A UCL injury, or an ulnar collateral ligament injury, is often nicknamed a Tommy John injury after the famous baseball pitcher Tommy John. He was the first major athlete to undergo surgery for this injury. His name has now become synonymous with the surgery.
The ulnar collateral ligament of the elbow is one of the major stabilizers of the elbow. It is located on the inside of the elbow running between the humerus (arm bone) and the ulna (one of the forearm bones). It helps to stabilize the elbow against valgus stress.
Mechanism of injury
Valgus stress on the elbow occurs when the hand of the throwing arm is pulled away from the body, putting stress on the inside of the elbow. Pitchers and other throwing athletes experience valgus stress on their elbows in the late cocking phase of throwing. This is the position where the shoulder is maximally externally rotated just before the arm comes forward to start to throw the ball.
There’s a tremendous amount of valgus force on the ulnar collateral ligament with every pitch or throw. Over time, the ligament experiences a tremendous amount of stress.
This is an injury most commonly experienced by pitchers, but it can be seen in many throwing and overhead athletes, such as football quarterbacks, baseball players at other positions, tennis players, and others.
Signs and symptoms of a UCL injury of the elbow
Acute events, meaning that there is one particular throw that ruptures the ligament, can occur, but this is usually not the case. This is typically an injury that develops over time.
A pitcher will usually complain of pain on the inside of the elbow that worsens over the course of the game. It typically gets worse as the season goes on, and the pain takes longer to go away after each game. He often complains of not having the same velocity or “zip” on their pitches or throws. He might also notice that he can’t locate their pitches or throws as well as he used to be able to.
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