What is an Injured UCL?



The NFL season has started and so have the injuries to key players.

Last week, Ben Roethlisberger, Quarterback for The Pittsburgh Steelers had a season ending injury on his elbow.

The Steelers have not yet confirmed, but highly likely he injured his UCL (Ulnar Collateral Ligament) in his throwing arm. What is the UCL and why is he out for the whole season?


What is the UCL?

The UCL is made up of 3 bands, a ligament is a strong band of tissue that attaches from bone to bone and holds bones together to help control the movement of a joint.

The UCL is on the inside ( medial) aspect of the elbow and attaches from the humerus ( upper arm bone) to the ulna ( forearm bone).

The 3 bands that make it up, provide stability to the elbow from all angles.


How do you injure the UCL?

An injured UCL can cause pain, instability or looseness of the elbow and inability to play your throwing sport.


The most common way to injury the UCL is repetitive stress to the 3 bands, for example overhead throwing athletes.

The more rare way to injury the UCL is traumatic, such as falling on an outstretched arm. The UCL then could rupture/ get pulled off of the upper arm bone ( humerus). This can also result in an elbow dislocation or avulsion fracture.


How is a UCL injury treated?

Non surgically: rest, ice, anti-inflammatories and physical therapy.

Surgically: UCL reconstruction or otherwise referred to as Tommy John Surgery.

The surgeon takes a tendon ( attaches muscle to bone) from somewhere else in the body or from a donor, to serve as the new UCL. Remnants of the original ligament may be attached to the graft to strengthen it.

Regenerative Medicine: platelet rich plasma ( PRP) and stem cell injections into a torn UCL to regenerate the ligament.


How long is rehab after Tommy John Surgery?

The recovery may last several months to a year based on individual goals. The physician and physical therapist will work together to monitor progress.

The elbow will initially be placed in a hinged brace to gradually increase the range of motion. If the plan is to return to throwing and competition, physical therapy is needed to strengthen the elbow region, address bio-mechanics of the shoulder and elbow to address how the elbow adapts to the throwing motion stress. Everyone recovers at a different speed, but the return to sport should not be rushed to avoid re-injury or delayed healing.


How long is rehab after PRP injections?

Research is still being done to determine if post PRP return to sport is faster or slower than traditional Tommy John Surgery.

We wish Ben Roethlisberger the best in his elbow rehab so he can successfully return to football next season.


References:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/ulnar-collateral-ligament-ucl-injuries-of-the-elbow

https://www.sciencedirect.com/science/article/pii/S2352320418300907

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