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Virginia Institute for Sports Medicine

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Orthopaedics in Action

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Elbow - UCL Rupture

What is it?

The ulnar collateral ligament, or UCL, in the elbow helps hold the ulna and humerus in line during motion at the elbow joint. Motions that cause the greatest amount of stress on this ligament include twisting and bending of the elbow, as in certain portions of the throwing motion. An injury causing a tear in this ligament can lead to pain and instability during activity. Injuries can be caused by repetitive stresses from poor throwing mechanics, inflexibility, or muscle fatigue. Constant stresses on the ligament can cause instability issues and adding more stress to surrounding structures, such as the ulnar nerve.

  • Sharp pain or “popping” sensation by the inside of the elbow
  • Point tenderness
  • Swelling in the area
  • Inability to throw or perform activity in typical manner
How is it diagnosed?

Clinical evaluation by our specialist will determine the mechanism of injury, special stress tests of the elbow, and possibly an x-ray or MRI to further evaluate the ligament for a diagnosis of a tear to the UCL. A partial tear of the UCL means that the ligament is still partially intact. A complete tear of the UCL means the entire ligament has been torn.


Once torn, the UCL ligament will not repair itself. Treatment of a UCL tear is dependent on the patient’s activities. Most patients benefit from a conservative program including formal physical therapy to improve stability, mechanics, and strength, which will help improve the function and reduce the pain. Over the counter pain medications can also be used to decrease the discomfort. If conservative treatment does not alleviate the symptoms, surgical intervention may be required.

Surgical intervention includes using a tendon graft, ( taken from another tendon in your body or from a cadaver), to replace the torn UCL and provide stability to the elbow joint. Post-operative, you will be in a hinged brace with activity limitations. You will progress through a formal physical therapy program.


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