ETIOLOGY

The ulnar collateral ligament provides the primary resistance to valgus stresses that occur during the late cocking and early accelerations phases of throwing or swining. It is most ofter injuried as a result of a valgus force from either repetitive trauma (in chronic condition) or a one time trauma (in acute conditions).

If the force on the soft tissues is greater than the tensile strength of the structure, then tiny tears of the ligament can develop. Months (and even years) of use cause a process of microtears, degeneration, and and eventually a rupture of the ligament with happen with a pop and immediate pain. The dominant arm is affected most often.

Professional pitchers have been the athletes treated most often for this problem. Other athletes such as javelin and disc throwers, football throwers, racquet sport athletes, and ice hockey players are all at an increased risk for a UCL sprains and tears. The entire elbow joint is at risk due to the abnormal forces caused by the repetitive stress injury.

Case Study (cont.)

In our athlete, it is impossible to tell if there were previous micro tears leading up to the current injury. However, due to the nature of the sport and the high physical demand placed on these elite level athletes, it is not out of the question.

Grading of sprains

Grade 1: Overstretching of the ligament, no joint laxity is noticable. Often associated with pain that lasts a short time period and patient gradually returns to normal daily living within a few days.
Grade 2: Slight trear of the ligament, joint shows increased laxity. This type of sprain can require rehabilitation and appropraite treatment to ensure full return to normal daily living activities.
Grade 3: A complete tear or rupture of the affected ligament. This will require surgery to repair the ligament or physical therapy to regain almost normal function without the ligament repair. Typically lasts months-years before return to normal function.