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ulnar collateral ligament
Ross Hauser, M.D.
The
ulnar collateral ligament
supports the inside of the elbow
and is a reason for most
chronic medial elbow pains.
The UCL is responsible for holding the ulnar bone to the distal end of the
humerus. This enables the arm to flex, pivoting at the elbow. An
patient's
complaint of pain on the inside of the elbow will cause the some doctors to
examine the lateral epicondyle's "sister," the medial epicondyle.
Some
doctors
will diagnose medial epicondylitis and recommend
NSAIDS,
or a
cortisone shot.
The ulnar collateral ligament is approximately three-quarters of an inch distal
to (away from) the medial epicondyle. It is a tremendously important structure
stabilizing the medial (inside) part of the elbow. When the elbow is flexed 90
degrees, as occurs during a wrestling match or football tackle, the ulnar
collateral ligament distributes over 50 percent of the medial support of the
elbow. (Morrey, B. Articular and ligamentous contributions to the stability of
the elbow joint. American Journal of Sports Medicine. 1983; 11:315-319.)
It has also been shown to be the most important stabilizing structure for the
elbow in response to an elbow blow to the lateral side (valgus stress)
(Hotchkiss, R. Valgus stability of the elbow. Journal of Orthopedic Research.
1987; 5:372-377.)
Another study showed that weakening of the ulnar collateral ligament had a
profound effect on range of motion of the elbow. (Morrey, B. A biomechanical
study of normal functional elbow motion. Journal of Bone and Joint Surgery.
1981; 63A:872-877.)
This could effect quite a number of different athletes in various sporting
events. The ulnar collateral ligament is also important because it refers pain
down the arm into the little finger and ring finger. This same pain and numbness
distribution is seen when the ulnar nerve is aggravated. The ulnar nerve lies
behind the elbow and is the reason why hitting your funny bone causes pain.
Because most physicians are not familiar with the
referral pattern of ligaments,
elbow pain and/or numbness into the
little finger and ring finger is often diagnosed as an ulnar nerve problem,
called
Cubital Tunnel Syndrome.
A more common reason for this condition is
ligament laxity in the sixth and
seventh
cervical vertebrae or in the ulnar collateral ligament, not a pinched
nerve. The point to remember here is that if an athlete is given a diagnosis
with the word "syndrome," the athlete should turn the other direction and run to
the closest
Prolotherapist. If the athlete is not significantly better after a
month of physiotherapy, it is time to check out of that mode of treatment and
check into
Prolotherapy.
A common mode of treatment for ulnar nerve problems is surgery. The orthopedist
removes the ulnar nerve from its normal home in the bottom of the elbow and
moves it to the side. An athlete given surgery as the mode of treatment for a
pain complaint should obtain a second opinion from a doctor who is competent in
the treatment of
Prolotherapy. Surgery should normally be performed only after
all conservative options, including Prolotherapy, have been attempted.
Prolotherapy to the ulnar collateral ligament is the most successful way to
eliminate medial elbow pain. |
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