Medial Collateral Ligament Injury
What is it: Medial collateral ligament injury can develop with repetitive valgus force across the elbow, most commonly seen with throwing or racquet sports. The injury may vary from mild degenerative changes to acute tear.
How does it present: Patients with more mild injury may present with medial elbow pain made worse by valgus type activities, such as throwing. Acute rupture usually presents with abrupt onset of pain, and may present after a single valgus stress event to the elbow if they have had symptoms for a long time.
Common exam findings: On exam, tenderness along the ligament, just below the medial epicondyle may be appreciated. Stability of the ligament can be tested by applying a valgus force across the elbow in 30 degress of flexion and in full extension.
Tests and treatment: An x-ray may show some calcification of the ligament if the injury has been longstanding. If further imaging of the ligament is required, magnetic resonance imagine (MRI) or ultrasound maybe considered. Treatment of ligment strains may be conservative with modification of activity, resting and icing. Physical therapy may be helpful. In recalcitrant cases or in cases of a full tear of the medial collateral ligament, orthopedic consultation is appropriate.