If you feel pain on the inside of your elbow when you’re throwing or notice that you suddenly lose strength or control, you may have a UCL injury, also called a Tommy John injury. This condition is common in athletes (especially pitchers), but it can affect anyone who stresses their elbow.
At Banner Health, our orthopedic and sports medicine specialists diagnose UCL injuries and offer personalized treatments so you can return to your activities safely.
A UCL injury happens when you damage the ulnar collateral ligament, which connects your upper arm to your lower arm on the inside of your elbow. The UCL helps stabilize your elbow when you’re throwing or doing other overhead movements.
Tommy John surgery is a procedure that repairs or reconstructs a torn UCL. Surgeons replace the damaged ligament with a tendon from another part of the body to stabilize the elbow so it can work properly.
It gets its name from Tommy John, a major league pitcher for the Los Angeles Dodgers. He had surgery on his UCL in 1974 and continued to play professional baseball after he recovered.
UCL injuries are usually caused by repetitive stress on the elbow, often from throwing. They can also be caused by trauma, like falling on an outstretched arm or dislocating your elbow.
With a UCL tear, you may notice:
In children and teens, elbow pain while throwing is not normal. It should be checked and treated to prevent damage to the ligament or nearby growth plates.
See a health care professional if you notice:
Early evaluation can help keep you from causing more damage to your elbow and help you find the right treatment plan. It’s especially important for young athletes to get checked at the first signs of reduced performance or ongoing pain.
Your provider may:
UCL injuries are often graded to help guide treatment:
Treatment depends on how severe the injury is and your level of activity. Grade 1 and 2 tears may heal without surgery, especially if you’re not an athlete. If you’re an athlete or you have a complete tear, you will probably need surgery.
You may recover with:
In some people with partial tears, platelet rich plasma (PRP) injections or acoustic shock therapy may help healing, although results are mixed.
UCL repair reattaches the existing ligament. It may be an option for some partial tears, especially for younger athletes. It usually has a faster recovery time than reconstruction.
A newer technique, called UCL repair with internal brace, uses high-strength tape to reinforce the repaired ligament.
With Tommy John reconstruction, your surgeon replaces your damaged ligament with a tendon from another part of your body, usually the forearm or hamstring. This ligament stabilizes your elbow so you can throw again.
Tommy John surgery is the gold standard for competitive athletes. With rehab, most people can return to their pre-injury performance level.
Complications are uncommon, but as with any surgery, there are risks. Possible complications include:
With non-surgical treatment, you may be able to get back to your regular activities and throwing in three to four months. A structured throwing program can help you avoid injury.
After reconstruction, recovery can take nine to 18 months. Competitive or professional pitchers should expect recovery to take 15 to 18 months. You’ll need physical therapy, rehab and a gradual return to throwing.
These guidelines can help you avoid Tommy John injuries:
Common signs include inner elbow pain, a popping sensation when the injury happens, weakness and decreased throwing ability.
Partial tears may heal with rest and therapy, but complete tears often need surgery.
Recovery typically takes nine to 18 months, depending on the individual and level of activity.
No. It is more common in athletes who perform repetitive overhead motions.
If elbow pain is affecting your performance or daily activities, schedule an evaluation with a Banner Health specialist.
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