This 2014 narrative review by Bruce and Andrews covers the anatomy, biomechanics, diagnosis, and management of UCL injuries in throwing athletes — from physical exam and imaging to nonsurgical rehab and three major reconstruction techniques — synthesizing evidence to guide decision-making in competitive throwers.
When a competitive pitcher presents with medial elbow pain in late cocking or acceleration — even without a 'pop' — suspect chronic UCL attenuation and work up with MR arthrography; valgus stress exam alone may miss subtle laxity.
After failed conservative management (minimum 6 weeks no-throw, kinetic chain rehab), UCL reconstruction with the docking or ASMI technique offers >83–92% return to competition, but counsel athletes that return to the mound takes 9–12 months and that surgery will not enhance performance beyond the pre-injury baseline.
This 2014 narrative review by Bruce and Andrews covers the anatomy, biomechanics, diagnosis, and management of UCL injuries in throwing athletes — from physical exam and imaging to nonsurgical rehab and three major reconstruction techniques — synthesizing evidence to guide decision-making in competitive throwers.
When a competitive pitcher presents with medial elbow pain in late cocking or acceleration — even without a 'pop' — suspect chronic UCL attenuation and work up with MR arthrography; valgus stress exam alone may miss subtle laxity.
After failed conservative management (minimum 6 weeks no-throw, kinetic chain rehab), UCL reconstruction with the docking or ASMI technique offers >83–92% return to competition, but counsel athletes that return to the mound takes 9–12 months and that surgery will not enhance performance beyond the pre-injury baseline.