What is a UCL Injury?

The Ulnar Collateral Ligament, which is on the medial side of the elbow, is made up of three ligaments. They are called the anterior oblique, posterior oblique and transverse ligaments. The anterior oblique is the most durable of the three ligaments within the Ulnar Collateral Ligament. The UCL is the ligament which stabilizes the elbow joint from being abducted. A UCL injury may develop over a long period of time, eventually causing such extreme pain that it can end the career of an athlete. It may also be a sudden, acute rupture.


A UCL injury is most often due to repetitive overhead throwing. It is not uncommon for a baseball pitcher to have this condition; in the past, if a pitcher had a UCL injury, it was referred to as a “Dead Arm”. In baseball, it is rare for a sudden throw to cause a UCL rupture, but is instead a series of smaller tears that accumulate over time, then suddenly give way. Other common causes of Ulnar Collateral Ligament Injuries are:

  • Repetitive overhead movements, like throwing a baseball or tennis
  • Poor throwing mechanics and improper form
  • Rupture during contact sports like wrestling or football
  • Accidents

Adolescents and adults alike can acquire a UCL injury if there is too much repetitive use, a collision or fall happens during a high contact sport, or an accident occurs.


Signs and symptoms of UCL INJURY can include:

• Mild to severe pain, both sudden and gradual

• Pain along the inside of the elbow

• A sharp popping noise, followed by pain when throwing

• Swelling, bruising, loss of range in motion

• Decrease of throwing velocity


Depending on the severity, surgery may or may not be necessary. Rest, ice, compression and elevation (RICE) is often the first recommendation, along with by non steroid anti-inflammatory drugs (NSAID). After any swelling has decreased, exercises and physical therapy are often the next treatment procedures. If surgery is performed, the Tommy John procedure has been proven to be very successful.

Elbow pain that is restricting activity, reducing athletic performance, worsens over time or is accompanied by swelling or loss of motion should be seen by a physician. Contact Dr. Madsen at Madsen Orthopedics for a diagnosis and treatment of Ulnar Collateral Ligament Injury.