In late August 2010, one of the most touted young baseball phenoms, Stephen Strassburg, experienced a torn ulnar collateral ligament in his pitching elbow. This has become one of the most common sports injuries. Soon he will undergo a surgery to replace the torn ULC, and hopefully within 12 to 18 months return to the mound.
Tommy John Surgery
Ulnar collateral ligament replacement surgery was developed by Dr. Frank Jobe when the Los Angeles Dodgers’ pitcher, Tommy John experienced the injury in 1974 and asked Dr, Jobe to find a way to help him continue to pitch. After the surgery and a lengthy rehabilitation period, John returned to pitching and successfully pitched several more years. The surgery has been dubbed Tommy John surgery and in fact, Dr. Jobe has trademarked the name “Tommy John procedure.”
Since 1974, ulnar collateral replacement surgery has saved the careers of hundreds of professional and amateur pitchers. Among some of the most famous are Kerry Wood, Eric Gagne, Mariano Rivera, John Smoltz and Matt Morris. Prior to 1974, the number of pitchers who ended their careers because of elbow injury or pain is unknown. Some have speculated that Sandy Koufax may have developed the “dead arm” that ended his career in 1966 as a result of a damaged UCL.
Keep the Pitch Count Low
Studies have shown that the the volume of throwing contributes to the incidence of injury. Therefore limiting the number of pitches thrown in a game as well as the number of innings worked in a season can help to prevent UCL injury. The type of pitches can contribute to injury as well, such as curve balls and sliders, but the most important factor is limiting the total number of pitches to prevent injury. Proper warm up and icing after throwing are also important components to maintaining healthy muscles and joints.
Pitchers are not the only athletes susceptible to damaging the UCL. Catchers, short stops, and second basemen are among some of the most common players who have also had this injury and surgery.
Anatomy of the Elbow
The elbow is a hinge joint which means it moves in one dimension to flex and extend. The motion of overhand throwing forces the elbow into the most unnatural position to perform this action causing undue stress and strain on the joint. Joints are stressed with repetitive motion and pitchers typically throwing 100 or more pitches in a game every four to five days cause considerable stress to the elbow.
The two major ligaments in the elbow which hinge the humerus bone to the ulna and radius bones are the ulner collateral ligament (also known as the medial collateral ligament) and the lateral collateral ligament.
With continued stress, the UCL becomes stretched, ragged on the edges or even completely torn and the elbow becomes unstable. The ulner nerve, commonly known as the funny bone nerve, becomes irritated and the elbow becomes painful. There may also be numbness in the elbow and forearm all the way down to the fingers. Most commonly the little finger and ring finger are involved. At this point, ULC replacement becomes necessary to control pain, improve movement and extend a pitching career.
Kathy Quan - Kathy Quan RN BSN has been a home health/hospice nurse for over 30 years. She has authored five books and writes for several online ...
