Conditions Covered on This Page
Elbow Conditions
UCL Tear — Tommy John Surgery
The ulnar collateral ligament (UCL) is a small but critical band of tissue on the inside of the elbow that keeps the joint stable during throwing motions. When it tears — most often in overhead athletes like baseball pitchers, quarterbacks, and volleyball players — the result is pain, reduced velocity, and an inability to throw with full effort. UCL reconstruction, commonly known as "Tommy John surgery," replaces the damaged ligament with a tendon graft and has a well-documented track record of returning athletes to competition.
How It Happens
- Repetitive overhead throwing stress over months or years
- A single acute pop during a throw (less common)
- High pitch counts and year-round throwing without rest
- Poor throwing mechanics placing excess load on the elbow
- Most common in baseball pitchers, but also quarterbacks, javelin throwers, and tennis players
Signs & Symptoms
- Sharp or aching pain on the inner (medial) side of the elbow during or after throwing
- A sudden "pop" sensation in the elbow
- Loss of throwing velocity and control
- Elbow stiffness or inability to fully straighten the arm
- Numbness or tingling into the ring and pinky fingers (ulnar nerve involvement)
Research shows that 80–90% of athletes who undergo Tommy John surgery return to their prior level of competition, though full recovery typically takes 12–18 months. Early surgical intervention after a complete tear is associated with better outcomes than delayed treatment.
Treatment Options
Non-Surgical (Partial Tears)
- Complete rest from throwing for 6–12 weeks
- Anti-inflammatory medications to reduce pain and swelling
- Physical therapy to strengthen the surrounding forearm and shoulder muscles
- Platelet-rich plasma (PRP) injection — may help partial UCL tears heal
- Gradual return-to-throwing program under therapist guidance
UCL Reconstruction (Tommy John)
- The torn UCL is replaced with a tendon graft (typically from the forearm, hamstring, or a donor)
- Graft is woven through tunnels drilled in the ulna and humerus bones
- Minimally invasive technique used when possible to protect nearby structures
- The ulnar nerve may be repositioned if it is irritated
- Outpatient procedure — patients go home the same day
Experiencing elbow pain that is affecting your throwing? An early evaluation can clarify whether your UCL is partially or fully torn and guide the best path forward.
Request an AppointmentTennis Elbow (Lateral Epicondylitis)
Tennis elbow is one of the most common overuse injuries of the arm — and despite the name, most people who get it have never picked up a racket. It is caused by repetitive gripping and wrist extension that overloads the tendons on the outer side of the elbow. The result is microscopic tendon damage and chronic pain that can make everyday tasks like lifting a coffee cup, shaking hands, or using a computer mouse surprisingly difficult.
How It Happens
- Repetitive gripping, lifting, or wrist extension at work or during sport
- Poor backhand technique in tennis or racket sports
- Occupations involving repeated forearm use: carpentry, plumbing, painting, typing
- Sudden increase in activity level without gradual build-up
- Most common between ages 30–50
Signs & Symptoms
- Pain and tenderness on the outer (lateral) side of the elbow
- Pain that worsens with gripping, lifting, or extending the wrist
- Weak grip strength — difficulty holding objects
- Pain that radiates down the forearm toward the wrist
- Morning stiffness that loosens up with activity
Tennis elbow is not truly an inflammatory condition — it is a degenerative tendon problem (tendinosis). This is why anti-inflammatory medications alone often provide only temporary relief. The most effective long-term treatments target tendon healing and load management.
Treatment Options
Non-Surgical (First-Line Treatment)
- Activity modification — reducing the repetitive motions that caused irritation
- Physical therapy focused on eccentric strengthening of the wrist extensors
- Counterforce brace (tennis elbow strap) to offload the tendon
- Corticosteroid injection for short-term pain relief
- PRP injection — strong evidence for improving tendon healing in chronic cases
- Most patients improve in 6–12 months with conservative care
Surgery (Refractory Cases)
- Reserved for patients who fail 6–12 months of conservative treatment
- Arthroscopic or open debridement removes the diseased tendon tissue
- Healthy tendon is preserved and any bone spurs are addressed
- Outpatient procedure with a small incision or keyhole approach
- Excellent results: 85–95% patient satisfaction
Golfer's Elbow (Medial Epicondylitis)
Golfer's elbow is the mirror image of tennis elbow — instead of the outer side of the elbow, it affects the tendons on the inner side. These tendons control wrist flexion and forearm pronation (rotating the palm downward). Like tennis elbow, it is an overuse tendon condition seen in golfers, baseball players, rock climbers, construction workers, and anyone who performs repetitive gripping or wrist-curling motions. The good news: the vast majority of cases resolve with proper treatment and activity modification.
How It Happens
- Repetitive wrist flexion and gripping activities
- Golf (particularly improper swing mechanics)
- Baseball or softball pitching and batting
- Rock climbing, weightlifting, racket sports
- Manual labor: hammering, using tools, heavy lifting
Signs & Symptoms
- Pain and tenderness on the inner (medial) side of the elbow
- Pain that worsens with wrist flexion or forearm rotation
- Weak or painful grip
- Numbness or tingling radiating into the ring and pinky fingers (ulnar nerve)
- Stiffness, especially in the morning or after rest
Golfer's elbow can involve the ulnar nerve, which runs along the inner elbow. If you notice numbness or tingling in your fingers, it is important to have this evaluated — nerve involvement can affect recovery planning and, in some cases, requires separate treatment.
Treatment Options
Non-Surgical (Highly Effective)
- Rest from aggravating activities and modification of technique
- Physical therapy: eccentric forearm flexor strengthening
- Wrist/elbow brace during activity
- Corticosteroid or PRP injection
- Over 90% of patients improve without surgery
Surgery (Rare, Last Resort)
- Open or arthroscopic debridement of degenerated tendon tissue
- Ulnar nerve decompression or transposition if nerve is compressed
- Only considered after 6–12 months of failed conservative care
- Outpatient procedure; generally very successful
Elbow Arthroscopy
Elbow arthroscopy is a minimally invasive procedure in which a small camera (arthroscope) is inserted into the elbow joint through tiny incisions. It allows Dr. McLaughlin to see and treat a wide variety of elbow problems without making a large open cut. Because the incisions are so small, patients typically experience less pain, less scarring, and faster recovery compared to traditional open surgery — and most go home the same day.
Common Reasons for Elbow Arthroscopy
- Loose bodies (bone or cartilage fragments floating in the joint)
- Osteochondritis dissecans (OCD) — a cartilage and bone condition in young athletes
- Elbow stiffness or contracture — removing scar tissue to restore motion
- Lateral or medial epicondylitis not responding to conservative treatment
- Synovitis (inflamed joint lining) in rheumatoid or reactive arthritis
- Evaluation of unexplained elbow pain or instability
What to Expect
- Performed as an outpatient procedure
- General or regional anesthesia (nerve block)
- 2–4 small incisions less than 1 cm each
- Arm kept elevated for first 48 hours to reduce swelling
- Physical therapy usually begins within 1–2 weeks
- Most patients return to daily activities within 2–4 weeks
The elbow is one of the more technically demanding joints for arthroscopy because of how close the nerves and blood vessels are to the joint surface. Surgeon experience and volume matter significantly in elbow arthroscopy outcomes — it should be performed by a fellowship-trained sports medicine and shoulder surgeon.
Recovery Overview
Simple Procedures (Loose Body Removal)
- Sling use for comfort: 3–5 days
- Gentle range of motion begins immediately
- Return to light activities: 1–2 weeks
- Return to sport: 4–8 weeks depending on activity
Complex Procedures (Stiffness, OCD)
- Protective splinting: 1–2 weeks
- Formal PT program begins at 2 weeks
- Functional motion restored: 6–12 weeks
- Return to overhead sport: 3–6 months
Ankle & Foot Conditions
Chronic Ankle Instability
Ankle sprains are the most common sports injury — but when the ligaments on the outside of the ankle do not heal properly, the result is an ankle that repeatedly "gives way." Over time this leads to chronic ankle instability, a condition where the joint feels loose, unpredictable, and prone to re-injury. Many athletes describe a constant sense of the ankle rolling outward, especially on uneven surfaces. Left untreated, chronic instability can cause cartilage damage and accelerate arthritis.
How It Happens
- One or more ankle sprains that did not fully heal
- Returning to sport too soon after a sprain
- Incomplete rehabilitation — weak peroneal muscles
- Activities with cutting, pivoting, or jumping: basketball, soccer, football
- High-arched (cavus) foot type increases susceptibility
Signs & Symptoms
- Repeated ankle sprains or "rolling" episodes
- Persistent feeling of looseness or giving way
- Pain, swelling, and tenderness along the outer ankle
- Difficulty walking on uneven ground
- Reduced confidence and performance in sport
Studies show that up to 40% of people who sprain their ankle develop chronic instability. The Broström procedure — a surgical repair of the stretched ligaments — has a 90%+ success rate and allows most athletes to return to full sport within 4–6 months.
Treatment Options
Non-Surgical (Always First)
- Structured physical therapy: peroneal strengthening and proprioception training
- Ankle bracing during sport to prevent re-injury while healing
- Balance and neuromuscular training (balance boards, single-leg exercises)
- Activity modification during the rehabilitation period
- Many patients become symptom-free with dedicated PT
Broström Procedure (Ligament Repair)
- The stretched or torn ATFL and CFL ligaments are tightened and re-attached
- Augmented with local tissue (inferior extensor retinaculum) for added strength
- Ankle arthroscopy is often performed at the same time to address cartilage damage
- Boot or cast for 4–6 weeks, then PT begins
- Return to cutting sport: 4–6 months
Achilles Tendon Tear
The Achilles tendon is the thickest and strongest tendon in the body — connecting the calf muscles to the heel bone and powering every step, jump, and sprint. When it ruptures, most people describe it as feeling like they were kicked or shot in the back of the leg, followed by immediate difficulty walking. Achilles ruptures are serious injuries, but with the right treatment — surgical or non-surgical — the majority of patients return to full activity.
How It Happens
- Sudden explosive push-off: accelerating, jumping, or pivoting
- Most common in "weekend warrior" athletes in their 30s–50s
- Prior Achilles tendinitis weakening the tendon over time
- Certain antibiotics (fluoroquinolones) can weaken tendon tissue
- Sports: basketball, tennis, racquetball, soccer, football
Signs & Symptoms
- A sudden "pop" or snap at the back of the ankle
- Feeling of being kicked or shot in the heel
- Immediate inability to push off the foot or walk normally
- Swelling and bruising at the back of the ankle
- A palpable gap in the tendon above the heel (Thompson test positive)
Both surgical and non-surgical treatments are effective for Achilles ruptures, but research shows surgery offers a lower re-rupture rate (approximately 4% vs. 12% non-surgical) and faster return to sport for competitive athletes. The best choice depends on your age, activity level, and overall health — Dr. McLaughlin will discuss both options thoroughly.
Treatment Options
Non-Surgical (Functional Bracing)
- Best for less active patients, older adults, or those with medical risk factors for surgery
- Early functional bracing protocol — boot with heel lift keeps tendon ends close
- Gradual weight-bearing and range of motion exercises begin early
- Physical therapy is intensive over 6–12 months
- Modern non-surgical protocols have significantly improved outcomes
Achilles Repair (Surgery)
- Torn ends of the tendon are stitched back together through a small incision
- Minimally invasive techniques reduce wound complications
- Boot worn for 6–8 weeks post-operatively
- PT focuses on progressive loading: early calf strengthening is key
- Preferred for active patients and competitive athletes seeking fastest return
Suspect an Achilles rupture? This is a time-sensitive injury — early evaluation leads to better outcomes. Please contact our office promptly.
Request Urgent EvaluationPeroneal Tendon Injuries
The peroneal tendons run along the outer side of the ankle and are responsible for stabilizing the foot and preventing ankle sprains. They can be injured in a variety of ways — torn, inflamed (tendinitis), or dislocated from the groove behind the ankle bone. Peroneal tendon injuries are frequently missed or mistaken for chronic ankle sprains, which is why persistent outer ankle pain after a sprain warrants a careful evaluation.
Types & Causes
- Peroneal tendinitis: overuse inflammation from repetitive activity
- Longitudinal split tear: partial tear running along the tendon length
- Peroneal subluxation/dislocation: tendon pops out of its groove during activity
- High-arched foot places more stress on the peroneal tendons
- Common in runners, dancers, soccer and basketball players
Signs & Symptoms
- Pain, swelling, or tenderness along the outer ankle bone
- Snapping or popping sensation around the ankle during movement
- Ankle instability or giving way
- Pain that worsens with activity and improves with rest
- Weakness when pushing the foot outward or pointing the foot down
MRI is the gold standard for diagnosing peroneal tendon injuries, as the tendons cannot be fully assessed with X-ray alone. Dynamic ultrasound can also show peroneal subluxation in real time. Many peroneal tears are discovered at the time of ankle instability surgery.
Treatment Options
Non-Surgical
- Rest, ice, compression, and elevation for acute injuries
- Immobilization boot for 4–6 weeks for significant tendinitis or small tears
- Physical therapy: peroneal and ankle strengthening exercises
- Custom orthotics to correct foot alignment and offload the tendons
- Corticosteroid injections generally avoided (can weaken tendons)
Surgery (When Non-Surgical Fails)
- Peroneal tendon repair: torn tendon edges are stitched together
- Tenodesis: a badly damaged tendon is secured to the adjacent healthy tendon
- Groove deepening procedure: re-creates the groove for tendons that keep dislocating
- Retinaculum repair: tightens the band that keeps tendons in place
- Boot and PT required post-operatively; return to sport in 4–6 months
Common Foot Injuries in Athletes
The foot is a complex structure of 26 bones, 33 joints, and over 100 tendons and ligaments — and athletes put it under enormous stress. Certain foot injuries are notorious for being underestimated and undertreated, leading to delayed diagnosis and prolonged time out of sport. Below are three of the most important foot injuries in athletes, each of which deserves prompt medical evaluation.
Lisfranc Injury
The Lisfranc joint complex is where the long bones of the midfoot meet the toes. A Lisfranc injury involves a sprain, fracture, or dislocation of this area — and it is one of the most commonly missed injuries in emergency settings. It typically happens when a foot is planted and the body rotates over it, or from direct crushing force.
Symptoms of Lisfranc Injury
- Significant pain and swelling across the top of the midfoot
- Bruising on the bottom of the foot (a classic warning sign)
- Pain that worsens with standing, walking, or pushing off
- Inability to bear weight on the foot
Treatment
- Non-displaced stable sprains: non-weight-bearing boot for 6–8 weeks
- Unstable or displaced injuries require surgical fixation (screws or plates)
- Return to sport: 4–6 months for stable injuries; 6–12 months after surgery
- Missed or undertreated Lisfranc injuries can cause permanent deformity and arthritis
Bruising on the bottom (sole) of the foot after a foot injury is a red flag for Lisfranc injury and should prompt urgent imaging. This injury is often initially read as a simple sprain — if you have foot pain that is not improving after a sprain, request an MRI or weight-bearing X-rays.
Jones Fracture
A Jones fracture is a break at the base of the 5th metatarsal — the small bone on the outer side of the foot. It is notorious for its poor blood supply, which means it heals slowly and has a high rate of not healing (nonunion) if treated incorrectly. It is especially common in high-level athletes and can be career-threatening if mismanaged.
Symptoms of Jones Fracture
- Sudden outer foot pain from a misstep, cutting, or ankle roll
- Tenderness and swelling at the outer midfoot
- Pain with weight-bearing; sometimes a "pop" is felt
- Confirmed by X-ray (important to distinguish from other 5th metatarsal fractures)
Treatment
- Non-athletes: non-weight-bearing cast for 6–8 weeks (high nonunion risk)
- Competitive athletes: surgical fixation with intramedullary screw strongly preferred
- Surgery dramatically reduces time to return to sport (8–12 weeks vs. 3–4 months)
- Bone stimulator or bone grafting if healing is delayed
Turf Toe
Turf toe is a sprain of the main joint of the big toe — the metatarsophalangeal (MTP) joint. Despite sounding minor, it can be a significant injury in athletes. It happens when the toe is forcefully bent upward, stretching or tearing the plantar plate and surrounding soft tissue. It is common on artificial turf (hence the name) and in football linemen, soccer players, and gymnasts.
Symptoms of Turf Toe
- Pain, stiffness, and swelling at the base of the big toe
- Pain that worsens when pushing off (running, jumping)
- Bruising and limited range of motion at the big toe joint
- Graded 1–3 depending on severity of ligament damage
Treatment
- Grade 1–2 (mild-moderate): RICE, rigid-soled shoe, buddy taping; return to sport in days to weeks
- Grade 3 (complete tear): non-weight-bearing boot 2–4 weeks; PT for 4–8 weeks
- Surgery is rarely needed but may be required for sesamoid fractures or complete plantar plate tears
- Undertreated turf toe can lead to hallux rigidus (big toe arthritis)
Foot and ankle injuries in athletes deserve an expert eye — the difference between a sprain and a Lisfranc injury can determine whether you're out for 2 weeks or 6 months.
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