UCL Injury (Elbow) | Orthopaedics | Loyola Medicine

Ulnar Collateral Ligament UCL Injury (Elbow)

Overview and Facts about Ulnar Collateral Ligament UCL Injury (Elbow)

An ulnar collateral ligament (UCL) injury is damage to the inside of the elbow caused by repetitive use or trauma. The UCL is attached to the bone in your upper arm (humerus) and the bone in your forearm (ulna). Over time, this ligament can stretch or tear, affecting your range of motion, strength and stability. A UCL injury is common in sports that involve throwing or overhead motions, such as baseball, volleyball or javelin.

Treatment is approached first with non-surgical methods, including anti-inflammatory medications and physical therapy. Surgery to heal a UCL injury is called Tommy John surgery, named after a famous baseball player who first underwent surgery for this injury. 

Symptoms and Signs of Ulnar Collateral Ligament UCL Injury

Symptoms of a UCL injury are usually noticeable when performing overhead motions, such as pitching. Symptoms include:

  • Pain on the inside of the elbow with an overhead motion
  • Numbness or tingling in the arm or fingers
  • Instability in the elbow joint
  • Soreness
  • Swelling along the inside of the arm 

Causes and Risk Factors of Ulnar Collateral Ligament UCL Injury

The most common cause of a UCL injury is from repetitive stress on the ligament over time, especially in athletes in sports involving overhead motions. This injury can also be caused by trauma, such as a fall onto an outstretched arm. A traumatic UCL tear may be accompanied by an elbow fracture or dislocation. 

Tests and Diagnosis for Ulnar Collateral Ligament UCL Injury

Diagnosis of a UCL injury is usually performed by an orthopaedic specialist, physical therapist or sports medicine physician. He/she will evaluate your injury with a thorough examination of your elbow and review of your medical history. He/she may also collaborate with an orthopaedic surgeon and perform imaging tests, such as an MRI or X-ray, to confirm where the damage is located. 

Treatment and Care for Ulnar Collateral Ligament UCL Injury

Treatment for a UCL injury usually begins with non-surgical options, including rest, icing of the affected area, non-steroidal anti-inflammatory medication and physical therapy to improve strength and range of motion.

If surgical intervention is necessary, your surgeon may recommend Tommy John surgery (or UCL reconstruction) to repair the torn ligament. Tommy John surgery involves replacing the torn ligament with a tendon from another place in the body, or from a donor.

Following surgery, you will need to participate in a period of physical therapy to restore your range of motion and arm strength. Your doctor will determine how long you need to follow a physical therapy regimen and when it is safe to return to your sport or activity.