A Conservative Approach to Treating Ulnar Collateral Ligament Injury

What is an ulnar collateral ligament injury?

The Ulnar Collateral Ligament (UCL) is located in the medial elbow. The UCL can become damaged over time from slow deterioration or from an acute injury. Damage is sustained when the UCL is overstretched, frayed, or torn. The most common cause of UCL injury is overuse and repetitive stress damage (Lyman et al, 2002). Repetitive motion such as throwing or pitching, painting, spiking a volleyball, and using a racquet and other activities that laser2bring the UCL to its highest tensile strength are some of the most common reasons for repetitive stress injuries of the UCL. Symptoms include tenderness about the elbow, swelling and inflammation, and pain when moving the arm from the elbow; in some extreme cases with a torn UCL, there will also be bruising about the elbow joint.

What is “Tommy John” surgery?

The number of UCL reconstructive surgeries has spiked since the 1990s. UCL reconstructive surgeries, also known as Tommy John surgeries for the famous baseball player who first underwent UCL reconstructive surgery, consist of an invasive procedure wherein the surgeon grafts a tendon from somewhere else in the body, usually the other forearm or the hamstring, to the medial elbow, replacing the ulnar collateral ligament. The ulnar nerve is also moved during the surgery to minimize damage as a result of accumulation of scar tissue and inflammation, both from the overuse of the UCL and the UCL reconstructive surgery. Tommy John surgeries should be a last resort for when the UCL has become overstretched, frayed, or torn beyond its ability to heal and regenerate functional tissue (Purcell et al, 2007).

How chiropractic care can help.

When symptoms of UCL injury arise, it is important to contact a healthcare professional immediately to survey the extent of the damage. When caught in the early stages, UCL injuries can be treated with chiropractic treatments, eliminating the need for an invasive Tommy John surgery and restoring pain free function to the elbow. A chiropractor will be able to diagnose and treat a UCL injury, and based on its acuteness, formulate a treatment plan to return the patient to an optimal level of performance.

Soft tissue therapies such as Active Release Technique (ART) work to reduce the incidence of fibrous adhesion build up in soft tissue as the result of microtears in the UCL. Using precise directional force, the chiropractic doctor sends the adhesions back into the blood circulation and restores range of motion to the elbow. Graston can also be used in conjunction with ART in order to address larger buildup of scar tissue and fibrous adhesions in the forearm.

Cold laser therapy is also effective at reducing inflammation in the elbow joint. Light energy in the form of photons enters the site of the injury to promote healing by breaking up adhesions and built up scar tissue. Laser therapy is pro-inflammatory; this means that it aids in the natural inflammation process by giving inflammation factors a boost. Laser therapy enhances the immune system’s natural defense against injury, which is acute inflammation that lasts over a short amount of time, while also combating the incidence of chronic inflammation, which is the buildup of excessive inflammation over time that leads to uncomfortable swelling and pain.

Beyond treating the symptoms of UCL injury, chiropractors are also able to formulate targeted rehabilitative plans to return the patient to their goal level of function. While treatment and rest are also a priority, reserving and building strength in the forearm is also a goal. Weight training, stretching, and conditioning with exercises in elbow supination, pronation, and flexion can help strengthen the UCL in order to cope with the stress of repetitive motion. Further, the chiropractor will be able to evaluate weakness and asymmetry in the muscles of the forearm to help the patient adapt their movement to avoid further injury and increase the impact of their movements.

If you have questions about treatment of UCL injuries or other sports related injuries, call (415) 788-8700 to speak with a certified sports chiropractor today.

 

Sources:

Lyman, S., Fleisig, S., Andrews, J.R., & Osinski, D. (2002). Effect of Pitch Type, Pitch Count, and Pitching Mechanics on Risk of Elbow and Shoulder Pain in Youth Baseball PitchersThe American Journal of Sports Medicine, 30(4), 463-468.  

 Purcell, D., Matava, M.J., Wright, R.W. (2007). Ulnar Collateral Ligament Reconstruction. Clinical Orthopaedics and Related Research, 455, 72–7.