Clinical Decision Making and Management Following Ulnar Collateral Ligament Reconstruction in an Overhead Throwing Athlete: A Case Report

Background: Ulnar collateral ligament reconstruction is a common surgery for baseball athletes with ulnar collateral ligament insufficiency. Chronic stress or an acute rupture from the overhead throwing motion can cause trauma to this ligament which may require surgical intervention in some cases. This case report discusses the rehabilitation approach that was used for an elite baseball athlete following ulnar collateral ligament reconstruction and the process for the return to sport after this procedure. Purpose: The purpose of this case report is to highlight clinical decision making for an athlete recovering from ulnar collateral ligament reconstruction surgery as well as discuss key time frames and interventions in the rehabilitation process to ultimately assist this player to return to sport at the highest level. Case Description: A baseball pitcher in his early twenties presented to physical therapy one-day post-ulnar collateral ligament reconstruction surgery with the goal of returning to pitch and continue his baseball career. Interventions and Timelines: This athlete reported to physical therapy treatment six times per week over the course of his rehabilitation. The timeline for his rehabilitation can be broken down into three phases. Discussion: With the increasing number of baseball players undergoing ulnar collateral ligament reconstruction surgery, this case report overviews the rehabilitation timeline, evidence-based interventions, and a return-to-throw protocol that assisted this athlete in returning to overhead throwing.