Ulnar Collateral Ligament Injury of the Elbow
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What is an ulnar collateral ligament injury of the elbow?

The elbow joint is made up of the bone in the upper arm (humerus) and bones of the forearm (ulna and radius). The ulna is on the inner or pinky side of the elbow. The ulnar collateral ligament attaches the bones in the upper arm to the bones of the forearm. Ligaments are strong bands of connective tissue that connect one bone to another. An injury to your ulnar collateral ligament causes pain on the inner side of your elbow.

How does it occur?

The ulnar collateral ligament can be injured from overuse or from an acute injury. The most common way this ligament is injured is from repeated throwing. This is a common injury for pitchers and quarterbacks. The act of throwing puts stresses on your inner elbow. Over time the ulnar collateral ligament can develop micro-tears which eventually can worsen.

Sometimes this ligament can be injured from a fall onto the elbow or on the outstretched hand. It can also be injured if another person lands on your elbow. These types of injuries are acute sprains. Sprains may be graded 1, 2, or 3 depending on their severity:

  • grade 1 sprain: pain with minimal damage to the ligaments
  • grade 2 sprain: more ligament damage and mild looseness of the joint
  • grade 3 sprain: complete tearing of the ligament and the joint is very loose or unstable

Sometimes sprains are just called mild or severe, depending on the amount of ligament damage.

What are the symptoms?

Symptoms can include:

  • pain on the inner side of the elbow, both with activity or with rest
  • swelling
  • weakness
  • loss of power with throwing

How is it diagnosed?

Your healthcare provider will take your history and examine you. Your provider will test for looseness or laxity in the elbow. You may have an X-ray to see if there are any bony injuries to the elbow. An MRI, MRI arthrogram (dye is injected into the elbow joint before the MRI), or ultrasound may be done to see if the ligament is torn. The ligament may be partially or completely torn.

What is the treatment?

The first treatment for this injury is ice and rest.

Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time for the first 2 to 3 days or until the pain goes away. After that, ice your elbow at least once a day until all your symptoms are gone.

Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

If you have an overuse injury, it is very important to rest from throwing. If the problem is diagnosed early and you have a partial tear, rest for 3 to 6 weeks may be enough. Sometimes the rest period needs to be longer. Your provider will give you rehabilitation exercises. You may be referred to physical therapy. After that rest period a gradual return to throwing may need to be supervised by your healthcare provider, physical therapist or athletic trainer.

If your injury is from a fall and not from repeated overuse your recovery time will be faster.

If the ligament is completely torn, you may need surgery to repair it. You may also need surgery if you have a partial tear that does not improve after rest and rehabilitation.

How long will the effects last?

A sprain may get better within a few weeks if the injury was not severe. The recovery time for an overuse injury can take weeks to months.

When can I return to my sport or activity?

The goal of rehabilitation is to return to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity depends on how soon your elbow recovers, not by how many days or weeks it has been since your injury. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to throwing when you have no pain at rest or with your rehabilitation exercises. You must start throwing softly, for short distances, and for only a few minutes at a time. You will slowly and gradually increase the amount of throwing that you do. Always stop if you develop pain.

What can I do to prevent an ulnar collateral ligament injury of the elbow?

Proper throwing techniques can help prevent injuries. Not throwing too much and stopping if your elbow hurts are most important.


Written by Pierre Rouzier, MD, for RelayHealth.
Adult Advisor 2012.1 published by RelayHealth.
Last modified: 2010-07-27
Last reviewed: 2011-06-07
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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