THE UCL EPIDEMIC

In any overhand throwing sport, there is one constant, the breaking down of an athlete’s throwing elbow. Located deep within the human elbow lies the Ulnar Collateral Ligament, or UCL. During every throw, the UCL takes an absurd amount of force. Sports like baseball have athletes break down at rates far beyond any other sport, but not all athletes will receive an elbow injury during their career. The way to prevent elbow injuries is to understand the prerequisites to safe throwing and allow proper recovery.

The UCL is a ligament located within the human elbow that is strained during every throw an athlete makes. After a certain point of this repeated stress, the UCL could suffer damage. There are three main types of injuries: sprains, partial tears, and complete tears. Sprains are unique from the two forms of tears in that they do not need to be treated with a surgical operation. Any form of tear, partial or complete, needs to be repaired with either reconstruction surgery or an internal brace. All the injuries require a rehabilitation period, that vary in length, so preventing injuries will ensure that athletes are able to play as much as possible. For athletes to begin throwing in a safe and effective manner, they must educate themselves in what they are embarking on. Overhand throwing is not a natural movement for humans, so the human body breaks down quicker (Dryden). Many throwers overlook or do not understand the dangers of throwing and experience issues as a result. Ignorance is dangerous for the athlete who do not understand the danger they are placing on themselves.

Athletes who are in tuned to their throwing will prepare their bodies to throw. The first area of importance is strength.  Tread Athletics’ research concluded that the UCL can only take 30 to 40 Newton Meters of torque, before experiencing damage to the ligament and the average throw places 50 to 120 Newton Meters torque on the thrower’s UCL (drheenan). Tread Athletics research proved that the UCL alone is not strong enough to withstand throwing. Many throwers often overlook these metrics and throw in a manner that leaves them vulnerable. The role of the muscles is to remove torque from the UCL. Athlete’s quadriceps, hamstrings, glutes, obliques, and shoulders are some of most foundational muscles in throwing. According to Josh Heenan of Tread Athletics, their research regarding strength and injury concluded that athletes who meet certain strength thresholds can reduce their chance of getting UCL surgery by 480 percent (drheenan). Tread Athletics data says that strength is the very foundation of throwing. Strength is often viewed as a tool to increase performance but is better viewed as a tool to mitigate injury risk.

In addition to strength, a good pre-throwing phase is essential for warming up and preparing the body to throw. Allowing proper blood flow will permit the body to preform better and prevent injury (“The Right Way to Warm up and Cool Down.”). Anyone who properly warms up and cools down will experience better results in their training and performance, not just throwing athletes. Many people will not stress their bodies as much as throwers, so throwers need to properly warm up and cool down as essential part of their injury risk mitigation. This means for a throwing athlete, that the warmup phase is essential to not only preform, but to mitigate injury risk associated with throwing. Many professional athletes and organizations have set warmup procedures and will often do this as an entire team to indirectly stress its importance. Many people overlook the warmup phase and often will end up hurting themselves because of their body’s inadequate preparation.

After intense physical activity, giving the body rest is essential. After intense physical activity, the body breaks down and needs time to recover. The two biggest elements of recovery are time and sleep. Muscles need time repair themselves after activity and sleep is where the best recovery occurs (Vyazovskiy). The breakdown of athlete’s muscles is a regular occurrence, but when athletes overstress or overstress by a lack of recovery time, serious injury could occur. Athlete who stress their bodies a lot, need to sleep to allow proper time for recovery. Athletes who don’t give their muscles time to recover could suffer from injuries as a result.

After intense physical activity, giving the body rest is essential. After intense physical activity, the body breaks down and needs time to recover, and the best way to do this is by giving the body proper time and getting enough sleep (Vyazovskiy). Vyazovskiy research concluded that giving the muscles time to recover as well as getting adequate sleep, is most effective. Many throwers will properly warm up and cool down but forget that after physical activity, the body has broken down and needs time to recover before being strained again. For throwers, the most common way of not allowing proper recovery, is by throwing hard multiple days in a row. This repeated stress on already fatigued and broken-down muscles, is what leads to injuries.

Preventing UCL injuries begins with the proper understanding of throwing. Throwing athletes breakdown much faster that any other athlete, so knowing how to prevent injuries and stay healthy is essential. The UCL is fragile and is not meant to undergo the overhand throwing motion because of the torque placed on it.

Edward Franklin Albee III was an American playwright who was born in Washington DC but grew up in New York City. Albee is best known for his works The Zoo Story (1958) and A Delicate Balance (1966) which are both Theater of the Absurd. Edward Albee would believe that UCL injuries are experiences of mistakes and suffering and as a result, people come out wiser and more resilient.

Before Edward Albee became a playwright of note, Albee biological father abandoned him and his family shortly after Albee’s birth (“Biography”). Albee’s adoptive parents did not care much for Edward, often neglecting him. The idea of neglect in Albee’s life shows similarities to UCL injury patients. Many people who experience UCL injuries neglect their healthy and let the situation deteriorate into a situation where irreversible damage. This issue can be fixed with proper relationships and connection to people who understand the UCL. In Albee’s childhood, he lacked relationships, and this resulted in a troubled childhood.

Edward Albee’s plays were not only theatrically masterpieces but plays that show ideas parallel to UCL injuries. In the play A Delicate Balance, the idea of fear is presented. In the play, fear is a force that drives the characters forward. Throughout, the play quotes such as, “WE GOT…FRIGHTENED” and “We got scared”, can be heard (Albee). These quotes establish and reaffirm the importance of fear in driving the characters forward. Fear not only drives the characters forward as a whole, but characters individual fears drive themselves in their own unique direction. The characters struggle with their individual fears such as going insane, growing up, and just life in general (Albee). The character individual fears are essential in understanding fear in the context of the plot and in the context of UCL injuries. In baseball culture, saying Tommy John is the equivalent of a curse and the stigma around the name has greatly alter the culture in baseball. Many throwing athletes live in fear of having an injury that will require surgical repairs, because of the recovery and time missed. The parallels between A Delicate Balance continue beyond the general idea of fear itself. While everybody fears having an injury, there are more individual beliefs that drive athletes forward. Every athlete has some internal fear drives them forward, as well as the general fear of the UCL.

Another play by Edward Albee is The Zoo. In this play, the ideas of alienation and reality are explored. As soon as Jerry enters the story, his social skills, or lack thereof, are apparent. As Jerry approaches Peter, he greets him by saying “I’ve been to the zoo. I said, I’ve been to the zoo. MISTER, I’VE BEEN TO THE ZOO!” (Albee). His unusual greeting is followed up by Jerry explaining to Peter that he lost both of is parents at a young age. Jerry’s outward projection and his tragic childhood events help the audience establish Jerry’s missing foundation to be a normal person. This lack of foundation alienates Jerry into the person he is portraited as. Many athletes can feel the same feeling of alienation from not have the proper foundation. The feeling of alienation in any athlete can be detrimental, as the feeling of lonely is not an environment that athletes, and people in general, flourish in. Be giving athletes the proper foundation to throw in a safe and effective manner, injuries are avoided, and the alienation problem can be avoided. Another idea explored is reality. Jerry’s perception of reality is significantly altered because of past events, this idea is similar to many throwing athletes. Many athlete’s perception of reality is altered by past events. This alter states can force athletes into situation where injury is more likely because past events have damaged an athlete’s mental state. Have the purest perception of reality is essential to make good decision for long term health.

Edward Albee was also quoted saying things with parallels to UCL injury. “If you have no wounds, how can you know if you’re alive?” (Svoboda). Albee believed that wounds are unique to everyone and can used to define peoples’ lives. The idea from this can be extracted and placed into the context of UCL injuries. The wounds, scars, and anything else, physical or mental, that help to make a person unique is what tells people that they lived. Albee understand that humans will live life imperfectly and that we will eventually attain something that blemishes us. We must look beyond the scars and look at the learn to be made.

Albee’s parallels continue and his idea of learning is no different. “Sometimes a person has to go a very long distance out of his way to come back a short distance correctly” (“Edward Albee Quotes.”). Albee understands that for some people they must do a lot of wrong to do one thing right. The UCL injury epidemic is a learning experience for everyone, including athletes, coaches, and even the medical professionals that are preforming the operations. Athletes are learning the absolute limit their bodies can take before experiencing irreversible damage. Athletes need to challenge their bodies but knowing where the limit is, is essential. Coaches are learning how to develop their players in a manner that stays away from the undescribed limit. Even the medical professionals are learning more about the operations. As technology advances and more data about the operations surfaces, the operations will continue to improve, and the rehabilitation phase will be more efficient in assure athletes are able to get back on the field.

Edward Albee would believe that UCL injuries are experiences of mistakes and suffering and as a result, people come out wiser and more resilient. Albee’s brilliance and playwriting ability give us the ideas to draw the parallels between his work and the UCL epidemic that has swept the baseball world by storm.

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