UCL Injuries: Elbow Pain in Baseball Players

It is finally March, and that can only mean one thing — baseball season is here! As spring training gets underway across the country ball players must focus on getting their bodies ready for the grind of the long upcoming season. One of the main focus areas for many players is the arm and protecting against the dreaded UCL sprain.

UCL Injury Basics:

The UCL is the Ulnar Collateral Ligament which connects the ulna and humerus medially. (In terms of anatomy, if you stand with your arms at your side, palms facing forward, the medial aspect of your elbow touches your body.) This ligament is responsible for stabilizing the elbow and protecting other structures that pass through the ulna such as the ulnar nerve. The mechanism of this injury is usually caused by a valgus force or a force that acts on the medial aspect of the elbow (the inner part of the elbow). For example, in the six phases of high-velocity throwing the valgus force is applied during the cocking, acceleration, and deceleration phases.

This injury can be acute — meaning the athlete can describe a specific incident of exactly when and how the injury occurred — or it can be chronic — meaning overuse can play a role in causing micro – tears to the structure which will compromise the structure over time. In either case, the athlete will describe pain in the elbow. Below are the common signs and symptoms associated with a UCL sprain:

1. Point tender pain over UCL
2. Swelling in Elbow
3. Numbness/ tingling in 4th and 5th fingers
4. “Pop” on medial side of elbow with sharp pain

Diagnosing a UCL Injury:

1. Positive Valgus Stress Test during evaluation
2. MRI Reveals tear in the ligament

Treatment Options for UCL Injuries:

Non-Surgical

• Reduce pain and inflammation with rest, ice, and anti-inflammatory medication
• Begin Physical Therapy to strengthen muscles surrounding joint in order to stabilize the joint in order to allow the ligament to heal

Surgical

• Repair of existing ligament
• Reconstruction of ligament (Most common)
  • Ligament is replaced with a tendon either from the patient’s body (Autograft) or a donor (Cadaver) graft

UCL injuries are common injuries in sports that involve high volume throwing and overhead motions such as baseball, softball, and volleyball. These sports require tedious attention to detail when it comes to biomechanics and listening to your body. Athletes that experience pain on the medial side of their elbow while throwing should be suspicious of a UCL injury and seek an evaluation from an Athletic Trainer, Physical Therapist or Physician.

About the Author:
LJ Sernek is an Certified Athletic Trainer in the Chicagoland area. As a graduate assistant he worked exclusively with the Lindenwood University – Belleville baseball team.