Sports focused physical therapy & performance training in Algonquin, IL
Resource Hub
Whether you're an athlete recovering from injury, a coach looking to support your team, or a parent seeking trusted information, you've come to the right place. This resource hub is packed with expert-backed guides, rehab tools, performance tips, and educational content designed to help athletes move better, recover faster, and return stronger. Explore our growing library of videos, handouts, and articles—all created by professionals who understand the demands of sport and the science of recovery.
Tommy John Injury
A Tommy John injury refers to an injury to the ulnar collateral ligament (UCL) in the elbow. It is named after former Major League Baseball pitcher Tommy John, who was the first professional athlete to undergo a surgical procedure to repair this type of injury in 1974. The UCL is a ligament on the inner side of the elbow that helps stabilize the joint during overhead motions and connects the humerus (upper arm bone) to the ulna (forearm bone). Previously, Tommy John surgery was only done on MLB players, however, currently 57% of all Tommy John surgeries are done on 15–19-year-olds. This injury has become an epidemic among young baseball players.
​
This injury is common among baseball pitchers and other athletes who engage in repetitive throwing motions, such as javelin throwers, quarterbacks, or tennis players. The repetitive stress placed on the UCL during these activities can lead to the ligament becoming stretched, frayed, or torn.
The UCL is composed of three main bundles:
-
Anterior Bundle – The strongest and most important for elbow stability, especially in overhead throwing motions. This is the most often injured ligament.
​ -
Posterior Bundle – Less significant in stabilizing the elbow but contributes to movement when the elbow is flexed beyond 90°.
​ -
Transverse (Oblique) Bundle – Connects the ulna to itself and provides minimal functional support.
Predictors of Injury
Outside of trauma (such as a fall onto an outstretched hand), most UCL injuries occur due to a variety of biomechanical, physiological, and contextual factors.
Here are some common issues that predispose an athlete to injury:
Pitching Mechanics
Poor pitching mechanics, such as improper arm action, excessive shoulder abduction or external rotation, and late forearm turnover, can increase stress on the UCL ligament.
Pitching Workload
High pitch counts, excessive innings pitched, and inadequate rest between pitching appearances, increase the risk of overuse injuries.
Pitch Types and Velocity
Certain pitch types, such as sliders and curveballs and consistently high pitch velocities, can place increased stress on the elbow joint and UCL.
Fatigue
Pitching while fatigued leads to alterations in mechanics and decreased neuromuscular control, which can increase the risk of injury. Pitching while fatigued results in thirty-six times greater incidence of sustaining a shoulder or elbow injury.
Age and Level of Play
Younger pitchers, particularly adolescents, are more susceptible to overuse injuries due to ongoing growth and development of the musculoskeletal system. Additionally, pitchers at higher levels of play may experience increased demand and competition, which can contribute to injury risk.
Previous Injury History
Pitchers with a history of prior elbow or shoulder injuries are at an increased risk of sustaining an UCL injury.
​
Strength and Mobility Imbalances
Muscular imbalances, particularly weakness or tightness in the shoulder, forearm, or core muscles, can affect biomechanics and increase stress on the UCL.
Pitching Environment
Environmental factors such as pitching off non-regulation mounds, playing on hard surfaces, playing on multiple teams, playing a level up, or pitching in cold weather may increase the risk of injury.
Genetics
Genetic predispositions may play a role in the integrity of connective tissues, potentially influencing susceptibility to UCL injuries.
Pitcher's Role
Pitchers who specialize in pitching year-round or who participate in multiple leagues simultaneously may be at greater risk due to the cumulative effect of repetitive stress on the elbow joint.
Identifying and addressing these predictors through proper training, conditioning, pitch count management, and biomechanical analysis, can help reduce the risk of Tommy John injuries in baseball pitchers.
Possible Symptoms
-
Pain on the inner side of the elbow.
-
A sudden popping sensation during throwing.
-
Decreased throwing velocity or accuracy.
-
Loss of motion/pain with motion.
-
Swelling or tenderness in the elbow.
​
Common UCL Injuries
-
Grade I Sprain: Involves no tear, but the ligament is stretched.
-
Grade II Sprain: The ligament is stretched and/or partially torn.
-
Grade III Sprain or Tear: There is a complete tear through the ligament.
Diagnosis
-
Physical exam: Valgus stress test (doctor applies pressure to check for instability).
-
MRI scan: Confirms ligament damage; either partial or full thickness tears.
-
Ultrasound: Assesses real-time movement and potential ligament tears.