Elbow UCL Rehab for weightlifters-what you need to know

It all comes down to the triceps and wrist wraps---  Below is information that has really helped me with my UCL recovery.  You can use the information in the article to have an informed conversation with your doctor before starting a rehab program for an injured UCL.  Afterall, I'm not a Doctor- I'm just a rocket scientist.
 
It is common for weightlifters to injure their Ulnar Collateral Ligament in competition, due to hyperextension. This usually happens when attempting to save a lift backward. 

Many of the doctors who work on UCLs come from a baseball paradigm and associate it with “Tommy John”, the famous baseball pitcher who had the first ever surgery for a UCL injury in 1974.  In other words, for the average orthopedist, most of the UCL tears they will see are from baseball pitchers and will not have a lot of experience tailoring their treatments to weightlifters.

 

 Although it is the same ligament that weightlifters injure, weightlifters are using this ligament in a different manner. In baseball, a pitcher uses the UCL almost like a rubber-band in a slingshot. They load it up with tension, then release it.  In weightlifting, lifters utilize the UCL for stability in the backwards and forwards direction (in front of and behind the head).  In effect, the treatments for UCL tears need to be more sport specific especially as you enter the phase of the athlete returning to competition.

From personal experience,  I have found that the average American physical therapist focuses entirely too much on the biceps and the extensors of the forearm when rehabbing a UCL injury. When really, triceps and the flexors, I found, are at least as important, if not more, for weightlifter stability (they are antagonistic muscles afterall!).  Many therapists even prioritize shoulder and scapular strengthening over the triceps as this relates to throwing mechanisms due to their baseball centric world view.

Think about it- what happens when you are supporting a bar overhead?  Your arms are fully extended with your forearm rotated such that the thumb is in line with your ear and your wrists are fully bent backwards.  Right? So, what are your muscles doing:  the triceps and extensors are in extension, and there is a lot of load on the flexors as your wrist is bent fully backward.

Perhaps, developed triceps, flexors, and extensors will help relieve loading from the UCL. Developing these muscles, according to my French doctor as well as any bodybuilding expert, lots of repetitions with not to heavy a weight is key.  Exercises like tricep pull downs are great. The goal is bulk, here (I know contrary to much of what we do in weightlifting).

Something else that can help --->Stabilization during lifting:

This is a pre-injury photo of me with 110kg. You can see me with obly ine of my leather wrist wraps on; the wrist without the wrist wrap is bent back much further.

In weightlifting, we are not permitted to wear elbow wraps. However, the muscles of the forearm have two attachment points- one by the elbow and one by the wrist.  An orthopedist in France (the same guy that told me to work more triceps ) pointed out to me that wearing wrist wraps will stabilize one of the attachment points of these muscle groups, and may be more effective than stabilizing at the elbow. 

Physically, this makes sense as when I wear my Risto leather wrist wraps, the amount my wrist can bend backward is restricted.  This does two things: (1) it reduces loading on the flexor tendons, which will change loading on the UCL, (2) the wrist wrap is actually absorbing some of the load being transmitted from the extensors.  It's got to relieve some of the hoop stresses in the forearm.

Overall, I feel more stable with leather wrist wraps and was able to do overhead work sooner with them.

Here's a post recovery photo of me demo-ing the wrist wraps, note the better wrist angles, and you can even see my flexors bulging, illustrating how they play in securing the bar overhead.

If you get anything out of this article -- the message is work your triceps , forearm,and wear leather wrist wraps to aide your elbow.