An ulnar collateral ligament tear or sprain is usually caused by overuse. Athletes, especially baseball players, are more prone to injuries of the ulnar collateral ligament; however, even gymnasts, wrestlers, and javelin throwers create excessive pressure on the elbow joint with their repetitive motions causing the joint to swell, damaging cartilage, creating bone spurs, and tearing of their ulnar collateral ligament.
Tear of Ulnar Collateral Ligament
Also known as the Tommy John surgery, an Ulnar Collateral Ligament Repair is done on patients with severe ulnar collateral ligament injuries.
Symptoms of an ulnar collateral ligament tear include:
- Hearing a popping noise
- Feeling a clicking
- Grinding sensation in the joint
Nonsurgical treatment for ulnar collateral ligament tears include resting the elbow and avoiding future activities that stress the joint. Bracing and orthobiologic injections can also treat these tears, while physical therapy can strengthen the muscles that help support the ligament. Severe partial or complete tears of the ulnar collateral ligament usually require surgical intervention.
Surgery – Tommy John Surgery
Also known as the Tommy John surgery, an Ulnar Collateral Ligament Repair is done on patients with severe ulnar collateral ligament injuries. It is also used to restore strength and flexibility to elbow joints after the ulnar collateral ligament has been torn or sprained. There has been a rise with the Tommy John surgery in athletes between the ages of 15 and 19 due to overworking the elbow. Baseball pitchers are now limited in the number of pitches they can throw in each game to minimize the overuse of these joints. This surgical technique was developed by the Los Angeles Dodgers team physician who used it to repair a UCL injury by pitcher Tommy John in 1974.
Dr. Stowell will perform a physical examination to assess your symptoms and may even order an MRI to get clear images of your ligament. If he determines that surgery is necessary, Dr. Stowell will make an incision to see the inside of your elbow. He will drill holes in your ulna and humerus bones and take a tendon usually from your wrist on the same arm to use as a graft. He will use this tendon to weave through the holes and secure it in place. Dr. Stowell may also transpose your ulnar nerve based on your symptoms.
After surgery, Dr. Stowell will send you home in a brace to stabilize your elbow for about three months. He may prescribe non-steroidal medications or opioids for pain management and give you specific post-op instructions. The tendon must be protected and strengthened gradually with physical therapy. Full rehabilitation period depends on each individual and can vary any time between six months to a year. With a diligent recovery, ninety percent of patients make a full recovery and return to sports.