By Abby Sims
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Only one day after going on the DL with what was purported to be a muscle strain of the flexor tendons attaching at the inner elbow (medial epicondylitis), a contrast MRI revealed that Joba Chamberlain has a ligament tear that will likely require Tommy John surgery.

Though reported that Yankee brass professed surprised at the severity of the injury, when a pitcher has significant medial elbow pain, a tear of the ulnar (medial) collateral ligament (UCL) is generally suspected.

As discussed in yesterday’s Injury Breakdown post, symptoms of an Ulnar Collateral tear, medical eipcondylitis and  irritation  or entrapment of the ulnar nerve share many similarities.  When it is an overhead athlete doing the complaining – particularly a pitcher who must put repetitive stress on the inner elbow – a tear is one likely culprit.  What is remarkable however, is the success with which Joba pitched while injured.

Comparing these diagrams will help you to see the intimate relationship of the ulnar collateral ligament and the tendons that were initially suspected of causing Chamberlain’s pain..

Elbow Ligaments

Flexor Tendons at the Medial Epicondyle

Take a look at an Injury Breakdown post from August of 2010, on then 22-year-old Nationals phenom Stephen Strasburg, to learn more about UCL tears and the Tommy John procedure.


Abby Sims has a Masters degree in Physical Therapy from Duke University and a Bachelors in Physical Education from Rutgers University. She has owned and operated orthopedic and sports physical therapy practices in New York City for the past 30 years. During that time Abby has had the pleasure of working with many professional athletes and celebrities.

In addition to her clinical work and speaking at medical conferences, Abby and her husband, sportscaster Dave Sims, provide media coaching for athletes via their AthletiSense communications program. You can follow Abby’s daily fitness/wellness tips on Twitter @abcsims

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