How a UCL Injury Can Affect the Career of a Baseball Pitcher

The arm movements of a pitcher.

The ULC, or Ulnar Collateral Ligament, injury is a tear in the inside of the elbow that runs from the Ulnar Collateral Ligament to the Humerus. It occurs with overuse and wear and tear on the ligaments in the elbow.

To confirm the research on this type of injury an interview was conducted with a second year Doctorate of Physical Therapy student, that is currently attending the University of Hartford, David J. Wojtowicz, Jr., SPT.

David expressed that his interest in physical therapy, and sports medicine, began when he was a freshmen in high school. He volunteered at his local hospital at the age of 14 and moved on to their extensive rehabilitation center.

At the age of 16 he started working as a volunteer at an orthopedic clinic and soon became a part time employee, working there during school breaks. David said, “I always wanted to pursue the field of sports medicine, and that is how I ended up a DPT major.”

During his course of study he attended other facilities, such as the Norwalk Rehabilitation Center, so he has seen various types of injuries requiring rehabilitation services. His course work has included the study of a UCL injury.

One example of someone who had a UCL injury that David spoke about was Boston Red Sox pitcher Chris Sales. David said, “it is still an unknown as to how the surgery will affect his career, but he has missed the 2020 season. He will need extensive rehab in order to come back.”

This type of injury is most commonly associated with baseball pitchers, but it can also occur in other athletes who perform frequent overarm movements. UCL injuries can range from a complete tear to just some inflammation. Chris Sales, a pitcher for the Boston Red Sox, had this type of surgery.

The illustration below shows you where the damage can occur: 

The Boston Red Sox announced that, “Chris Sales underwent Tommy John surgery on March 30 2020. He has begun his long road to recovery.”

The type of symptoms he will experience with a UCL injury are clumsiness and weakness of hand grip; elbow pain and stiffness; loss of function in the elbow and arm; numbness or tingling in the ring and little fingers and hand; and swelling and bruising. 

What is the most common type of UCL injury and who gets them? 

The most common type of ULC injury is a complete tear that will require surgery. This occurs more commonly with baseball injuries, especially a pitcher, like Chris Sales. Baseball catchers and outfielders can have this type of injury as well because they use overarm motion, but not as common as a pitcher.

One way the pitcher will know that he got this type of injury is that sometimes the UCL tear will feel like a “pop” after throwing the ball and then he will feel intense pain. Click onto Throw a Baseball and you will see the overarm motions that a pitcher will use. 

David explained that the force on the tendons of the elbow when the pitcher releases the baseball are intense. He said, “imagine the force needed to throw a ball 95 miles per hour.”

What type of test should you have before you agree to UCL surgery? 

The first thing a pitcher would do is see an orthopedic specialist who will exam his elbow, review his symptoms and take a full medical history. There are a number of diagnostic test that the doctor can perform to make sure that he has a complete tear of his UCL.

These different tests consist of a CT scan; MRI, musculoskeletal ultrasound; and X-rays. If the tests show that it is a complete tear surgery is usually the recommended course of action. If it is not a complete tear there are nonsurgical treatments available. 

Nonsurgical treatment for UCL Injuries of the elbow 

Before a pitcher commits to having surgery for his UCL injury, he may try a more conservative approach to relief his symptoms. He can keep his elbow immobilized to prevent it from any type of movement until the injury heals.

The use of icing can help reduce the swelling that causes pain. There is also the option of using pain or anti-inflammatory medications that will not only reduce swelling but the pain medication will help reduce the pain. He can also try physical therapy and strengthening exercises to try and heal the injury.

But, if all this fails, the doctor would probably recommend the UCL surgery. Chris Sales was one of the pitchers who didn’t want the surgery until all options had been tried. He did say, “I knew that Tommy John was always an option, but I was happy that the Red Sox tried everything they could.”

David told me, “making the decision to have Tommy John surgery should only happen if both doctor and patient feel it’s the only option.”

Chris Sales comment when he made the decision to have the Tommy John surgery.

What is UCL surgery and how long is the procedure? 

This type of surgery was first performed on a major league baseball pitcher called Tommy John in 1974. UCL reconstruction surgery is also know as Tommy John surgery, named after the the pitcher Tommy John.

The surgery has come a long way since then, giving the player an opportunity to return to pitching again. The surgeon will transplant tendons (called a graft) from other areas of the body or from a donor, rebuilding the UCL. The goal of the surgery is to stablize the elbow and restore mobility and function.

The length of the surgical procedure to repair the UCL tear is usually around 60 – 90 minutes. As long as he comes through the surgery without any issues, the doctor will let him leave the hospital after a short stay in the recovery room. 

UCL surgery recovery 

The amount of time it takes to recovery from UCL surgery depends on how fast the tissues heal. Rest is the key element in the process of healing. The doctor will wait until he thinks the patient is ready to start the physical therapy and pain management program that is customized to his needs.

The program will be designed to regain strength, range of motion and function, and help to alleviate pain. The recovery time for a UCL surgery can be anywhere from six to nine months, depending on how he reacts to treatment.

David added, “a recovery plan will be developed exclusively for Chris Sales and what his specific needs will be for recovery.” This link goes to an article that talks about Chris Sale’s surgery. Chris Sales Surgery


Chris Sales comment after UCL surgery.

Interesting facts about UCL injuries 

Over the years about 30-40 percent of baseball pitchers tear their UCL. This will generally cause them to miss six months of a season, and in some cases, the whole baseball season.

Most of the players affected with this type of injury will have the UCL surgery, hoping they can return to playing baseball. It is also interesting to note that about 62 percent of UCL injuries happen in the first three months of the baseball season.

In this article it talks about ways to prevent UCL injuries, and the different causes to the UCL. Preventing a UCL Tear

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