Indian weightlifter Sanket Mahadev Sargar, who won a silver medal in the 55kg category at the Birmingham Commonwealth Games 2022 (CWG 2022), will stay back in the United Kingdom for the treatment of the UCL injury he suffered during his bout. An Ulnar Collateral Ligament (UCL) tear, according to experts, takes at least three months to heal.

To recall, the 21-year-old from Maharashtra’s Sangli had come to the medal ceremony with his right arm bandaged.

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Sargar lifted a total of 248kg (113 snatch, 135 clean and jerk) to secure the first medal for India at the CWG 2022.

“There were two options with Sanket. To take him back to India or treat him here. After initial assessment, we thought it is best we treat him in the UK itself. We are chatting with elbow injury experts and the government has okayed his treatment,” a team source told PTI.

What is UCL injury?

The ulnacollateral ligament is located on the inside of the elbow and attaches the upper arm bone (humerus) above to one of the forearm bones (ulna) below. “The UCL provides stability and prevents excessive movement at the elbow when there is a force pushing it inwards,” said Christopher Pedra, consultant, sports physiotherapist, Sir HN Reliance Foundation Hospital.

How does the UCL get injured?

The UCL can get injured in many ways, but most common is “gradually through overuse, in throwing or hitting movements”. “Athletes playing sports like baseball (pitchers), tennis, golf and cricket (bowlers) are more likely to be affected in this way. A fall onto an outstretched arm can cause a traumatic rupture of the ligament and may involve a fracture or dislocation,” explained Pedra.

Birmingham Commonwealth 2022 silver medallist Sanket Mahadev Sargar (Source: Narendra Modi/Twitter)

Symptoms

According to Dr Akhilesh Yadav, associate director – Orthopedics and Joint Replacement, Max Hospital, Vaishali, some of the common symptoms are

*Tenderness and pain on the inside of your elbow during or just after an exercise session where there is use of arms overhead
*Pain while swinging your arm quickly forward
*Tingling or numbness in the ring and pinky fingers
*Shaky grip of hands
*Loss of the ability to throw hard and fast

Management and treatment

Management for this condition can be either non-surgical or surgical. “Non-surgical management would involve a period of immobilisation (rest), medication for pain, ice and then pain-free exercise to increase strength in the muscles around the elbow to compensate for any laxity/instability due to the stretched/torn ligament,” Pedra said. Dr Yadav added that the severity of UCL injury and how much one intends to utilise their arm for demanding overhead motions or throwing exercises “will determine the course of treatment”. “Minor UCL injuries may self-heal with time,” he said.

Dr Yadav further mentioned that the purpose of surgery is to enhance elbow strength, regain range of motion, and reduce discomfort. “Surgical management typically consists of replacing the torn ligament with a tendon graft (similar to how an ACL in the knee is repaired). This procedure is commonly known as Tommy John Surgery (after the baseball player on whom this procedure was first performed in 1974),” Pedra noted.

What to keep in mind

*While the risk factors for non-surgical management are negligible, it must be known that there is residual instability after a period of rehabilitation. “This can then progress to surgery, should the athlete require further stability for their sport. Surgical management comes with the standard risks of any surgical procedure (anaesthesia complications, bleeding, blood clots, delayed post-operative healing, breathing concerns, infection, accidental injury to other structures during surgery) and the possibility that the surgery may not have the desired outcome, and there may be lasting disability in the elbow,” Pedra said.

Recovery

Recovery may take anywhere from 6-12 weeks for non-surgical management, and up to a year if surgical management is required. Dr Yadav shared that for many weeks after surgery, “bracing is necessary, and a slow, progressive therapy is crucial for a healthy recovery”. “Following three months, throwing and overhead motions are usually doable, and competition is usually permitted six to nine months after surgery,” said Dr Yadav.

Prevention

According to Dr Yadav,

*Pre- and post-athletic activity should always include warm-up and cool-down exercises.
*If you are hurt or in pain, avoid practising or playing.
*Work on your posture and endurance by strengthening any weak muscles with the help of a physical therapist or sports trainer.
*Take proper rest after practicing or playing

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