Torn UCL

Overview

The ulnar collateral ligament, also known as the UCL, is the band that connects the elbow to the humerus and to the ulna. The UCL consists of an anterior and posterior section. The anterior section is above and in the front part of the humerus but below the ulna. The posterior section is a triangular shape that connects below the olecranon and lower part of the humerus. A torn UCL can be extremely painful and cause serious damage if left untreated.

This type of injury usually progresses overtime and if noticed early on, the level of future damage can decrease. The UCL is mainly responsible for stabilizing the ligaments in the elbow. If a ligament is torn, then the tether that holds the bones and tissues together becomes too long and the bones have too much free range, which can cause extreme pain.

Causes of a Torn UCL

The UCL is often damaged from sports injuries. Sports injuries to the UCL are the most common causes of ending sports careers such as baseball. Some of the causes for a torn UCL are:

  • Torn UCLRepetitive throwing
  • Previous nerve or tendon damage of the surrounding area
  • Motor-vehicle accident
  • Repetitive stress to the elbow
  • Sports that often cause a torn UCL are:
  • Baseball
  • Soccer
  • Softball
  • Football
  • Golf
  • Rugby
  • Tennis
  • Cheerleading
  • Javelin Throw

Symptoms of a Torn UCL

Below is a list of the common symptoms that are associated with a torn UCL

  • Unstable elbow and joint
  • Numbness in hands or fingers
  • Swelling
  • Looseness of the elbow
  • Pain when throwing
  • Bruising
  • Fever usually only associated with infection of the area
  • Pain on the inner part of the elbow
  • Decreased mobility or range of motion

Diagnosis

Due to the fact that a UCL injury can slowly deteriorate and become worse, if detected early enough, surgery can be avoided. To properly diagnosis a torn UCL, doctors will perform the following tests to confirm the tear:

  • X-ray
  • Physical examination
  • Valgus stress test
  • Magnetic Resonance Imagining (MRI)
  • MRI with gadolinium dye
  • Musculoskeletal ultrasound
  • Arthroscopy or Keyhole surgery
  • Computerized Tomography Scan (CT or CAT scan)

Torn UCL

Treatment

The most common type of treatment among athletes for a torn UCL is the Tommy John surgery. This type of surgery has been around since 1974 and was first performed on legendary pitcher Tommy John of the Los Angeles Dodgers, hence the name. During surgery, the injured UCL with be replaced by a different tendon from another body part. This helps restore the mobility and quality of the UCL. Unfortunately, the recovery time after surgery can range from 12-18 months. Even though surgery can fix a torn UCL, doctors can sometimes wait 6 months to a year before performing surgery on torn UCL patients.

If surgery is not required, then strengthen the elbow joint is the best way to heal a torn UCL. Physical therapy is a great way to improve the quality of the elbow and strengthen its stability. Pain medications, such as NSAIDS, can help reduce swelling and pain. Placing ice packs on the affected area can help drastically reduce swelling. Rest is a key ingredient to healing a torn UCL, both for non-surgical and surgical patients.

Tips and Prevention

Do not leave a torn UCL untreated because it can cause larger tears of UCL. For athletes, it may appear like the end of your career if you have a torn UCL, but if treated properly you may get in more playing time. A little elbow grease never hurt anyone, so try certain exercise to avoid a torn UCL. Exercises such as wrist flexors, tricep curls and forearm twists can help strength the muscles and avoid a tear. Whether surgery was required or not, avoid immediately diving back into sports activities.