Elbow surgery to reconstruct a torn ulnar collateral ligament (UCL) is a common procedure performed on athletes who engage in overhead throwing activities, such as baseball, tennis and volleyball, and gymnastics. In these activities, the UCL can be stretched, torn or otherwise damaged from the constant stress of overhead motion. To mend a torn UCL, a damaged ligament in the elbow is surgically replaced with a tendon from somewhere else in the body, such as a hamstring or forearm. A nontraumatic UCL tear should be treated with rest followed by a rehabilitation program for about six months before surgical intervention is considered.
While surgery aims to restore elbow stability and enable the athlete to return to his or her sport as soon as possible, recovery can often take as long as a year. A 2010 study of athletes who underwent the surgery over a 19-year period showed that after surgery and physical therapy, 83% returned to play at or above their previous level an avera ge of 11.6 months after surgery. Thus, it is critical to involve physical therapists early in the recovery process. An individually designed rehabilitation program will likely include
- gentle handgrip, shoulder and wrist mobilization exercises
- a special hinged brace to protect the elbow
- range-of-motion (ROM) exercises to be performed daily
- strengthening exercises for the shoulder, arm, wrist and hand
- monitored flexibility and conditioning exercises to support proper throwing techniques
Most athletes who follow a formal physical therapy rehabilitation program can expect to attain their previous full ROM. As rehabilitation progresses, we will gradually increase the strength-training exercises with heavier weights and exercises that use all parts of the arm. Another benefit of physical therapy is that you will learn to perform cardiovascular exercises to ensure maintenance of your overall fitness. With a dedicated physical therapy program, 70% to 95% of athletes tearing their UCL return to play at or above previous levels. With our guidance, you may find that you can return to your sport even stronger than before.