UCL (Tommy John) Injury Treatment in San Antonio

Expert care for elbow ligament injuries, from initial evaluation to surgical reconstruction.

what is a UCL (Tommy John) Injury?

The ulnar collateral ligament (UCL) is one of the key stabilizing structures inside your elbow. It helps you perform motions that require force and precision, especially throwing, lifting, and rotational movements. When this ligament becomes stretched, torn, or ruptured, it can cause significant pain, weakness, and loss of function.

UCL injuries are common in baseball players, overhead athletes, and individuals who perform repetitive throwing or heavy lifting at work. At Ortho San Antonio, our orthopedic specialists diagnose and treat UCL injuries using the most advanced non-surgical and surgical options, including Tommy John surgery, to help patients return to their highest level of activity.

Common Symptoms of a UCL Injury

A UCL injury can develop gradually from overuse or happen suddenly during a high-force throw. Symptoms may include:

  • Pain on the inside (medial side) of the elbow

  • A “pop” or sharp pain during a throw

  • Loss of throwing velocity or accuracy

  • Tingling or numbness in the ring and small fingers

  • Difficulty gripping or holding objects

  • Elbow instability or feeling like the joint may “give out”

  • Swelling or stiffness after activity

If you are an athlete experiencing these symptoms, early evaluation is key to preventing long-term damage.

What Causes UCL Injuries?

While UCL injuries are often associated with baseball, especially pitchers, they can occur in anyone who performs repetitive overhead or forceful arm motions.
Common causes include:

  • Repetitive throwing (especially fastballs or high-volume pitching)

  • Chronic overuse without adequate rest

  • Sudden high-velocity motion (a single hard throw)

  • Poor throwing mechanics

  • Weakness in the shoulder or core, placing stress on the elbow

  • Traumatic falls or workplace injuries

Our specialists evaluate the elbow, shoulder, and biomechanics to understand why the injury occurred, helping you heal and prevent re-injury.

How UCL Injuries Are Diagnosed

At Ortho San Antonio, diagnosis begins with a detailed physical exam and a discussion of your symptoms and athletic/activity history. Imaging may be used to confirm the extent of the ligament damage, including:

  • X-rays to rule out fractures or bone abnormalities

  • MRI or MR arthrogram for detailed ligament evaluation

  • Ultrasound for dynamic, real-time assessment during movement

This allows us to tailor a personalized treatment plan that aligns with your sport, season, and functional goals.

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Dr Hinchey at Ortho San Antonio Elbow Pain Tommy John Injury

UCL (Tommy John) Injury Treatment Option

Non-Surgical Treatment Options

Many partial UCL tears can heal without surgery, especially when diagnosed early. Non-surgical options include:

  • Rest and Activity Modification
    Avoiding high-stress throwing motions gives the ligament time to recover.

  • Bracing or Elbow Support
    Used during early recovery to stabilize and protect the joint.

  • Physical Therapy
    A specialized rehabilitation program focuses on strengthening the shoulder, forearm, and core while improving throwing mechanics to reduce stress on the elbow. Therapy also works to restore flexibility and motion, followed by a gradual, structured return-to-sport progression to ensure safe and effective performance.

  • Anti-Inflammatory Medications
    Helps relieve pain and swelling in the early stages.

  • Regenerative Medicine (PRP)
    Platelet-rich plasma injections may help stimulate healing in partial UCL tears.

Most athletes respond well to non-surgical care when treated early and guided by a sports-focused rehabilitation plan.

Tommy John Surgery (UCL Reconstruction)

Tommy John surgery repairs the damaged UCL using a tendon graft from your body or a donor. This graft restores elbow stability and allows athletes to return to high-level throwing.

During the procedure, the damaged ligament is replaced with a new graft that is carefully positioned, tensioned, and secured to support full elbow function. Modern techniques allow for less invasive incisions, more precise graft placement, and improved recovery timelines.

When Surgery Is Recommended

If the ligament is completely torn, or if a high-level throwing athlete requires full elbow stability, surgery may be recommended. Symptoms such as persistent pain, elbow instability, or inability to throw at full strength often indicate the need for surgical intervention.

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Inside elbow pain? Learn what a UCL injury really is

A UCL injury happens when the ligament on the inside of the elbow is damaged from repetitive throwing or high-force motion.
In this video, Dr. John Hinchey explains what a Tommy John injury is, why it occurs, and how these injuries are treated at Ortho SA.

learn more on Our Youtube Channel

If you’re experiencing elbow pain, loss of throwing power, or symptoms of a UCL injury, early evaluation is essential.

At Ortho San Antonio, our team of board-certified surgeons identifies the source of your elbow pain and provides the most effective treatment options to help you heal and regain full function.

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