Here’s an interesting study on the incidence of ulnar collateral ligament (UCL) injuries in professional football quarterbacks.  With only ten reported cases between 1994 and 2008, it’s obviously (and not surprisingly) much lower than the rates we see in professional baseball players.  This is right in line with what I discussed in Weighted Baseballs: Safe and Effective or Stupid and Dangerous?

However, what is very interesting to me is that 9/10 cases were treated non-operatively; in other words, Tommy John surgery is much less prescribed in football quarterbacks than baseball pitchers – meaning that the quarterbacks respond better to conservative treatment.

What’s up with that?  They are the same injuries – and presumably the same rehabilitation programs.

In my eyes, it’s due to the sheer nature of the stress we see in a baseball pitch in comparison to a football throw.  As a quarterback, you can probably “get by” with a slightly insufficient UCL if you have adequate muscular strength, flexibility, and tissue quality.  While this is still the case in some baseball pitchers, the stresses on the passive structure (UCL) are still markedly higher on each throw, meaning that your chances of getting by conservatively are probably slightly poorer.

I’m sure that the nature of the sporting year plays into this as well.  Football quarterbacks never attempt to throw year-round, so there isn’t a rush to return to throwing.  There are, however, a lot of stupid baseball pitchers who think that they can pitch year-round, so kids often “jump the gun” on their throwing programs and make things worse before they can heal completely.

That said, we’ve still worked with a lot of pitchers who have been able to come back and throw completely pain-free after being diagnosed with a partial UCL tear and undergoing conservative treatment (physical therapy).  It’s an individual thing.

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