The Ulnar Collateral Ligament (UCL) is located on the medial side (inside) of the elbow joint. The UCL connects the humerus (upper arm bone) and the ulna (inner forearm bone). The UCL is comprised of anterior, posterior, and transverse bundles. All three components of the UCL provides support and stability to the elbow joint.
UCL tears can occur gradually or acutely and are commonly seen in athletes who participate in repetitive overhead movements and throwing, like baseball pitchers. Over a period of time, the UCL (specifically, the anterior bundle) is gradually torn as forces are constantly applied to the elbow joint. Gradual UCL tears lead to pain and stiffness on the inside of the elbow after long periods or repetitive throwing or overhead motions, and typically result in loss of velocity, command and control while throwing.
Acute tears can also occur while throwing and are often felt as a pop or a dead arm. Separately, UCL tears can also occur acutely after trauma to the elbow or after an elbow dislocation. Sudden UCL tears are often seen in wrestlers, gymnasts and other athletes that fall on an outstretched arm. Acute UCL tears cause swelling, pain and stiffness in the affected elbow and athletes often recall a “popping” sensation.
Non-operative treatment typically involve rest, anti-inflammatory medications (NSAIDs), activity modification, physical therapy, and occasionally PRP injections.
Surgery is recommended in throwing who have failed attempts at non-surgical treatment or who cannot return to throwing. Surgical repair or reconstruction restores stability in the joint, alleviates pain, and allows for a full return to sport.