While there are a number of ligaments around the elbow that provide stability, the most commonly injured in overhead athletes, specially baseball players of all age is the Tommy John Ligament AKA the medial ulnar collateral ligament (UCL).
This ligament is on the inside (medial) part of the elbow that is closest to the body. Although injury to the medial ulnar collateral ligament (Tommy John ligament) is most commonly thought of in overhead throwing athletes (i.e., baseball, softball, or javelin throwers), it can also occur in football players , volleyball players , gymnasts, wrestlers, or other contact athletes.
These injuries can be the result of a sudden, acute injury, but is more common due to overuse. Playing in multiple teams, playing all year long, pitching and catching in the same game/season, pitching while tired.
Injuries to the UCL can vary significantly in severity as the ligament can tear partially or completely, and it can tear in different locations (proximal, distal, or mid-substance). All of these factors must be taken into consideration when determining the optimal treatment strategies for UCL injuries.
In recent years, there have been significant increases in the rates of UCL injuries, especially in the youth baseball academies. Dr. Gonzalez a Regenerative Orthopedic and Sports Medicine Specialist believes we are experiencing an epidemic in the number of UCL injuries in the last decade.
Signs and Symptoms
- Inability to throw a baseball, softball, or other object
- Decreased throwing velocity,
- Decrease control
- Feeling or hearing a “pop” in the arm
- Pain on the inside (medial) part of the elbow
- Decreased elbow motion
What to do
Seek immediate care if any injury to your elbow causes signs or symptoms of a UCL injury. This is especially true if you feel a “pop” in the inside part of the elbow while throwing. It’s important to get a prompt and accurate diagnosis to determine the severity of the injury and get proper treatment. If you are unable to throw or have pain that is negatively affecting your throwing, you should be evaluated as soon as possible.A sports medicine specialist can evaluate the condition to make sure the right diagnosis is made.Images modalities can be done in the medical office like xrays, ultrasound and MRI/MRA to evaluate the elbow and the UCL.Dr. Gonzalez, alongside the team of the Andrew’s Institute in Pensacola, Florida created a protocol to use high resolution Ultrasound machines to help in the diagnosis of Tommy John Injuries.
Treatments
After a Tommy John Ligament injury is confirm, the physician will recommend treatments options like-rest-physical therapy with a gradual return to throw protocol– Orthobiologics ( PRP or Stem Cells)– Surgery ( Repair vs Reconstruction)In this videos, Dr. Gonzalez shows how to use Ultrasound to evaluate the Ulnar Collateral Ligament.Make sure to check out elbow pain Regenerative medicine treatments for more information about UCL tear.
