. Each player’s situation is unique and should be treated in accordance with his or her treating orthopedic physician.
Below, is a video of Dr. Ahmad performing a Tommy John surgical procedure.
The Baseball Health Network’s Jim Monaghan spoke with minor league pitchers Artie Lewicki and PJ Cerretto about their respective Tommy John surgical procedures and subsequent rehab programs.