November 16, 2012 | Dr. Robert Truax
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Every season, you hear about major league pitchers who undergo Tommy John surgery and spend extended time on the disabled list. While men on the mound are more susceptible to elbow injury than other ballplayers, injuries are not an inevitable consequence of throwing hard. In fact, knowing the real causes of elbow pain and staying alert for injury symptoms can help pitchers keep on throwing. (Learn how to keep your shoulders healthy.)
The ulnar collateral ligament, or “UCL,” is a supporting ligament on the inside portion of the elbow. For pitchers, UCL may as well stand for “utterly crucial ligament," since it is responsible for holding the elbow joint together during throwing, especially in the early (acceleration) and late (cocking) phases of a pitch. Older players usually tear this ligament, whereas Little League and junior high players usually injure the bone to which the UCL attaches. The injury rarely results from a single event. It builds up over time, due to the constant stress of repeated throwing.
If you feel an ache in your elbow and notice a decrease in your pitching velocity or control, your UCL is telling you something is wrong. When this happens, it’s critical to stop pitching and get evaluated. Once you have the proper diagnosis, you can enlist in a good rehab program that can get you back into the game.
The first step pitchers can take to keep their UCLs healthy is to monitor their pitch counts. This is particularly important for younger players who are still physically immature. Keep track of your pitch numbers and don’t overdo it.
The second and third strategies are interrelated: use good throwing mechanics and build core strength. For example, a basic rule of pitching form is to keep the elbow above the shoulder during the acceleration phase of the throw. This reduces stress on the ligament. To keep your elbow above your shoulder pitch after pitch, game after game, requires good core strength. (Learn how to build core strength.) And by “core,” we’re not just talking abs; the legs and back must also be strong enough to support an explosive throwing motion.
If you do injure your UCL, you have treatment options, including Tommy John surgery. Read Tommy John Surgery and Baseball Pitchers to learn more about the post-injury alternatives pitchers have.