UCL Injury (Thrower's Elbow)
UCL Injury in San Antonio, TX
If you throw a baseball, football or javelin, pain on the inside of your elbow, a loss of velocity or a sudden pop during a throw may signal an injury to the ulnar collateral ligament (UCL). These injuries can sideline throwing athletes, and an accurate diagnosis helps you plan the right path back.
Travis C. Burns, MD is a board-certified orthopedic surgeon in San Antonio, TX, with fellowship training in orthopedic sports medicine. You can schedule an evaluation at his Medical Center, Alamo Heights or Westover Hills office to discuss your elbow injury and the options that may fit your goals.
What Is a UCL Injury?
A UCL injury is a sprain or tear of the ulnar collateral ligament, the band of tissue on the inside of your elbow that connects the upper arm bone (humerus) to a forearm bone (ulna). The UCL resists the strong forces that pull the elbow apart during the late cocking and acceleration phases of throwing. Repeated throwing can stretch, fray or tear it, and it can also tear from a single injury such as a fall on an outstretched arm.
Pain on the inside of the elbow can also come from Golfer's Elbow, while pain on the outside often points to Tennis Elbow.
Types and Causes of UCL Injury
- Partial tear or sprain: The ligament is stretched or partly torn but still provides some stability.
- Complete tear: The ligament is fully torn, often causing instability during throwing.
- Chronic overuse injury: Repeated stress gradually weakens the ligament over time.
- Acute injury: A single throw or fall causes a sudden tear.
Risk factors include high pitch counts, year-round throwing without rest, poor throwing mechanics and fatigue.
Symptoms of UCL Injury
Symptoms may include:
- Pain on the inside of your elbow, especially during or after throwing
- A pop felt or heard at the time of injury
- Reduced throwing speed, accuracy or distance
- A feeling that your elbow is loose or unstable
- Numbness or tingling in the ring and small fingers
- Swelling or bruising on the inside of the elbow
How UCL Injury Is Diagnosed
Diagnosis usually involves a detailed history of your throwing and symptoms and an exam that tests the stability of your elbow and checks the ulnar nerve. X-rays can look for bone spurs or fractures, and MRI or MR arthrography can show the ligament and the extent of a tear. Stress imaging may be used in some cases.
Nonsurgical Options to Try First
Many partial UCL injuries are treated without surgery. Options may include:
- Rest from throwing for a period of time
- Ice and anti-inflammatory medication when appropriate
- Physical therapy to strengthen the forearm, shoulder and core
- A gradual, structured return-to-throwing program
- Review of throwing mechanics and workload
- Injections, which may include PRP therapy in some patients
When Surgery May Be Recommended
Surgery may be considered for complete tears, or for partial tears that do not improve with nonsurgical care, especially if you want to return to competitive throwing. Your goals, sport and level of play are important parts of this decision.
Surgical Options That May Be Considered
Surgical options may include UCL reconstruction, often called Tommy John surgery, in which a tendon graft replaces the torn ligament, or repair of the ligament in selected patients. The best option depends on the type of tear, the quality of the tissue and your goals.
Recovery
After nonsurgical care, you may follow a gradual throwing program once pain settles and strength returns. After surgery, recovery is long and staged: motion is restored first, then strength, followed by a progressive throwing program, and return to competitive throwing often takes many months. See the Postoperative Instructions and Physical Therapy Protocols pages.
Why Choose Dr. Burns for UCL Injury (Thrower's Elbow) in San Antonio, TX?
Travis C. Burns, MD is a board-certified orthopedic surgeon with subspecialty fellowship training in orthopedic sports medicine through the John A. Feagin, Jr. Sports Medicine Fellowship. His practice centers on arthroscopic surgery of the shoulder, hip and knee, which gives him a sports medicine perspective on how injuries affect your activity, work and daily life.
Dr. Burns previously served as Chief of Sports Medicine at San Antonio Military Medical Center, where his clinical focus was complex shoulder, hip and knee injuries. He has been active in research and academic medicine, including more than 35 peer-reviewed publications. You can meet with him at the Medical Center, Alamo Heights or Westover Hills office, depending on what is most convenient for you.
Frequently Asked Questions About UCL Injury
What is a UCL injury?
A UCL injury is a sprain or tear of the ligament on the inside of your elbow, most common in athletes who throw overhead repeatedly.
Is a UCL injury the same as Tommy John surgery?
No. A UCL injury is the damage to the ligament, while Tommy John surgery is one surgical option used to reconstruct it.
Can a UCL tear heal without surgery?
Sometimes. Many partial tears improve with rest, therapy and a structured throwing program, while complete tears in throwers more often need surgery.
How long does it take to return to throwing?
It depends on the injury. Nonsurgical recovery may take weeks to a few months, while recovery after reconstruction often takes many months.
How can I prevent a UCL injury?
Prevention focuses on limiting pitch counts, taking rest periods, improving mechanics and strengthening your shoulder, core and forearm.
Request an Appointment
If you have pain on the inside of your elbow when you throw or have lost velocity, an evaluation can help you understand your injury. Request an appointment in San Antonio with Dr. Burns at the Medical Center, Alamo Heights or Westover Hills office to discuss your UCL injury options. You can call (210) 705-5060 to schedule a visit.
