UCL Tommy John Assessment

today we're gonna talk about assessing a

UCL's brain also known as a Tommy John

sprained the UCL is in the medial

portion of the elbow frequently seen a

baseball plays I know there's a lot of

injuries that can happen in the elbow

and shoulder today I just want to focus

on how I assess a UCL sprain so first

take up to taking a good history I want

to look at palpation is he sore on the

medial epicondyle or on the sublime

tubercle that's where the ligament is

the anterior being specifically so I'm

gonna palpate palpate around see if I

can replicate his symptoms I got to

differentiate that by medial flexor

pronator strange that's gonna be more in

this area so palpation first then while

he's in seated I'll go into a milking

maneuver milking signs I'm gonna grab

his thumb bring him into and read

external rotation and then cause a

valgus stress to his elbow so n range

external rotation valgus stress so can i

replicate his symptoms on the medial

aspect then I'll have him go on his

stomach's let's go in your stomach shoot

and I'm into a prone valgus maneuver

I like this test versus acceded values

because it locks out the shoulder better

and would not get an external rotation

of the shoulder so here I got his

shoulder about ninety degrees of

abduction I'm standing at his head I'd

go full pronation unlock the elbows

slightly and then I can cause a valgus

maneuver in that position to try to

replicate his symptoms and to try to

measure the total amount of translation

that's going on is medial elbow so again

full pronation unlock the elbow valgus

and then finally let's go on your back

then also look at end range external

rotation does that replicate his

symptoms if a flex of pronator strain is

thought to have happened he probably

won't feel symptoms with this that's how

I differentially diagnose if I'm

suspecting a UCL Frank he'll probably

feel pain at end range external rotation

I'll also go and range external rotation

and give a valgus stress on maintaining

external rotation and pulling them into

a valgus position while I'm extending

his elbow again replication of symptoms

on the medial side of the elbow is

clearly indicative for a UCL sprain in

my opinion so those clusters of tests I

think are going to be your keys to get

diagnosed meet UCL sprain or Tommy

John's brain in a baseball player thanks