Sideline assessment and return-to-play decision-making for an acute elbow ulnar collateral ligament sprain.
Throwing athletes including baseball, softball and javelin throwers are prone to ulnar collateral ligament (UCL) injury due to repeated valgus forces sustained at the elbow during their sporting activities. Injury to the UCL typically occurs during the late cocking/early acceleration phase of throwing and the athlete often complains of a sudden, sharp medial elbow pain that makes further accurate throwing almost impossible. Elbow range of motion (ROM) may initially be normal but once edema develops there is usually a loss of full elbow extension. The severity of the strain may correlate with the degree of laxity on valgus testing, although absence of valgus laxity does not rule out UCL injury.
The authors of this article proposed certain guidelines when deciding on return to play (RTP) for an athlete with UCL injury. These include normal ROM and strength compared to contralateral side, no edema, negative laxity on valgus stress and the ability to perform sport specific activities with control and accuracy. They also cautioned that further assessment by a physician may be warranted if severe injury is suspected > From Edwards et al., Int J Sports Phys Ther 8 (2013) 212- 215. All rights reserved to The Sports Physical Therapy Section of the American Physical Therapy Association.
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