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Ulnar collateral ligament (UCL) injuries are most commonly reported in baseball players (particularly in pitchers) but have also been observed in other overhead athletes including javelin, softball, tennis, volleyball, water polo, and gymnastics. Partial injuries have been successfully treated with appropriate nonoperative measures but complete tears and chronic injuries have shown less benefit from conservative measures. In these cases, surgical reconstruction has become the treatment modality for overhead athlete who wishes to continue to play. This article discusses the functional anatomy and biomechanics of the UCL as related to the pathophysiology of overhead throwing, as well as the important clinical methods needed to make accurate and timely diagnosis. It also gives an updated review of the current clinical outcomes and complications of surgical reconstruction.

The throwing athlete represents a very interesting and challenging patient population to treat. Few other athletes require the unique combination of stability combined with inherent laxity to allow them to achieve peak performance. Treatment of them and their injuries necessitates an understanding of this phenomenon, recognition of common pathologies encountered, and experience in the process. In this section, we will review several of the most common entities that we encounter in the care of throwing athletes and the current literature on these topics as well as describing our approach to the decision-making process with regards to their treatment. We will also review our surgical techniques for each of these when nonoperative care has failed or acute intervention is deemed necessary.

SummaryThe rehabilitation program following an elbow injury or elbow surgery plays a vital role in ultimate outcome. The unique orientation of the elbow complex, high degree of joint congruence, and capsular configuration contribute to much of the difficulty experienced by the therapist in treating

SummaryRotator cuff injuries in the overhead athlete are frequently seen at all levels of competitive sports. The repetitive, high magnitude forces generated at the capsuloligamentous complex, as well as at the rotator cuff itself, can result in loss of glenohumeral stability and primary as well as