Youth injuries in baseball and UCL repair surgeries have become widespread as more kids increase their year-round playing time with less time off for rest (especially in areas like Stuart and Tradition where it’s sunny and warm basically all year). The result is that elbow and shoulder injuries have spiked.

“One thing that’s a growing trend across America and specifically in South Florida has been youth injuries in baseball, particularly in throwers,” says Marcus A. Rothermich, M.D., a fellowship-trained orthopaedic surgeon and sports medicine specialist at South Florida Orthopaedics & Sports Medicine.

“The problem has been described by Dr. James Andrews (co-founder of the American Sports Medicine Institute) as an epidemic. Younger baseball players across the country are now playing nearly year-round when it’s critical for those young elbows to rest for at least part of the year. One common thing we’ve seen rising rapidly over the last several years is an increase in tears or injuries to the ulnar collateral ligament (UCL) of the elbow.”

What Is a UCL Injury?

The ulnar collateral ligament (UCL) connects the lower arm bone to the upper arm bone and is the primary stabilizing ligament in the elbow particularly with overhead motions such as throwing and pitching. UCL injuries stem from overuse and repetitive throwing motions which can cause tiny tears and inflammation to the tissue and eventually lead to a complete rupture.

A traumatic event or injury can cause the UCL to tear or be pulled off the bone. Typical examples include falling, a car accident, or an on-the-job injury. UCL injuries can also be seen in other sports and activities including:

  • Tennis
  • Javelin throwing
  • Fencing
  • Painting

Damage to the UCL can cause significant elbow pain on the inside of the elbow, prove challenging to repair and rehabilitate, and can often end a professional athlete’s career unless surgical treatment is performed.
Baseball UCL Youth Tears

How Is a UCL Tear Treated?

For mild UCL tears, rest, anti-inflammatory medications, and physical therapy may provide sufficient relief of symptoms. However, for athletes who need the full strength and maximum function of their elbow, UCL reconstruction surgery (known commonly as Tommy John surgery) is often indicated when non-surgical methods fail to provide the desired results.

According to Dr. Rothermich, advances in treatment interventions to repair or reconstruct the UCL can get young baseball athletes back on the mound safely in a shorter period.

“The ulnar collateral ligament repair is typically done with an auto-graft using the patient’s own tissue from their palmaris longus tendon or a hamstring,” says Dr. Rothermich. “Recently there have been modernization developments to the UCL repair technique: the native tissue in the athlete’s elbow is repaired and then reinforced by overlaying a collagen-dipped internal brace tape.”

UCL Youth Tears: A Growing Problem Among Athletes

Marcus A. Rothermich, M.D

Recovery After UCL Surgery

The return timetable after surgery depends on the type of procedure required. UCL reconstruction surgery typically presents a more lengthy, diligent, and methodical rehabilitation process than a UCL repair.

“The biggest differences between a UCL repair and UCL reconstruction are in the rehabilitation timetable and the indications for that type of surgery,” says Dr. Rothermich. “For players who are younger, typically in high-school or early college, they have good quality tissue in their native ligament which can be repaired and often the internal brace technique is used to reduce rehabilitation time.”

“Traditionally for a UCL reconstruction, twelve to eighteen months are required before a player gets back on the mound at 100% capacity,” Dr. Rothermich continues. “With with the UCL repair technique using an internal brace, the recovery time can be cut down drastically to between six and ten months.”

Dr. Rothermich uses a custom-designed return to throwing program developed at by the American Sports Medicine Institute in Birmingham, AL, that employs a step by step progression, getting the athlete back on the mound as soon as possible.

“The internal brace technique also requires a very rigorous and regimented rehabilitation protocol that was developed in Birmingham,” he says. “Typically these players return to the mound in a shorter time, and we’re excited to pioneer and offer this to patients in South Florida.”

To learn more about UCL injuries and treatment, please feel free to contact us.