UCL of the elbow stands for ulnar collateral ligament. The is a ligament along the lateral (outside of the) elbow that holds the humerus (upper arm bone) and radius (one of the two bones in the forearm) together. The UCL is actually made up of three separate “bundles” of ligamentous material.
The three bundles are strategically placed around the elbow in three separate directions and insert into the bone. There are also superficial and deep layers that weave into the joint capsule. This is what gives the lateral elbow so much strength and stability.
It also explains why when the ligament is torn, an athlete might be out for a while. It takes time to heal, recover, and rehab to be back at the preinjury competitive level. In the case of acute trauma, it is possible to treat the problem conservatively (without surgery). The athlete usually works with a physical therapist and/or athletic trainer to protect the healing tissue at first and then later regain strength, motion, and full function.
With more chronic injuries, the tendon wears away, fragments, and splits from repetitive overloading. This kind of damage is more likely to require surgical repair or reconstruction to make recovery and return-to-play possible. Surgery is also more likely if the athlete experiences elbow dislocation (instability) because of UCL disruption.
When it comes to surgical approaches to UCL injuries, the surgeon must evaluate each athlete individually to determine whether repair or full reconstruction is needed. There are several different ways to surgically approach the problem. In the case of ligamentous repair, good-to-excellent results have been reported for young athletes with an acute tear of the ligament where it attaches to the bone.
In general, many athletes are indeed able to recover and return to full sports participation. That wasn’t true 30 to 40 years ago but newer surgical techniques and medical treatments have changed the picture quite a bit. It’s very likely you will see your favorite pitcher back on the mound next season.