The ulnar collateral ligament, or UCL, is an elbow ligament that holds bones together and helps the elbow move. UCL injuries are common in throwing sports like baseball, softball and track's javelin event. Depending on the severity of the ligament injury, patients have the option to treat a UCL problem with rehab or surgery.
What is the UCL?
The UCL is located on the inside -- when your palm is facing you -- of the elbow. The UCL is composed of three bands, or divisions: the anterior, posterior and transverse bands. The UCL attaches to two bones, the humerus bone of the upper arm and the ulna bone of the lower arm. The anterior band of the UCL is the primary restraint, or stablizer, for the elbow joint and therefore the most likely to be injured.
How the UCL is injured
Activities that place the greatest stress on the elbow are twisting and bending actions like throwing a baseball or a javelin. Throwing motions can put heavy stress on the ligament, especially if the thrower has bad or unsound mechanics. The UCL can be injured gradually or with a single pop and tear. Gradual injury involves overuse, which leads to small tears, which eventually loosen and destabilize the UCL. Some athletes can feel a sharp pain or pop after one throw, which can indicate a complete tear of the ligament.
When Surgery is the Choice
If you want to return to strenuous overhead or throwing activities, surgery is often recommended because the torn ligament often won't heal enough to allow throwing on its own. Physical therapist Tammy Wadsworth notes that it is feasible to try nonsurgical options first and later turn to surgery if the results are not satisfactory. Surgery can involve simply reattaching the existing ligament or using a new ligament from the wrist or a cadaver. Repairing the existing ligament is very rare and can only be used when the ligament is not torn but simply pulls away from the humerus.
Rehab Instead of Surgery
If you do not plan to engage in heavy throwing or overhead activities, then a rehab program can often be enough to relieve pain and provide stability by increasing the workload for surrounding muscles. A UCL injury is unlikely to impair daily activities like carrying groceries, exercising, lifting weights or playing non-throwing sports. Non-surgical rehab focuses on strengthening the muscles that surround the elbow. An initial rest period is used, during which the patient ices and takes anti-inflammatory medicine until pain and swelling in the elbow are gone. After that period, the goals are to strengthen and add flexibility in the forearms, biceps and triceps muscles to help support a weakened elbow.
