Home > Blog > Physiotherapy & Hand Therapy > Conditions > Elbow  Pain > Elbow Ulnar Collateral Ligament Injury Physiotherapy

Elbow 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.

Elbow UCL 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 improve

  • 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 activities.

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 possible damage.

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
  • coordination
  • balance

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 injured ligament.

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.

We will:

  • 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 muscles.
  • 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.

Back to Top

book an appointment today
(or check your pains / injuries)

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.


Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
  2. improve range of motion, strength and dexterity
  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes


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 and conditions.

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.


  • Cupping TCM
  • Auricular Therapy TCM
  • Herbal TCM Medicine & Supplementation


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 solution.

do Tell Your Family, Friends And Colleagues About Us =)

We appreciate you as our valued clients and want you to know that the # 1 way we grow as a clinic / brand is through word of mouth referrals from valued patients like yourself.

We prefer not to rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. When you have the chance, please tell your family, friends and physicians about the positive results and experience you have had in our physio clinics.

book an appointment today
(or check your pains / injuries)

Recent Articles

  1. Physiotherapy and Hand Therapy at Tampines Singapore

    Jan 18, 23 03:01 AM

    Phoenix Rehab Physiotherapy and Hand Therapy at Tampines Singapore

    Read More

  2. Germaine Sim Hand Therapist

    Dec 11, 22 03:43 AM

    Germain Sim is a hand therapist practicing hand therapy, splinting, assessing and treating finger, hand and elbow pains in Phoenix Rehab

    Read More

  3. Adele Ang Principal Physiotherapist Singapore

    Jun 29, 22 08:32 AM

    Adele is a registered physiotherapist with over 25 years of experience including treating national athletes as well as recreational athletes having worked in Singapore Sports Council and Singapore Spo…

    Read More

  4. Achilles Tendon Pain Physiotherapy

    Feb 03, 22 04:05 AM

    Achilles tendon pain is very common among recreational and elite sportspeople. But it is also common among sedentary individuals

    Read More

  5. Tendonitis Physiotherapy & Hand Therapy

    Feb 03, 22 12:16 AM

    Tendonitis, tendinopathy and tendinosis are all tendon injuries and treated by physiotherapists and hand therapists

    Read More

  6. Cervical Spondylosis Physiotherapy

    Jan 11, 22 02:01 AM

    Cervical spondylosis is a general term to describe the degenerative condition in the neck which results in pain and other symptoms

    Read More

  7. Tendon Pain Tendinopathy Physiotherapy

    Jan 07, 22 12:28 AM

    Tendinopathy (tendon injuries) can develop in any tendon of the body and has many names such as tendinitis and it can be treated with good tendon physiotherapy

    Read More

  8. The importance of staging and compression in tendinopathy physio

    Dec 15, 21 01:47 AM

    Tendon problems are common in runners and can become a persistent issue if not properly treated.

    Read More

  9. Tendon Pain Physiotherapy and Hand Therapy

    Dec 14, 21 11:23 PM

    Pain and pathology in a tendon, known as tendinopathy, is a common injury in athletes that can be difficult to manage. Physio and hand therapy can help healing

    Read More

  10. Tendon Injuries Physiotherapy, Hand Therapy, TCM & Massage

    Dec 07, 21 01:31 AM

    We use the world’s best tendon recovery programs through cutting edge treatment techniques for all tendon injuries (and tendon injuries differ accordingly)

    Read More