SPORTS INJURIES
Ulnar Collateral Ligament
The
ulnar collateral ligament is the reason for most chronic
medial elbow pains. This ligament supports the inside of
the elbow. It 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 athlete's complaint of pain on
the inside of the elbow will cause the orthopedist to examine
the lateral epicondyle's "sister," the medial epicondyle.
The orthopedist will quickly 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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