UCL Injury including Tommy John Surgery

Leading Off...

-Consists of three main sections in

triangular formation: the anterior oblique,

posterior oblique and transverse portion.

-Distributing over 50% of medial

support to the elbow, the UCL is a

crucial ligament within the arm.

-Unfortunately, UCL injuries have

become a common injury amongst

the sports world.

Two Causes of UCL Injuries

1) A slow, often chronic deterioration.

• BASEBALL

And the Pitch...

2) An acute, sudden rupture.

Any one of these devastating hits could have led to an acute, sudden UCL tear or rupture.

But does it hurt?

Tommy John Surgery

-Surgical treatment may better help restore ROM in the end, especially if the arm is heavily relied on, such as for Major League pitchers.

-Known formally as simply UCL reconstruction surgery, Tommy John surgery was named after none other then Tommy John himself and requires a tendon from another area of the body (usually the wrist) or cadaver to be removed and used as a replacement/reinforcement for the torn UCL.

-Nowadays, chances of successful Tommy John surgery are around 90%.

Rounding Third...

-Rehabilitation is the final step in repairing a torn UCL (if Tommy John surgery was performed.)

-Initially includes protection of the surgical area, where an immobilizer is worn, accompanied by cold treatments and minor excercises, like squeezing a soft ball

-The second phase, after about a month on average, includes gradually improving range of motion, re-building muscular strength and eventually tossing the splint across a variety of physical therapy (wrist curls, elbow extensions/flexions, etc...).

-The final phase requires one to maintain the elbow's range of motion, continuing on an increase of power, strength and endurance throughout the entire arm. Exercises are performed to increase flexibility, coordination and overall physical fitness. If performed on an athlete, activities specifically designed to return them to competitive form will be re-introduced.

-On average, pitchers can return to major league level play in about a year, while it takes slightly less (6-8 months) for position players, of all sports.

Journey Through An Ulnar Collateral Ligament Tear

courtesy of eorthopod.com

But who is Tommy John?

-First major league player to undergo UCL reconstruction.

-Was given a 1% at returning to baseball.

-Spent 18 months rehabbing, however he made it back to the majors, garnering 168 more wins across 12 more seasons before retiring at 46.

courtesy of legendsrevealed.com

-The constant and specific overhead movement used by pitchers increases the risk of UCL injuries, particularly tears or ruptures.

- During the initial phase of throwing, the shoulder is horizontally abducted, externally rotated and the elbow flexed. This causes slight stress upon the Ulnar Collateral Ligament.

-Additionally, a tremendous amount of strain is caused during the acceleration phase of a throw. With the body jolted forward, and the humerus undergoing a whipping motion, the forearm is left trailing, causing heavy stress on the UCL.

-Over time, this stress can lead to micro-tears and minor ruptures which pile up, accumulating across a pitcher's thousands of pitches per season, until something finally has to give, as demonstrated in the video.

Traumatized

-An acute rupture of the Ulnar Collateral Ligament can occur from a sudden blow to the body, more specifically the arm, and when the elbow is flexed. These occur most often in physically contacting sports, like hockey and football.

-Though less likely to occur in baseball, such a sudden rupture can lead to severe, sometimes career ending injuries amongst athletes.

"Rehabilitation After a Tommy John Surgery." LIVESTRONG.COM. N.p., n.d. Web. 19 Mar. 2013. <http://www.livestrong.com/article/421187-rehabilitation-after-a-tommy-john-surgery/>.

"Tommy John Surgery." Wikipedia. Wikimedia Foundation, n.d. Web. 19 Mar. 2013. <http://en.wikipedia.org/wiki/Tommy_John_surgery>.

"Ulnar Collateral Ligament (elbow)." Wikipedia. Wikimedia Foundation, n.d. Web. 19 Mar. 2013. <http://en.wikipedia.org/wiki/Ulnar_collateral_ligament_(elbow)>.

"Ulnar Collateral Ligament Injury." Wikipedia. Wikimedia Foundation, n.d. Web. 19 Mar. 2013. <http://en.wikipedia.org/wiki/Ulnar_collateral_ligament_injury>.

Works Cited

-Both short and long term tears or ruptures of the UCL will lead to moderate to severe pain along the medial aspect of the elbow, particularly while clenching the fist.

-Whether the tear occurred at a sudden instance or over time, the worst of the injury can be recognized through a signature "popping" sensation, and sometimes even an elbow dislocation.

-Swelling, bruising, and a sudden loss in range of motion all attribute a UCL injury.

-If diagnosed early enough, slow deterioration's via micro-tears and ruptures (like in Baseball) can be healed without the need for invasive surgery. This includes completing the RICE cycle, anti-inflammatories and physical therapy, including bicep curls, pronation and supination of the forearm and grip stengthening excercises.