A sprained UCL, or ulnar collateral ligament, is a painful elbow sprain. Although your elbow isn’t very big, an elbow injury can occur in many places. Your elbow is made up of muscles, tendons, and five ligaments. The UCL is the most commonly injured part of the elbow in athletes that do a great deal of throwing.

The UCL is the ligament located on the medial, or inner, side of the elbow. Like all ligaments, it connects one bone to another. The UCL helps stabilize the elbow joint, preventing the bones from moving too much and holding them together to prevent dislocation.  When damaged, athletes are unable to participate in activities that require throwing or use motions similar to throwing.

A sprain is a stretch or tear in a ligament. A strain, on the other hand, is a stretch or tear in a muscle or tendon. It’s possible to strain parts of your elbow, but despite the fact that the term is sometimes used, there’s no such thing as a UCL strain. There is indeed a UCL sprain, and it can throw you out of your game. Learn the symptoms, causes, treatment, and recovery to get back in the game after this elbow injury.

Symptoms of a Sprained UCL: How Do You Know if You Have a UCL Sprain?

Experts at Johns Hopkins University explain that the signs and symptoms of a UCL sprain can include

  • Gradual onset of pain, increasing over time
  • Pain on the inside of the elbow, especially after using it extensively and repetitively
  • Pain when accelerating the arm forward
  • Tingling or numbness in the pinky and ring fingers
  • Popping sensation when the UCL has finally reached its limit
  • Intense pain right after the moment of injury

Numerous other authorities add swelling, tenderness, possible bruising, stiffness, and immobility to this list.

As with all sprains and strains, elbow strains are categorized, or graded, according to their severity.

  • Grade one injuries are mild, with only minor tearing or stretching of the UCL and little loss of strength and functioning
  • Grade two injuries are moderate, with more tearing or stretching than grade one injuries but not the complete tearing of grade three, and they involve partial loss of strength and functioning
  • Grade three injuries are the most extensive, most damaging, and most painful of UCL sprains, and they result in full, albeit temporary, loss of strength and functionality

Your level of injury will determine how it’s treated and how long it will take for full recovery. Grade one and even some grade two injuries can improve with rest so you can return to activity in as little as two weeks. Even these lower level injuries, though, will worsen with certain activities. Listening to your signs and symptoms, especially your pain level, will help you prevent further damage.

Causes of a UCL Injury: How Can You Sprain Your Elbow?

The most common cause of a UCL injury is overuse. Overuse in sports injuries means that the same body part—in this case the elbow—is used repeatedly and repetitively.

With UCL injuries, the athlete uses the same throwing or overhead motion over and over again, sometimes for years. Microtears develop, the ligament gradually stretches, frays, and degenerates. Eventually, it reaches its limit and the injury becomes impossible to ignore.

Because of the nature and use of the UCL, certain athletes are typically the ones to sustain this type of elbow sprain. These are widely recognized as

  • Baseball pitchers
  • Javelin throwers
  • Tennis players
  • Ice hockey players
  • Water polo players

Diagnosing Your Elbow Injury

When you injure your elbow, it’s important to know with certainty that it’s the UCL that’s injured. When you know precisely what’s wrong, you can target your treatment for a more efficient recovery, which will put you back into the game as quickly as possible for your injury.

UCL sprains are typically diagnosed by a doctor. The various diagnostic procedures outlined by Houston Methodist Orthopedics and Sports Medicine include

  • A physical exam to check for laxity, or looseness, of the joint
  • Valgus stress test, in which the doctor puts pressure on the inside of the elbow while flexing and extending the joint looking for gapping (space) in the joint as well as crepitation (a popping or crunching sound) with movement

If a grade three injury is suspected, the doctor may possibly order additional testing and procedures such as:

  • MRI with contrast dye
  • Ultrasound
  • CT scans
  • Arthroscopy, a surgical exploration of the elbow

The imaging tests and arthroscopies may help, but they don’t always find the problem; therefore, they’re not automatic practices.

Treatment and Recovery: Getting You Back Out There

Treatment and recovery are the best part of the injury process because they’re healing and they get you back in your game. In all but the most severe UCL sprains, time and resting of the elbow are the main requirements to allow the body to heal itself.

Other treatment methods include

  • Pain- and inflammation relievers (non-steroidal anti-inflammatory drugs/NSAIDS like ibuprofen or naproxen)
  • Ice used sparingly to avoid increasing swelling and further irritating already-irritated nerves)
  • Physical therapy
  • Correcting posture as well as throwing position and mechanics

In extreme cases, surgery is needed to repair or replace the ligament. UCL replacement surgery is commonly known as Tommy John surgery, after the baseball pitcher who in 1974 was the first to undergo this procedure.

For athletes suffering from a grade three UCL sprain who desire to return to their sport as a player, surgery is a treatment option that will help them achieve this goal.

Recovery from a UCL injury will take a few weeks to a few months or more, depending on the severity of your injury. Daily stretching and strengthening exercises, done under the supervision of a doctor, trainer, or physical therapist, will help your elbow recover and your whole body stay in top shape for your comeback.

A UCL injury definitely limits throwing motion and ability. Happily, the limitation is localized. Johns Hopkins researchers and physicians assert that even with a UCL sprain, you can exercise, lift weights, run, carry out tasks of daily living, and more. Just don’t throw stuff. You’ll be back to doing that soon enough.

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