From the Research
The recommended treatment for a mild ulnar collateral ligament (UCL) sprain with minimal joint effusion is primarily conservative management, as indicated by the most recent and highest quality study 1.
Overview of Treatment
The treatment approach should prioritize reducing pain and inflammation, protecting the ligament, and promoting natural healing.
- Initial treatment should include rest, ice, compression, and elevation (RICE protocol) for the first 48-72 hours to reduce pain and swelling.
- Patients should take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (400-600mg three times daily with food) or naproxen (500mg twice daily with food) for 7-10 days to manage pain and inflammation, as supported by general medical knowledge.
Immobilization and Rehabilitation
- A hinged elbow brace or thumb spica splint should be worn for 2-4 weeks to protect the ligament while allowing controlled movement, as suggested by 2.
- After the acute phase, physical therapy focusing on progressive range of motion exercises, strengthening of the forearm muscles, and proprioceptive training should begin, typically lasting 4-6 weeks.
Return to Activities and Surgery Consideration
- Gradual return to activities is recommended as pain subsides, usually within 4-8 weeks depending on injury severity.
- Surgery is rarely needed for mild sprains unless conservative treatment fails after 3 months or the patient is a high-level throwing athlete, as indicated by 3 and 4. This conservative approach is effective because mild UCL sprains maintain structural integrity of the ligament, and these measures provide adequate support for natural healing while preventing complications from immobilization such as stiffness and muscle atrophy.