Questions Dr.

Blum:

1. What is the function and what is a UCL?

The Ulnar Collateral Ligament (UCL) of the elbow is a ligament on the inside (ulnar) of the
elbow that is the main stabilizer to prevent valgus stress.

2. What can players do in order to prevent UCL injuries or shoulder injuries?

Generate power via training legs, developing a strong core; strengthen rotator cuff and forearm
muscles; avoid overuse via inning restrictions.

3. What are causes of a UCL injury in baseball?

Probably multifactorial, including genetics and overuse. Probably the most common
denominator is a simple wearing out of the ligament over millions of cycles that the elbow is
taken through by starting pitching at an early age through high school, college, and
professionally. Studies have been done to look at all the risk factors and there isn’t one
particular factor that puts an elbow at higher risk, but it makes sense that things wear out over
time.

4. What is a good amount of pitches for pitchers to throw in a day or game?

Probably 60-80, but this depends on muscle and mechanical maturity.

5. After pitching, what should pitchers do the next day or right after in order to take care of
their arms?

Limit inflammation (Ice), rest, condition forearm muscles, avoid stress.

6. Due to many pitchers injuring their arms because of curveballs when is a good age for
players to start throwing curveballs?

There is some thought that curveballs increase the torque on the ligament and that it should be
limited until 14 years old.

7. How long does it take to recover from UCL surgery?

Average time to recovery is 7-9 months.

8. What is recovery like after surgery on a UCL injury?

The first 8 weeks is in a simple hinge brace which limits extension (straightening) of the elbow.
At 6 week full extension is allowed and gentle strengthening is initiated. Therapy continues with
advanced strengthening at 3 months, gradual reintroduction of a throwing program at 4 months,
and eventual return to pitching between 7-9 months.

9. How can you build arm strength in order to throw harder without injuring your arm?

It’s impossible to prevent injury 100% of the time, but building up strength and stamina in the
forearm muscles helps as a secondary stabilizer for the elbow to prevent valgus stress on the
UCL.

10. How can we get players to be more honest with coaches and themselves if their arm is
sore or feel fatigue after throwing a while?

That’s probably the most difficult question, since the pressures from players themselves,
teammates, family members, trainers, and coaches can be intense. Soreness and fatigue can
be normal, but understanding that sharp pain that consistently impacts velocity and control
could be a sign that something may be injured is important. If players understand that pushing
through pain could lead to further damage that could require extended periods of inactivity and
possibly even surgery, they perhaps will be more likely to communicate their pain symptoms
earlier.