The ulnar collateral ligament is a strong band on the inner side of the elbow that resists the sideways stress of throwing. It can be strained or torn gradually through repeated throwing and overhead sport, or suddenly in a fall or elbow dislocation. Many injuries recover with rest from throwing and a structured rehabilitation programme, and surgery is mainly for athletes who need to return to high-level throwing.
Also known as UCL sprain, medial collateral ligament injury of the elbow, thrower's elbow
Anatomy: where the problem is
Front view of the elbow. Highlighted in the diagram: inner elbow ligament.
Symptoms
- Pain on the inner side of the elbow during or after throwing
- Loss of throwing speed, distance or control
- A pop or sharp pain on a single throw in some cases
- Tenderness just below the bony bump on the inner elbow
- A feeling of looseness or instability
- Tingling in the ring and little fingers if the nearby nerve is irritated
Causes and risk factors
- Repeated throwing or overhead hitting, which stresses the inner elbow
- A sudden increase in throwing volume or intensity
- Throwing when tired, or with poor technique
- A fall onto an outstretched hand
- An elbow dislocation
What the evidence says helps
- Rehabilitation is the usual first step for partial injuries: a period of rest from throwing, followed by strengthening and a staged return to throwing.1
- In one study of throwing athletes treated without surgery, 42 per cent returned to their previous level of competition, taking about 24 weeks on average.1
- For athletes with a complete tear who want to return to high-level throwing, ligament reconstruction is the established option. In a series of more than 700 athletes followed for at least two years, 83 per cent returned to the same or a higher level.2
- Recovery after reconstruction is long: return to competitive throwing took around a year on average.2
- People who do not throw for sport rarely need surgery and usually do well with rehabilitation.1
Things you can try at home
- Stop throwing and other painful overhead activity until you have been assessed
- Keep the elbow, wrist and shoulder moving within comfort
- Use ice for short-term relief in the first few days after an acute injury
- Maintain general fitness and leg and trunk strength while the elbow rests
- Return to throwing in planned stages, not all at once
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A hot, red, swollen elbow with a fever or feeling unwell: see a GP the same day or call NHS 111
- An elbow that looks deformed, or cannot be bent or straightened after a fall: go to A&E
- Arm pain with chest pain, breathlessness or sweating: call 999
- Numbness, pins and needles or weakness in the hand that is getting worse: see your GP promptly
- A pop on the inner elbow followed by swelling, bruising or a feeling that the joint is unstable: get it assessed within a few days
How Apollo can help
We examine the stability of the elbow, the forearm muscles that protect the ligament and the nerve on the inner side of the joint. We also look at the shoulder, trunk and hips, because the whole chain affects how much stress reaches the elbow in throwing. Rehabilitation includes strengthening, a staged return-to-throwing plan and strength testing to guide each step. If the elbow is unstable or you are not progressing, we refer you for imaging and a specialist opinion, and we provide rehabilitation after surgery.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can an elbow ligament injury heal without surgery?
Partial injuries often do, with rest from throwing and structured rehabilitation. Complete tears in people who want to return to high-level throwing are more likely to need reconstruction. People who do not throw for sport usually manage well without surgery.
How long before I can throw again?
It depends on how severe the injury is. In one study, athletes treated without surgery who got back to their previous level took about six months. After ligament reconstruction, a return to competitive throwing typically takes around a year.
Is this the same as golfer's elbow?
No. Both cause pain on the inner elbow, but golfer's elbow is a tendon problem where the forearm muscles attach, and it hurts with gripping and wrist bending. A ligament injury hurts with the sideways stress of throwing and may make the elbow feel unstable.
References
- Rettig AC, Sherrill C, Snead DS, Mendler JC, Mieling P (2001). Nonoperative Treatment of Ulnar Collateral Ligament Injuries in Throwing Athletes. The American Journal of Sports Medicine 29:15-17. View source
- Cain EL, et al. (2010). Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes. The American Journal of Sports Medicine 38:2426-2434. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
