CONWAY, SC (WMBF) – Ulnar collateral ligament injuries, once limited to professional baseball players, are becoming more common among younger athletes, according to local sports medicine doctors.
The UCL, located on the inside of the elbow, provides stability during throwing motions. When torn, it often requires Tommy John surgery, named after the former MLB pitcher who first underwent the procedure.
Major league players including Shohei Ohtani, Shane Bieber and Gerrit Cole have undergone the surgery in recent years.
“Surprisingly the UCL injuries are going down in major leaguers,” said Dr. Donovan Johnson of Conway Medical Center Sports Medicine.
Young athletes increasingly affected
Johnson said the injury pattern has shifted dramatically from professional to amateur levels.
“We’re seeing them in younger athletes now, particularly minor league players, college players, high schoolers in baseball,” Johnson said. “There’s usually three important reasons for it when we see UCL injuries. It’s either you’re throwing too hard with high velocity, the second is you’re throwing too much, the third one is usually poor mechanics.”
Johnson identified sport specialization as a key factor in the increase among young players. Many athletes now focus exclusively on baseball and softball year-round, leading to overuse injuries.
The ligament serves as one of the primary constraints keeping the elbow stable during high-velocity throwing motions, Johnson said.
Recovery process begins immediately
After Tommy John surgery, the recovery process starts within a week, according to Aaron Hardee, an occupational therapist at Conway Medical Center.
“About a week after surgery or within that post-operative week, the patient will be placed into a posterior elbow splint and that will maintain the elbow at about 90 degrees of flexion,” Hardee said.
Patients transition to a hinged elbow brace during the second post-operative week. The range of motion parameters are determined by the surgeon.
Athletes begin rebuilding range of motion starting with 30 degrees extended and roughly 110 degrees flexed, though the range varies by individual.
“At first not everybody is going to have that range of motion,” Hardee said. “Even though they are allowed to range the elbow in that specified amount, they may not be able to initially whether that’s from pain, swelling, stiffness.”
Lengthy rehabilitation process
For eight to nine weeks, athletes continue exercises with weights and resistance bands to strengthen the arm and ligament. One exercise targets rotator cuff muscles by having patients grasp a resistance band while keeping their elbow tucked at their side and rotating their arm outward.
Athletic training staff take over recovery after the initial rehabilitation period, initiating a “10 throws protocol” that focuses on strengthening muscles needed for pitching and throwing.
The complete Tommy John surgery rehabilitation takes 12 to 18 months to return to full strength. In some cases, athletes never fully recover, Johnson and Hardee said.
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