What is a UCL injury? An orthopedic surgeon speaks on what Carson Beck is dealing with

There are still things we don’t know about Carson Beck‘s right elbow. The Georgia quarterback suffered a ulnar collateral ligament (UCL) injury in the Bulldogs’ 22-19 SEC Championship win over Texas in overtime and he has since undergone an MRI where it was determined that the ligament was injured. We also know that he’s seeking additional opinions and there is no timeline for his recovery or return.

What we don’t know is the extent of the injury. Will Beck’s injury require surgery? Is it bad that he experienced numbness, weakness and tingling?

DawgsHQ caught up with Travis Patterson, MD, orthopedic surgeon with Northeast Georgia Physicians Group for some insight on UCL injuries. Dr. Patterson specifically requested that we avoid any situations where he would comment on Beck’s injury specifically seeing as how Beck isn’t his patient and he doesn’t have all the information. He is, however, experienced in dealing with UCL injuries and he offered some insight as to the different scenarios with which the Georgia signal caller might be dealing.

*** Dr. Patterson, along with the rest of his team at NGPG Orthopedic Surgery and Sports Medicine, provide care at 18 locations across North Georgia. Check out Northeast Georgia Orthopedics.

So from what I understand, there are three different grades of UCL injuries. Is that right? Can you explain kind of the differences between the grades?

Dr. Patterson: “Yeah, that’s correct and really, specifically, we’re looking at incomplete injuries to the ulnar collateral ligament versus complete injuries, and that’s essentially the level of tears that happen. There’s two separate bands that make up that ulnar collateral ligament, the anterior and posterior band, and you can have a partial tear that involves either one of those bands or complete tears that involve both bands that’s present there.So that does tend to dictate the treatment options as well when we’re discussing how to move forward with treatment.”

Right, and so I would assume, and you can tell me if this is correct, no tear equals no surgery, and what happens after that? Partial tear or complete tear, what is normally the treatment?

Dr. Patterson: “Yeah, so oftentimes even in the setting of a partial tear, it can be treated conservatively. Even full thickness tears in lower demand individuals that are tears related to trauma or other incidences that are not athletic-related, it can be potentially treated non-surgically and allow a chance to heal and scar in around that ligament as long as the ligament isn’t significantly displaced.

“When we’re talking about higher-level athletes, whether it’s pitchers that you hear the most about because of the significant strain that’s placed on the ulnar collateral ligament, or in this setting of quarterback, oftentimes surgical intervention may be offered as a means to add support and give an opportunity to heal potentially a little bit faster. But these can be difficult injuries to come back from the setting of full thickness tears.”

There are some examples of quarterbacks trying to play through this injury. Is there a difference between throwing a baseball with this injury and a football with this injury, or how does that work?

Dr. Patterson: “Yeah, there definitely is a difference in the amount of strain that the ulnar collateral ligament is seeing, both from the arm mechanics with pitching and with throwing a football, but also with the level of repetitions that are being seen. Somebody that’s pitching, they’re throwing over and over and over again, whereas football is not necessarily every single play that’s getting a throw, and some of those throws are not at the full velocity. So you don’t hear as much about football players and having ulnar collateral ligaments for that very reason.

“It usually is in the setting of a traumatic impact type injury as opposed to a throwing injury when we’re talking about ulnar collateral ligaments in a football player.”

Numbness, tingling, weakness in the hand, those types of things, is that indicative of that injury or maybe the trauma around that UCL injury? Can that be a symptom of a tear or anything like that?

Dr. Patterson: “Not necessarily. Usually if there’s numbness and tingling in the hand, particularly in the setting of a strain on the inside of the elbow, we’re talking about the ulnar nerve and essentially just having a stretch type injury, that can potentially be a minor thing. So this could be something that’s a minor injury and has just a small strain around it and then has some irritation or stretch to the ulnar nerve as opposed to having involvement of the collateral ligament itself.

Will you get everything you need to know out of an MRI out of this, what are the different tests that can be run to kind of figure out the full scope of what’s going on here?

Dr. Patterson: “MRI is good for diagnosing this. It’s not perfect by any means. It depends a little bit on the quality of the images that are gained. There can be some factors that come into play with just making it difficult to fully read an MRI in this setting. But I would imagine that that would give them some pretty good insight as to his overall recovery.”