How is the UCL injured, and what are the symptoms?
The UCL can be injured in several different ways. Most commonly, there is a gradual onset of medial elbow pain due to repetitive stresses on the ligament. For athletes participating in overhead or throwing sports, poor mechanics, inflexibility, or fatigue can eventually lead to muscle strain, which places more stresses on the UCL. These stresses create microscopic tears in the ligament, which can add up to one big tear over time. (Figure 2) This gradual stress causes the ligament to stretch and become too long. Once it gets too long, it no longer holds the bones tightly enough during throwing activities. Occasionally, throwing athletes may experience a sharp “pop” or develop sharp pain along the inside of the elbow joint on one particular throw leading to the inability to continue throwing. Pain on the inside of the elbow may also be felt after a period of heavy throwing or other overhead activity, or the athlete may be unable to throw beyond 50% to 75% on successive attempts. Pain is
