What is an elbow ligament?

The elbow is a hinge joint that connects the humerus (upper arm bone) to the radius and ulna (forearm bones). The joint allows both bending and straightening of the elbow movements. The elbow joint is stabilised primarily by the medial collateral ligament, lateral collateral ligament, and annular ligament. Ligaments are strong pieces of cartilage that connect one bone to another and help provide support to the joints while still allowing for a motion. Although ligaments are relatively strong and rigid by nature, it is possible to injure them.

What are the signs and symptoms?

• Symptoms will depend on if the injury is acute or if it has developed over time, but include:
• Sudden onset pain on the inside of the elbow
• A sudden “pop” or pain along the inside of the elbow
• Rapid swelling and possible bruising developing later
• Decreased elbow motion
• Inability to throw anything
• Decreased throwing velocity, control or stamina
• Tenderness and pain when pressing in the area of the ligament on the inside of the elbow

What are the causes?

Ligament injuries, also known as ligament sprains, are caused when the fibres become stretched or torn, or even when a ligament completely ruptures. The worse the sprain or injury the more it will affect the ligament. Injury can be the result of a sudden, acute injury, or they can occur following long periods of overuse. There are a number of factors that increase your risk of a medial ulnar collateral ligament injury:

• Year-round throwing without any rest time
• Throwing at very high velocities
• High number of throws in a single day or back-to-back days
• Improper throwing mechanics
• Decreased shoulder range of motion or poor positioning of shoulder blades
• Participation in sports that require weight bearing on the arms, e.g. gymnastics
• Participation in contact sports where other athletes can fall into elbow

How is it diagnosed?

Elbow ligament injury can be diagnosed by taking a medical history and through physical examination. The physical examination is usually done to assess instability of the elbow, and looks for either the reproduction of your symptoms, such as pain or discomfort, or an increase in joint laxity or instability. If necessary, an MRI scan can be performed in order to confirm the diagnosis and highlight the extent of the damage to the ligament.

How is it treated?

The choice of treatment will depend on the extent of the injury and ranges from rest and physical therapy, to surgery. Non-operative management with rest, physical therapy, and activity modification is considered for many patients. This is particularly true for athletes with partial tears of the ligament and those that are not overhead throwers. Physical therapy is an important way help gradually improve elbow range of motion and strength. Restoring full mobility and normal functional use of arm is the primary goal. Surgery typically involves either fixing the current ligament or reconstruction by replacing injured ligament, and rehabilitation following elbow surgery follows a sequential and progressive multi-phased approach.

How can it be prevented?

Muscle strengthening exercises, proper stretching, and using the correct techniques for throwing can lower the risk of elbow ligament injury.