MCL (UCL, Tommy John) Injury
What is a MCL tear or Tommy John Injury?
The MCL is a ligament on the inside of the elbow. MCL stands for “Medial Collateral Ligament”. It is also called the UCL or “Ulnar Collateral Ligament”. Some people call it the “Tommy John” ligament.
What causes a MCL tear?
Tears of this ligament can be caused by overuse such as from throwing a ball too often. This usually happens in people who throw a lot. Although MCL tears tend to occur most commonly in baseball pitchers, any throwing athlete is at risk.
MCL tears can also be caused by a sudden injury such as from an awkward throw or a fall.
What are the symptoms of a MCL tear?
If the ligament gets injured from overuse such as from pitching a baseball too much then the most common symptoms are:
- pain on inside of elbow with throwing or stress to the elbow
- loss of accuracy
- loss of throwing speed
If the ligament gets damaged from an injury or accident, then the person usually feels sudden pain in the elbow. They may also notice their elbow feels “wobbly” or loose.
How can you tell if you have a MCL tear?
MCL tears are usually diagnosed by physical exam from your doctor. There is usually tenderness when pressing over medial epicondyle (see picture). Also, stressing the MCL, like from the milking maneuver (see video) usually causes pain. X-rays are needed. An MRI is also helpful to actually see the tear and important details about the tear.
How are MCL tears treated?
For MCL problems that happen from a sudden injury, the treatment is to immobilize the elbow and follow a specific program for MCL tears.
For overuse injuries in throwers, usually stopping throwing for 6 weeks and physical therapy is helpful. If this does not work then surgery is sometimes needed.
The surgery is called a “Tommy John” surgery to repair and reconstruct the ligament. Recovery from this surgery usually takes about 12 to 18 months.