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Pat Connor, MD

Throwing athletes have a higher risk of injury to their elbow -- sometimes resulting in Tommy John surgery, or Ulnar Collateral Ligament (UCL) reconstruction.

Dr. Pat Connor, Team Physician for the Carolina Panthers & Charlotte Knights, discusses the two care options available for athletes who suffer from a Tommy John ligament injury.

What is the UCL & How can it become injured?

Located on the inside of the elbow, the Ulnar Collateral Ligament (UCL) connects the upper arm bone (humerus) to the forearm bone (ulna). It helps secure the elbow joint.

UCL injuries often result from repetitive stress to the elbow, like throwing motions. This repeated stress causes tears in the ligament that can eventually lead to significant pain, decreased strength and mobility loss.

Who is at risk of a UCL or Tommy John injury?

Notorious in baseball players, Tommy John injuries also affect athletes across sports, including:

  • gymnasts
  • football players
  • wrestlers
  • cheerleaders
  • and other athletes.

How are UCL Injuries Treated & When should someone consider UCL reconstruction?

Not all elbow injuries or UCL tears require surgery to heal. Dr. Connor recommends treating elbow sprains and partial ligament tears conservatively at first.

However, for most sprains or partial tears,  injury symptoms tend not to be as obvious. Because of this, the injury may worsen before an athlete realizes something is wrong.

Dr. Connor recommends surgery when an athlete can no longer throw or effectively play their sport. Each surgery is highly individualized based on the patient’s needs and goals.

What happens during a UCL reconstruction surgery?


Traditional UCL Reconstruction or Tommy John Surgery

Tommy John surgery, or UCL reconstruction, is an extremely common procedure amongst throwing athletes, particularly baseball players.

In a traditional UCL reconstruction, your surgeon will replace the injured UCL with a tendon either from elsewhere in your body or from a donor. Your surgeon will secure the new tendon to the upper arm bone (humerus) and the forearm bone (ulna).

Complete recovery and rehabilitation from Tommy John surgery may take a year or more.

UCL Repair with Internal Bracing

For some athletes with less severe ligament injuries, there is an alternate reconstruction option available that utilizes an internal brace construction.

Rather than replacing the UCL with a tendon, like in a traditional reconstruction, the internal bracing repair mends the existing ligament.

The procedure is less invasive and has a shorter rehabilitation time, providing a valuable recovery option from partial UCL tears or an ulnar collateral deficient elbow. In fact, many patients regain full motion of the elbow in only 4-6 weeks and can then begin their return-to-throwing program.

Dr. Pat Connor, MD, is an orthopedic sports medicine physician fellowship-trained in Shoulder & Elbow and Sports Medicine. He practices at OrthoCarolina's Shoulder & Elbow Center, South Park office and Sports Medicine Center.

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