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Our 14-year old daughter went to cheer camp this year for the first time. She loves gymnastics and cheering. She came back with a nasty injury to her inside elbow ligament and may need surgery. Right now, she's seeing a physical therapist to rehab it. Will she be able to get back to sports without surgery?

Many athletes with elbow instability from a ligamentous injury can be treated successfully with rehabilitation. And it can be done without invasive procedures. At first, symptoms may be treated with rest and/or activity modification.

Resting from the aggravating activity is a challenge for most competitive athletes. But it can make a big difference in the speed of recovery. Sometimes activity modification is all that's needed. This can range from fewer cartwheels, back flips, and round offs to shorter practices each day or fewer practices per week.

Antiinflammatory drugs and analgesics may be used to reduce pain and inflammation. Icing may help but must be used with caution. Too much cold can cause a worsening of the swelling as the body sends more blood to the area to warm things up. And cold can be an irritant to the already damaged (and irritated) nerve.

Other modalities such as electrical stimulation and ultrasound with cortisone (called phonophoresis) may be used by a physical therapist when needed. The athlete will work with the physical therapist to develop a daily program of stretching and strengthening.

The athlete’s posture, strength, and performance of activities must be analyzed and corrected. Stretching exercises for the muscles of the forearm are included. A strengthening program for the entire shoulder/elbow/arm complex will be prescribed. High repetition, low weight exercise training is used to increase endurance without placing additional stress across the joint.

Pain relief is often immediate with rest, activity modification, and antiinflammatories. With time and the proper rehab program, many athletes are able to return to play without further treatment.

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