Do you need surgery for a UCL tear?

It is common for a patient to see an orthopaedic surgeon and find out that the injury he or she has won’t heal without surgery. Not every injury needs surgery, though. In this Ask Dr. Geier video, I explain how a common elbow injury in pitchers might not need surgery for non-athletes.

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Jessie asks:
I am not a sports player, but I fell on the palm of my hand and tore my UCL. My orthopedic surgeon thinks therapy and no surgery is the best option. But he says I may have limited ROM. Does this sound normal? Would I benefit more from surgery? I really want full use of my arm. Do they only repair the UCL if your a baseball player?

Baseball pitchers often need Tommy John surgery for UCL injuries in order to stabilize the elbow against the stresses that the pitching motion place on the elbow. Most non-throwing athletes and non-athletes don’t put their elbows through those same stresses. Therefore, they can usually go about their lives and perform their normal activities without undergoing reconstructive elbow surgery. Watch the video, and I explain the injury and treatment in more detail.

Please remember, while I appreciate your questions, I cannot and will not offer specific medical advice by email, online, on my show, or in the comments at the end of these posts. My responses are meant to provide general medical information and education. Please consult your physician or health care provider for your specific medical concerns.

[DrDavidGeier]

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[zacmilne]

I’m a 38-year-old right handed drummer and I also lift heavy weights. I noticed pain in my right UCL long before the tear, especially with overhead tricep exercises. It finally tore during a heavy bench press. I think the years of repetitive drum playing with my right arm weakened the right UCL. If it doesn’t heal within a few months I’ll probably go for plasma/ stem cell therapy or, as a final resort, surgery. I’m not giving up on drums or weight lifting

[Gianniazanatta]

Im not a baseball player, but I am a gymnast and I have had had an injury to my UCL twice in the same arm. The first time I fell and my mistake was putting my hands out to catch myself which is a mistake. Its better to fall on your chest because you may damage your wrists or hands if not your elbow. The second time I hyperextended my UCL is doing a one handed backhand spring and too much weight was causing stress to my UCL at the angle i was at and i heard and popping and grinding then it going back into place. But giving it proper time to heal without exposure to sports has helped for it to recover within a few months. It wasn't a complete tear so it did not require a surgery. And I went back to gymnastics fully functional and in full range of motion. But if you are not a athlete you may not get full range of motion only because you generally sit still with your arm. You're not constantly stretching and strengthening it back like a typical athlete. Thats why physical therapy may be very helpful to regain motion and strength. But pain will go away with time of healing

[theindiangamer]

I got this injury in 2005. It's been 12 years and I have undergone every form of physiotherapy. I have seen no improvement. It has worsen. It happened to me during a martial arts fight when I threw a powerful punch to the shoulder of the opponent. Currently I am undergoing prolotherapy but seeing no progress. As a gift now I have pain on the lateral dude too

[davidlynch]

I had a slight strain or even a tare in my right UCL and it changed my world. When you see an athlete have that arm blowout you don’t really understand how excruciating that endless pain is until it happens yourself. I can only imagine how bad a complete tare/break can feel after all mine could have been as little as a strain, but it HURT. Moral of the story is be careful with your arm as an athlete. Sometimes being the best doesn’t have to mean putting constant strain on your body. Just try hard and be humble.

[edyedison]

Excelente explanation, but, I would like you to talk about prices too.

[KristieZara]

Good morning. Thank you for this great video. I’m a 41-year-old non-athlete. Two weeks ago, I fell and placed my right palm on the ground to catch myself. This resulted in a “volar direction dislocation of the humerus from the proximal radius and proximal ulna.” Should that say “polar direction”? No fractures were demonstrated. Which ligaments did I injure with this type of trauma? I’m still struggling to extend my arm fully and fully flex. What exercises can I be doing do extend my range of motion before I’m ready for PT? Thanks!

[jacku]

Hello, I had this injury years ago when I accidentally sat on my palm, because of circumstance I couldn't treat it, and now I can't fully extend my thumb, I want to learn the piano but I need to know if I can still treat it?

[edgardbaltodano]

I have had this time of injury also. My question is, with out surgery, how long does it take to hear naturally? I am not an athlete but do work out. Will I be able to work out again?

[had]

Tore my ucl in a car accident. Ever hear of this before

[nancylynneborborema]

Dr.Geier,
I don't have a UCL, but I am a active horse rider an I lunge and help train horses my elbow has come out of the socket and feels loose at times and I have pain when I straighten elbow out and when I flex. It almost feels l like a toothache that never goes away.and when I do certain motion the pain increases and reminds me it's still there, I do have a tear, would I benefit from having RCL fixed?

[inayatg]

I have a question regarding another sort of elbow injury, I have recently found out that I have torn my LCL ligament which is the ligament on the radius and humorous joint, initially I had dislocated my elbow playing football and since it just kept popping out under any stress,

I play semi professional football and was wondering if an lcl ligament reconstruction is similar to a ucl and how long do you think it would take to get back to football given that I play outfield and my hand is not used as much as a sport such as base ball ?

[chazphelps]

I have severe tendonitis in my right shoulder dominant side supa and infa spinatus. (Mri report) Im a tennis teaching professional so i do tons of right arm and shoulder reps. 20 yrs and counting. Ive tried phys therapy-to strengthen the lower shoulder muscle group, electro light therapy, dry needling, cortizone shot, prp, electro therapy, and massage therapy… none of these provided noticeable pain relief or increased ROM. Just very tight & painful in different extension positions of those muscles. I’m currently on week 4 of a 6 week work medical leave and have seen a 10-15% pain improvement. But still only marginal improvement imo. Im 6’1 240 lbs and quite active. What would be your recommendation?

[mykie]

Love the content. I recently dislocated my elbow on a fall with an extended arm and outstretched hand. My ortho diagnosed me with right ulnar fractures and suspected multiple torn ligaments on my right elbow, possibly the UCL. I want full function of my elbow and to do my handstand pushups, handstand walks and hold heavy snatches, cleans and weight overhead. He was against surgery and stressed the notion that this surgery is only for pro pitchers and gymnasts, he recommended physical therapy only. Will i ever get full function of my arm like i used to, im specifically concerned about pressing and holding heavy weight in a pushup, bench press and over head with fully extended elbows and handstand pushups/walks. I have a passion for fitness, calisthenics and weight lifting and i want to be able to do this for the rest of my life.

[rambuchusrino]

I am wrestler, and I had been wrestling for 2 years, when I was bellied out and a kid put his knee on my shoulder or elbow, and pulled on my wrist, i could hear it tear, like pulling a few rubber bands apart, when I went to the doctor he said that it was 80% torn but I didn't need sugury. I waited the time that I needed for it to supposedly recover, and the next year I went back, about 3 weeks into practice, my teamate choped at my elbow, and it made the same noise. this year it has been achy since before the season started, during football season.

[JustinWestpiercehigh]

I have elbow pain and I am a pitcher baseball been pitching since I was 6 years old. Went and talked to my doctor she said she would have to look into it. I am wondering what I should do?

[benjaminlogue]

I’m a baseball player and have recently injured my elbow and scans possibly indicated a UCL tear and a small fracture as well.
What would your thoughts be?

[shannonhyney]

My son who is qb in football has a ucl strain partial flexor organ tear and plans on playing football in college it happened about 3 weeks ago seems to be healing well. What are your thoughts is that a injury that most guys can still throw football with

[wanghtgene]

I fell down when I play basketball on a concrete ground. MRI on on my elbow shows UCL and RCL complete torn after a dislocation (The position is in right place itself automatically quickly) and a minimally bone fracture. Do I need surgery or conservatively first.
Thank you very much
Tom

[johnbriggs]

I partially tore my UCL I play semi pro rugby its been 5 months the upper limb specialist said it wouldn’t require surgery but my arm hasn’t improved at all and I’m still getting pain, should I go back and see the specialist or stick to the rehab?