Ligaments of the Elbow

By Jessica Bruno OTR/L

Ligaments of the elbow keep the elbow stable.

Tennis elbow injury illustration.

Ligaments of the Elbow and their Role

The elbow is made up of connective tissue which forms tough elastic bands that connect bone to bone, called ligaments. Ligaments play an important role in joint stabilization throughout our body as the bands are flexible enough to allow movement, but tight enough to keep the joint stable. When ligaments are intact they provide the right equation of joint mobility and stability. They also provide support to muscles that surround joints.

Ligaments of the Elbow

Ligaments of the elbow provide stability to the joint capsule on each side. There is the lateral collateral complex (LCL) which includes the annular ligament, lateral ulnar collateral ligament (LUCL), and the radial collateral ligament (RCL) on the lateral side of the elbow. The medial collateral (MCL) complex includes the ulnar/medial collateral ligament (UCL/MCL) which is composed of an anterior, posterior, and transverse bundle.

Lateral Collateral Complex (LCL)

The annular ligament crosses the radius bone which is a forearm bone that originates at the lateral side of the elbow and ends on the thumb side of the wrist. The annular ligament helps to keep the radius stable during forearm rotation by encircling the radial head forming a protective sling.  The radial head rotates during forearm rotation, and is located at the part of the radius that articulates with the elbow.  The annular ligament helps with stability during this range of motion and keeps the radius in contact with its surrounding bones.

The lateral ulnar collateral ligament (LUCL) plays a vital role in posterior lateral stability of the elbow. It is often thought to be the main stabilizer on the outside of the elbow.  It originates on the lateral epicondyle and attaches onto part of the ulna bone. The ulna bone runs parallel with radius bone in the forearm. This ligament of the elbow can be stretched or torn after an elbow dislocation, which may or may not require surgery depending on the severity of the injury.

The radial collateral ligament (RCL) attaches to the lateral epicondyle and part of the annular ligament. This ligament of the elbow keeps the elbow stable by preventing varus instability.

Medial Collateral Complex (MCL)

This complex is composed of an anterior, posterior, and transverse bundle that originates at the medial epicondyle and joins the ulna to the humerus. The humerus is the upper bone of the arm above the elbow joint. This complex prevents valgus instability. The anterior band is stressed during elbow extension, the posterior band is stressed during elbow flexion, and the transverse band joins the anterior and posterior band.  The anterior band is thought to be most important stabilizer of valgus instability.

The ligaments of the elbow that make up the medial collateral complex are those often injured in baseball players, especially pitchers.  Some of these players undergo a “Tommy John Surgery” or UCL reconstruction surgery.  The injury often occurs in throwers due to the repeated stress on the ligaments during a throwing motion. Injuries can range from different grades of sprains to tears.  Depending on the severity of the injury treatment can include rest, physical or occupational therapy, anti-inflammatory medications, and sometimes surgery with rehabilitation afterwards.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.

Summary

Ligaments of the elbow play a vital role in providing stability to the elbow joint.  If a ligament becomes inured, the mechanics of the elbow can be thrown off.  In severe injuries or long standing chronic injuries, surgical intervention can help regain normal function.  If you think you have an injury to one of the ligaments of the elbow you can make an appointment with an upper extremity specialist.

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By Jessica Bruno OTR/L


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