Overuse and Repetitive Stress

The most common way the UCL gets injured is through overuse. This is especially true for athletes who engage in sports that involve overhead movements or repetitive throwing motions, like:

• Baseball pitchers
• Tennis players
• Softball players

When you repeat the same throwing motion over and over again, the stress can gradually cause wear and tear on the UCL. Eventually, this can lead to a tear in the ligament, which causes pain and instability in the elbow.

UCL Injuries in Children

Children, especially young baseball pitchers under the age of 15, are at risk of UCL injuries due to the repeated stress of throwing. If a child experiences pain while throwing, it is important to address it immediately because pain is not normal and can lead to more serious injuries if ignored.

It is also important not to confuse a UCL tear with Little League elbow, which is another type of overuse injury in young baseball players. Little League elbow affects the growth plates in the bones, whereas a UCL injury affects the ligament itself.

Traumatic Injuries

Sometimes, UCL injuries happen suddenly because of a trauma or accident. For example, a fall on an outstretched arm can cause the UCL to rupture or pull off the bone, which may even pull off a small piece of bone. This is called an avulsion fracture and is much less common than overuse injuries. Trauma may also be accompanied by other injuries, like an elbow dislocation or fracture.

A UCL injury may be associated with several common symptoms:

• A sudden “pop” or sharp pain along the inside of the elbow, usually during a throwing motion. This can stop you from being able to throw properly.
• Pain on the inside of the elbow after throwing or doing overhead activities, like serving in tennis.
• Pain when accelerating your arm forward, just before releasing the ball.
• Tingling or numbness in the pinky or ring fingers (this happens if the UCL injury affects nearby nerves).
• Instability in the elbow, making it hard to throw. However, most people with a UCL injury can still perform daily activities like carrying groceries or lifting objects (non-throwing activities) without too much trouble.

Diagnosing a UCL injury usually involves both a physical exam and certain tests. It’s best to see an orthopedic specialist or a sports medicine doctor for this type of injury. Here’s how the diagnosis typically works:

1. History and Symptoms: The doctor will ask you about your symptoms and what you were doing when you got hurt. They will also want to know if you’ve had any previous elbow injuries.
2. Physical Exam: The doctor will test your elbow for instability using a valgus stress test, which checks how much movement is in your elbow joint. This is one of the most common ways to diagnose a UCL tear.
3. Imaging: Although physical exams are helpful, the doctor might also order an MRI scan or X-ray to look for any damage to the ligament or bone. An MRI can show if the UCL is torn, but it isn’t always 100% accurate. To improve the accuracy of the MRI, the doctor might inject a special contrast dye (called gadolinium) into the elbow joint.