An important structure in stabilizing the elbow is the ulnar collateral ligament (UCL). Soccer goalkeepers are most likely to suffer a UCL injury than any other player on the field. An acute UCL injury may occur following a fall or with an external force such as another soccer player resulting in overstretching of the ligament. Repetitive stress placed on the ligament such as the goalie throwing the ball in practices and games can also result in laxity of the ligament with pain and instability. Because of the unique throwing mechanics of the soccer goalie it may be difficult for the youth athlete and should be taught early on in order to prevent injury. It is also important to consider larger muscle groups when training the soccer athlete to throw including the torso and lower body in order to prevent excessive stress on the shoulder girdle.
The soccer athlete may be able to play through a mild UCL sprain however it is important for the athlete to address the symptoms in order to prevent further damage and potential surgery. Following a UCL sprain, the athlete will be prescribed a specific rehab protocol beginning with rest and ice followed by early rehab that consists of light hand and wrist range of motion exercises. Once proper healing has occurred, under the supervision of a physical therapist or athletic trainer, the athlete will begin a specific UE strengthening program avoiding specific motions that may over stress the UCL.
Prevention of UCL injuries in the throwing athlete can be accomplished through EARLY assessment of throwing mechanics and practice of correct technique. In the throwing athlete, the posterior aspect of the shoulder should be targeted when considering preventative strengthening in order to avoid excessive stress on the UCL.