& Hand Therapy > Conditions
> Elbow Pain > Elbow Ulnar
Collateral Ligament Injury Physiotherapy
Ulnar Collateral Ligament Injury Physiotherapy
Elbow ulnar collateral ligament (UCL) injuries generally occur when repetitive
stress accumulates and damages the inside of the elbow, and this can and will compromise elbow stability.
injuries are most common in athletes who play "overhead" sports, such as
volleyball and baseball, which require using the arms in an overhead
position. These injuries are occurring in greater frequency with the
rise of sport specialization.
They are often referred to as "Tommy John"
injuries, named after the famous baseball pitcher who underwent the
first surgery for a UCL injury in 1974.
Our senior physiotherapists and senior hand therapists can help
- your arm's strength and range of motion
- your body's overall
stability and balance following a UCL injury
What Are Ulnar Collateral Ligament Injuries?
The elbow ulnar collateral ligament is a band of tissue that connects the
inside of your upper arm (humerus) to the inside of your forearm (ulna).
What this ligament does is that it functions to support and stabilize your arm when you perform a
motion, such as throwing a ball.
An elbow UCL injury may at first cause pain
and tightness in the area.
But, over time and with repetitive stress
or trauma, our elbow's UCL will slowly become stretched and even tear.
Good news is that invasive surgery is not
always necessary to heal a UCL injury, but it may be performed if pain
persists or the elbow feels unstable upon a return to sport or other
Signs and Symptoms
With an elbow ulnar collateral ligament injury, patients may experience:
- Soreness or tightness along the inside of your elbow
- Minor swelling and possible bruising along the inside of your arm
- Possible numbness and tingling in your arm
- Instability at your elbow joint (a feeling like your elbow might “give out” when you move it through certain motions)
- Pain when using your arm in an overhead position (eg, throwing/pitching a ball, swinging a racquet)
- Difficulty warming up for a sport, or needing a longer time to warm up
- Poorer performance (eg, a decrease in pitching speed)
How Is It Diagnosed?
Our senior hand therapists and/or senior physiotherapists will conduct a thorough evaluation that
includes taking your health and activity history.
We may ask you questions including:
- When and how did this injury occur?
- Was it sudden or gradual/over period of time?
- How long have you had pain?
- Have you had any numbness and tingling in your arm?
- Did you feel or hear a "pop" near your elbow when throwing or performing an overhead activity?
- Have you experienced any instability (eg, a feeling of your arm “giving out”) when performing an overhead activity?
- Have you experienced a decrease in job or sport performance?
- What other sports or activities do you participate in?
- Have you had to stop playing your sport, or performing your job, because of the injury to your elbow?
We may gently touch the area around your elbow
joint to locate the specific area of pain. We may
slightly bend your arm while applying pressure along the outside of your
elbow joint, or ask you to mimic a throwing motion as the therapist
resists against it.
To provide a definitive diagnosis, we may
collaborate with an orthopedic surgeon. The surgeon may order further
tests, such as magnetic resonance imaging (MRI) or magnetic resonance
arthrogram (MRA), to confirm the diagnosis and to rule out other
how our senior hand therapists and/or senior physiotherapists can help you
We can help improve your arm's strength and
range of motion following your elbow ulnar collateral ligament injury, as well as help restore
- your shoulder
- core stability
We also will
work with you before and after any necessary surgery, and can help
identify other issues that may have contributed to your injury, such as
range of motion and strength deficits, or improper throwing mechanics.
We will help you:
Boost your healing process
Decreasing stress across
the injured area is the best way to promote healing of a UCL injury.
We will likely tell you to take some time off from
your sport or other activity. We may educate you on the RICE
(rest, ice, compression, elevation) principle and may implement
"cross-friction massage" to help the body supply nutrients to the
We may employ the following to improve and accelerate soft tissue healing:
Strengthen your muscles
After your injury your arm
may feel weaker.
Strengthening the muscles of your shoulder, upper back,
and shoulder blades in addition to those of the forearm will help
decrease the stress at the elbow joint.
Addressing lower-body balance or
any weakness through your hips and trunk also may help decrease stress
across your elbow.
Improve your range of motion
After your injury you
may notice more difficulty straightening or bending your arm.
We will work with you to improve your arm's range of
motion, including possibly stretching your shoulder to help decrease
stress on your elbow when performing overhead movements.
Correct your movements
While every sport requires
different arm positions, certain positions may put an athlete at greater
risk for injury to the elbow.
Examining and modifying the movements you
perform may help you safely return to your sport. We will help design a specific program to allow a gradual full
return to activity.
Prepare to return to sport
An important component
of preparing for a return to sports after an elbow ulnar collateral ligament injury is preparing the
arm to properly withstand the stress placed on it during throwing or
other overhead motions.
We will work with you to
establish and implement a progressive program to prepare you for a
return to practice and competition.
If Surgery Is Required
If corrective elbow surgery is required, our senior hand therapists and/or senior physiotherapists may measure your arm
strength and range of motion prior to surgery to define a baseline goal
to achieve following the procedure.
Immediately following surgery, your arm will likely be placed in a
splint, brace, or sling to protect your elbow. Elbow physical therapy will
begin within the first week to 10 days following surgery.
- Provide appropriate guidance. You will receive an
individualized treatment program of gradual rehabilitation that will
ensure you heal in the safest and most effective way possible.
- Protect the graft/repair site in the early postoperative period.
You will be provided a brace that will likely need to be worn for 5 to 6
weeks, depending on your surgeon’s preference. Our senior hand therapists and/or senior physiotherapists
will show you how to ensure you don’t bend your arm too much or rotate
your shoulder too far during this time.
- Improve how far you can move your shoulder and elbow.
When you are ready, we will help you gently bend
and straighten your arm through different exercises and stretching
techniques. We also will gently stretch your shoulder to
help decrease stress across the elbow.
- Improve the strength of your arm. Through a series
of exercises, we will work with you to improve your
arm strength. Your hand grip and forearm strength will likely be the
first things you will work on following surgery. As you progress, the
exercises will begin to focus more on your shoulder blade and upper back
- Improve muscle strength and coordination. As you begin to heal and progress, your exercises will become more specific to your sport or other activity.
Resuming sport-specific activities
An athlete who
has experienced a UCL injury can begin to return to throwing at
approximately 6 months after surgery. The return is based on the surgeon
and our senior hand therapists and/or senior physiotherapists providing clearance to do so.
Returning to full competition
An athlete generally can be cleared to return to game competition approximately 12 to 14 months after surgery.
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Phoenix Rehab Physio Services
Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
See all the conditions our principal physiotherapists treat.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
- manage and decrease hand pains
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following injuries or post-operations
Commonly treated hand pain injuries includes
REFORMER CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
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DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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