Elbow Ligament Sprains or Tears

Elbow Ligament Sprains or Tears(UCL Injury) is an inner elbow injury. It’s most commonly an overuse injury and most famously known for being a baseball pitcher’s injury. If you have a UCL injury you will feel pain and tenderness at your elbow. Treatments include rest, ice, medications and physical therapy.

Ulnar Collateral Ligament (UCL) is a strong band of tissue on the inner side of your elbow. It keeps your elbow joint stable during the act of throwing or overhead arm movements.

Stress on your UCL from repetitive overhead movement or a fall on your outstretched arm can irritate and inflame, stretch, partially tear or completely tear your UCL. Ligament damage leads to pain, looseness in your elbow joint and loss of function.

The UCL is the most common ligament injured from repetitive overhand throwing. It’s probably best known as the ligament most often injured in baseball pitchers.

There are three grades of UCL sprain injuries:

• Grade 1: The ligament is stretched but not torn.
• Grade 2: The ligament is stretched and might be partially torn.
• Grade 3: The ligament is completely torn.

Symptoms

Mild to moderate symptoms include:

• Pain and tenderness on the inner side of your elbow during or after a session of overhead arm activity.
• Pain with a fast forward movement of your arm.
• Weak or unstable feeling at your elbow.
• Weak or clumsy hand grip.
• Loss of ability to throw as fast or hard.

Symptoms of a torn ligament include:

• Feeling a sudden pop along the inside of your elbow.
• Severe pain.
• Loss of ability to throw.
• Tingling and numbness in your pinky and ring fingers. This means your ulnar nerve is also pinched or injured.

Causes

Overuse, wear and tear injuries

Most cases of UCL damage are from overuse. Repetitive motion, like overhand throwing, stresses the ligament. Months or even years of continued strenuous use cause your UCL to stretch, become irritated and the tissue breaks down from small microtears. Your elbow joint becomes loose (“unstable”). Your UCL may become strained and inflamed, partially or completely torn, or one end of the ligament may pull away from the bone.

Traumatic injuries

Traumatic injuries to your UCL involve a blow or hit to your elbow. They are not overuse injuries. A fall with a landing on your outstretched arm “to break your fall” is one example. This can result in an elbow dislocation or fracture that can injure your UCL.

Diagnosis of Elbow Ligament Sprains

Orthopaedic Specialist at Shreya Hospital, Ghaziabad will review your medical and athletic history and perform a physical exam. During the exam, they’ll check your range of motion, elbow strength, elbow stability, arm muscle mass and appearance and may examine your shoulder. They’ll also ask you where you feel pain.

Tests your provider may order include:

• Valgus stress test. This is a physical test in which your provider places their fingers on your UCL after raising your lower arm 30 degrees. They then gently push your elbow inward toward your body while pulling your lower arm outward. A positive test is a feeling of looseness at the elbow joint and pain.
• Computed tomography (CT) and X-rays. These imaging tests show pictures of your bones, stress fractures and other bone issues that may contribute to your elbow pain and limited motion. They don’t directly show soft tissue like the UCL.
• Magnetic resonance imaging (MRI) scan. This imaging test shows injuries to soft tissues such as tendons and ligaments. It can also show small fractures not picked up on X-rays.
• Arthrogram. This is an MRI plus an injection of dye into your elbow joint to make hard-to-detect problems easier to see.

Treatment of Elbow Ligament Sprains

Treatment depends on the severity of your ulnar collateral ligament (UCL) injury and how much you want to use your arm for strenuous overhead movements or throwing activities. If you have a minor UCL tear, it may heal on its own. You may find relief from pain and discomfort from nonsurgical treatments.

Nonsurgical UCL injury treatments include:

• Rest.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). Ask your provider about a prescription-strength NSAID if you need it.
• Ice. Apply ice to your elbow daily to reduce pain and swelling.
• Physical therapy. Begin physical therapy to strengthen the muscles around your elbow.
• Injections of platelet-rich plasma (PRP). A small amount of your own blood is withdrawn and your platelets are separated from other blood components. The platelets are injected into the area of your injury. Injections of PRP may be helpful in those with a partial UCL tear.

Surgical treatments include:

• UCL direct repair. If a single traumatic event caused your UCL ligament to pull off the bone, it may be possible to reattach it.
• UCL reconstruction (Tommy John Surgery). If you have an unstable or torn UCL and nonsurgical treatments don’t provide pain relief or if you’re an athlete and want to continue throwing or engage in other strenuous overhead arm movements, your provider will recommend UCL reconstruction.

With this surgery, your surgeon takes a tendon from another area of your body or a donor. The tendon is attached to the ulna and humerus to act as the new UCL. The remaining parts of the original UCL may be attached to the new graft to strengthen it.

The goal of surgery is to restore elbow stability and range of motion, improve elbow strength and relieve pain.