Pain on the inside of the elbow when you throw, lost velocity, or an elbow that no longer feels trustworthy can point to an injury of the ulnar collateral ligament (UCL). At Ortho Las Vegas, UCL injuries are treated by William R. McGee, DO, known as Dr. Roddy McGee. He is a board-certified orthopedic surgeon with fellowship training in sports medicine, and he played baseball as a pitcher and outfielder in college.

We do not lead with surgery. Many UCL problems start with a clear diagnosis, rehab, and sometimes orthobiologics. When the ligament is fully torn, or conservative care has not worked, Dr. McGee offers UCL reconstruction, often called Tommy John surgery.

Who this care is for

UCL injuries are most often seen in overhead and throwing athletes. That includes baseball and softball players, quarterbacks, javelin throwers, and tennis players. This page is for high school, college, and adult throwers, and for recreational athletes whose elbow pain started with throwing, serving, or swinging.

Throwing athletes often have more than one problem at once. That can include flexor-pronator strain, valgus extension overload, olecranon stress fractures, ulnar nerve irritation, or golfer’s elbow. Part of the evaluation is figuring out which of these is actually driving your symptoms. See throwing injuries of the elbow for the full list.

What the UCL does and how it gets hurt

The UCL is a ligament on the inside (medial side) of the elbow. It connects the upper arm bone to the ulna, one of the forearm bones, and helps hold the elbow stable against the stress of throwing. Repeated throwing can stretch the ligament and cause small tears over time. Sometimes it tears all at once during a single throw.

Injuries range from partial sprains and microtears to full-thickness tears. That range matters, because partial injuries and complete tears are often treated differently. See elbow ligament injuries and elbow instability for related conditions.

Warning signs

• Pain or tightness on the inside of the elbow after throwing or overhead movements
• Lower throwing velocity or worse control
• A pop, snap, or catch while throwing
• The elbow feeling like it gives out under load
• Numbness or tingling in the ring and pinky fingers, which can mean ulnar nerve involvement
• Pain with elbow extension or follow-through, or loss of grip strength

If you have changed your mechanics or started avoiding throwing to protect the elbow, get it evaluated.

How we diagnose a UCL injury

UCL injuries can be missed or misdiagnosed, so the evaluation is thorough. It can include:

• A full history of your sport, position, workload, and goals
• A functional orthopedic exam, with stress testing of the ligament
• A biomechanical movement evaluation and strength and stability testing
• Musculoskeletal ultrasound and/or high-resolution MRI

The goal is to find out whether the problem is the ligament, a tendon, a nerve, or bone, and whether a ligament injury is partial or complete. Treatment is built from there.

Treatment options, from rehab to reconstruction

Bracing and rehab

For early injuries, bracing and a progressive loading program can stabilize and strengthen the elbow without surgery. Return-to-sport plans include strength work, correcting mechanics, and individual milestones.

Orthobiologics

For partial ligament sprains and chronic overuse, PRP (platelet-rich plasma) injections are done in the office under ultrasound guidance. For partial tears or more significant ligament damage, bone marrow concentrate (BMAC) is another option. Orthobiologics may help some partial tears. They will not reattach a completely torn ligament. Most insurers do not cover PRP or BMAC, and costs are discussed up front.

Percutaneous tenotomy (Tenex)

For chronic medial elbow pain from damaged tendon tissue, a minimally invasive, ultrasound-guided tenotomy can remove the damaged tissue and support tendon healing.

UCL reconstruction (Tommy John surgery)

Surgery may be the next step for full-thickness tears, severe instability, or injuries that have not improved with conservative treatment. It can also be the right choice for athletes whose sport demands full ligament stability. Dr. McGee performs UCL reconstruction for overhead athletes, including primary reconstruction, revision, and augmentation. When appropriate, he adds PRP or BMAC during surgery to support healing. The practice describes elbow ligament surgery as outpatient.

In general terms, UCL reconstruction replaces the damaged ligament with a tendon graft. The graft is passed through small tunnels in the bones on either side of the inner elbow to recreate the ligament. Dr. McGee will explain which technique fits your injury and your goals.

What recovery looks like, in broad terms

Recovery from UCL reconstruction is gradual and takes a lot of commitment. In general, it moves through phases. First comes protecting the repair and recovering motion. Next is building strength in the forearm, shoulder, and core. Then comes a structured throwing program, and finally a return to competition.

Return to full throwing is usually measured in many months, not weeks. Timelines vary with the athlete, the sport, the position, and the injury. Progress is based on how the arm functions at each stage, not on a date on the calendar. The practice provides rehab benchmarks, work on throwing mechanics, and guidance on preventing reinjury.

Young throwers

Elbow pain in young baseball and softball players is not always a UCL problem. In a growing athlete, pain on the inside of the elbow can come from growth plate stress, known as Little League elbow. If a young player has elbow pain with throwing, loses velocity, or hesitates to throw, get it checked early.

What makes this practice different

Dr. McGee completed a one-year sports medicine fellowship with Dr. Lawrence Lemak at the American Sports Medicine Institute in Birmingham, Alabama. Before medical school, he earned a degree in exercise physiology at the University of Utah, where he pitched and played outfield for the baseball team. He knows throwing from the mound as well as from the exam room.

Dr. McGee is the team physician for the College of Southern Nevada and Bishop Gorman High School athletic programs. He also works with the Justin Boots Sports Medicine team, which provides care for Professional Rodeo Cowboys, Professional Bull Riders, and the National Finals Rodeo. He is an adjunct professor at Touro University Nevada and a reviewer for the American Journal of Sports Medicine.

He handles both the biologic and the surgical sides of throwing-elbow care, so the person weighing PRP or BMAC against reconstruction is the same surgeon who can perform either. The first visit is for history, exam, imaging when needed, and a plan.

When to come in

Come in if elbow pain is affecting your velocity, accuracy, or ability to finish a throw. Come in if the pain has lasted more than a few weeks despite rest, or if you felt a pop followed by pain and weakness. It also makes sense to come in for a second opinion after being told surgery is your only option, or when rest and therapy have not solved the problem.

Numbness or tingling in the ring and pinky fingers should also be checked, because it can point to ulnar nerve irritation.

What a visit looks like

Call (702) 485-5885 or request an appointment online. Bring a photo ID, insurance information, any X-rays or MRIs you already have, and a list of your medications. Bring a referral if your insurance plan requires one. If you have details on your throwing workload, such as innings, pitch counts, or recent changes, bring those too.

The first visit covers your history, sport, and goals, plus a hands-on exam of the elbow and shoulder. X-ray and ultrasound are used when they help, and MRI is ordered when it will change the plan. You leave with a clear diagnosis and your options in plain language, including what each one can and cannot do.

Your care team

Dr. McGee leads sports medicine at Ortho Las Vegas. He treats shoulder, elbow, knee, and ankle injuries, both surgically and with orthobiologics. For the bigger picture, see sports medicine, the elbow overview, and throwing injuries of the shoulder.

Samantha Laub, PA-C, has worked with Dr. McGee since 2020 and has expertise in sports medicine orthopedics. She sees new patients, performs joint injections, and helps patients through recovery with education. Jake Bendicion, PA-C, is also part of the care team.

Location and hours

Ortho Las Vegas is at 6190 S Fort Apache Rd, Las Vegas, NV 89148, in Southwest Las Vegas. Our Fort Apache office is near Southern Hills Hospital and easy to reach from Spring Valley, Summerlin, Mountain’s Edge, and the 215 Beltway.

Phone: (702) 485-5885
Hours: Monday through Thursday, 8 a.m. to 5 p.m. Friday, 8 a.m. to 2 p.m.

Frequently asked questions

What is Tommy John surgery?

Tommy John surgery is the common name for UCL reconstruction. The damaged ulnar collateral ligament on the inside of the elbow is replaced with a tendon graft to restore stability for throwing. At Ortho Las Vegas it is performed by Dr. Roddy McGee, a sports medicine fellowship-trained orthopedic surgeon.

Do I need surgery for a UCL tear?

Not always. Partial or recent tears may respond to rehab, bracing, and in some cases PRP or BMAC. Complete tears, severe instability, or injuries that do not improve with conservative care may need reconstruction. Every case is evaluated individually.

Is Tommy John surgery only for pitchers?

No. Some UCL injuries can be treated without surgery. But other sports and activities also demand maximum stability from this ligament, and for some of those athletes, surgery is how they get back to that level.

Can PRP or BMAC heal a torn UCL?

For some partial tears, orthobiologics may support healing. They will not reattach a completely torn ligament. When surgery is needed, Dr. McGee may use PRP or BMAC to support healing around the reconstruction.

How long is recovery after UCL reconstruction?

Recovery is gradual and usually takes many months. It moves from protection and motion, to strength, to a structured throwing program, to competition. Your timeline depends on your sport, your position, and how your arm responds. Return to play is based on function, not a set date.

Will insurance cover Tommy John surgery?

Surgery is often covered, depending on your plan. PRP and BMAC usually are not. The practice reviews costs with you before you decide.

How do I make an appointment?

Call (702) 485-5885 during office hours or request an appointment online. The office is at 6190 S Fort Apache Rd, Las Vegas, NV 89148. Hours are Monday through Thursday, 8 a.m. to 5 p.m., and Friday, 8 a.m. to 2 p.m.