UCL INJURY: The Non-Surgical Road Back

A frayed ligament doesn’t have to end a pitching career. We share a raw, real case study of a high school senior with a partial UCL tear who skipped injections, rebuilt his foundation, and came back throwing harder—with less pain. The story isn’t about a miracle drill; it’s about finally honoring how the shoulder blade and arm are supposed to move together and how that single truth can protect an elbow under stress.

We start with an unexpected pivot: free throws. Hundreds of smooth shots helped restore full elbow extension, improve blood flow, and calm the brain’s protective reflex that turns a recovering arm into a guarded “lobster claw.” From there, we zoom in on scapular humeral rhythm—the backbone of safe, powerful overhead motion. When the upper trap dominates and the shoulder shrugs, the body loses clean deceleration, the ball leaves the glove too early, and the arm is forced to “throw uphill,” pushing unnecessary load straight to the UCL.

Through side-by-side video and clear cues, we walk through how delaying hand break until foot strike, training scapular depression and retraction, and focusing on downhill acceleration transformed mechanics without chasing gimmicks. You’ll hear the simple tests that exposed the root cause, how deceleration capacity sets the ceiling for safe velocity, and why “build proximal to distal” is more than a slogan—it’s the roadmap to durable performance. The proof is in the outcomes: a safer arm path, better finish, cleaner layback, and a mound return with more velocity than before the injury.

If you coach pitchers, parent a throwing athlete, or want to bulletproof your own elbow, this deep dive will sharpen your eye and your plan. Subscribe, share with a teammate who needs it, and leave a review with the worst cue you’ve ever heard—we might break it down on a future show.

Transcript

Case Study Setup And Stakes

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Hey everybody, this is Dr. Kevin McGovern. It is time for another episode of the Velocity RX podcast. We had a great show today, but first, before we do anything, please like and subscribe my YouTube channel. This episode is going to be very important. Um, it's a case study of a real live human being, uh uh, a student of Velocity Rx, and there's going to be a lot of visuals, so you're going to want to watch this uh in addition to listening to it on the YouTube channel. So, without further ado, let's get moving. So, um, we'll change names to protect the innocent. We'll we'll call this um student Russ. So, Russ is a going to be a high school senior. His dad contacted me because Russ had a partial tear of his ulnar collateral ligament. And he was going to one of these velocity centers, which allegedly does movement testing. Um, and all I will say about that is that I go over bridges every day, um, but I can't tell you the quality of the structure of the bridge because I am not a civil engineer or structural engineer at all, or a foreman, or could and know anything about construction. So there are a lot of people out there talking about human movement that um really are unqualified to do so. And I'll just leave it there because one of the very first um things that we tested for showed the root cause of why he has a um ligament injury or the root cause, and it it's in his basic human movement that allegedly was tested, and what happened was is they added on to a bad base, and it's one of the main causes of his injury. So I'm gonna share my screen here and let's get uh moving. So the title of this is UCL injury the non-surgical road back. So I began seeing Russ, his dad was gonna do PRP injections, which are all fine and dandy, but um I told him to hold off and let let's see where um what happened. So I'll get to the end, and then you can so he's now back in the mound, throwing harder than he was faster with uh than he was before he was injured. So that's the end result. So how did we get there? What did what did we do? So first I want to talk about um his injury. So when we look at something that is partially torn, right? It's kind of like uh, you know, you got that tire swing over the over the uh river or the quarry that's got a lot of fraying to it, right? So it's not the same rope that we bought at the hardware store at the beginning of the summer, and any minute that could go, or it's not gonna be able to hold as much weight, right? We can't send the fat kid that way, right? So ligament's the same way, right? So when we have fraying in the ligament, it's not as optimal length, so it's certainly not stabilizing the joint, and at any minute, it could go right now. It's eventually going to scar over and it'll heal to that degree, but you know, you've got to do a lot of uh quality movement. So the first thing that we did um before I did any testing is we switched to another sport, okay. We switched to basketball. There is no better elbow helping improving sport than shooting a basketball, and we were shooting at least a hundred a day free throws, right? That promotes full extension. Um, because the brain is gonna have you know little what I call cookies, like internet cookies in there, it's gonna remember when that arm got hurt, right? So it's gonna be apprehensive. And sometimes when people are coming back from elbow surgery, they have what I call the lobster claw, right? Kind of they don't fully extend their elbow because their the body is doing it to protect them. So a lot of free throws. What that does is that helps um when the ligaments repairing or scarring over, we're getting good range of motion, good blood flow to the area. It's helping repair that ligament in a nice clean way that we want. So that's kind of our frayed rope ligament. So now we look at the first test we did. This is sort of a fair um presentation here. So you hear me in all my social media, you'll hear me talk about the scapular humor rhythm. Scapular humor rhythm. And you can look up YouTube, you can search for that. There are a lot of good videos out there that talk about it. But basically, the scapular humeral rhythm is for every three degrees that my arm goes up, abducts, out, lifts. The shoulder blade needs to turn into the spine and depress. That means it's using middle trap, rhomboid, lower trap, serratus to turn that shoulder blade in. We don't want to engage our upper trap because the upper trap is going to do just the opposite of the scapular humor rhythm. It's going to elevate the shoulder blades, it's going to shrug, it's going to cause impingement, it's going to cause the arm to be late. So you'll hear me talk in my Tommy John injury formula. Drift, shrug, and drag. Well, the shrug is the upper trap engagement, right? The T, the inverted W, early abduction of both arms, right? Taking the ball to glove too early. What that does is that fires up your upper trap, which makes the shoulder blade move in the opposite direction that we want to. That's the root cause, right? It's a scapular humor rhythm. So you're gonna see here, right? So um this is the actual kid. So you're gonna see asymmetry here in his shoulder blades to begin with. So this is my scapular or shoulder coordination test, right? I'm looking for the shoulder blade to turn in. So as we move this along slowly, right? Let's see if that go back to the slide there. I don't want that slide. We want the next slide. Okay, so we want the as he goes to move here, right? You're gonna see as this plays in the background, his first move is gonna be to shrug, right? There it is, right? There's the upper trap, and you see how the shoulder blades get, especially now on the way down. So we can only go this this test shows a tremendous amount of issues, okay. Number one, the body can only accelerate as fast as it can decelerate, right? So most pitching is deceleratory, right? The body's trying to slow itself down so the arm doesn't come out of its socket and hit the guy in the front row. So when we fire muscles on the way up that are the wrong muscles, right? So the upper trap is the wrong muscle to fire in this case, it's the middle and lower trap. So the upper trap has deceleratory um characteristics, but that's for your head, that's for a whiplash. So you'll see, right? What he what we did here is that when we play this, you'll see on the way down his his scapula come off his back, right? All right, they just because the wrong muscles are being they weren't turned on to begin with, right? They were dormant, or they're you know, the upper trap took over. I call it a bully. So on the way down, you'll see his shoulder blades come off of his back, right? In a in a because the the deceleration should be for whiplash, not for throwing baseballs. So this is the first test I did, and here's a kid who is uh allegedly, not allegedly, he did work out at this facility doing all kinds of arm care stuff, and the first test, the first test that we did, the basic test, he doesn't have proper scapula humor or rhythm. So it's if we're looking at movement being math, we just did addition and subtraction, and it's wrong. So division is going to be wrong, multiplication is gonna be wrong, calculus is gonna be wrong, and so forth and so on, because the upper trap is doing the work of what should be done by the middle and lower trap. Okay, and there's a lot of reasons for this, right? The upper traps are an over you can see here. Look at look at this now. Watch this on the way down. What happens? But look at the shoulder blades. He can't he can't even control his arms on the way down, right? They just essentially fall, and because again, the wrong muscles are being used. So the upper traps are a postural muscle, they're on all day long, holding your head up. So the body is going to use the most available tool sometimes, not necessarily the correct tool. And then, of course, we've got taking the ball out of the too early, so on and so forth, leads us to now a shoulder blade at its base, at its basic function, is not working. So we can't throw balls overhead at full tilt, right? At max effort with a shoulder blade complex that's not that's not working correctly. No wonder he hurt his elbow. I don't even have to look at his mechanics to know that if I saw this in any picture, that this has to be fixed, or he's going to get injured. It's not a matter of if, it's when. So now moving to the next slide, right? We're gonna see um throwing, right? And again, we talk about let's okay, there's the ball out of the oh, again, we go back to oh, it does that. It advances too early on me. Let's uh go back to that slide again. So we're gonna pause this and get it again. There we go. Okay. So let's hit play. And we're gonna pause this where he is literally throwing. So let's talk about this. Okay, there comes the ball out of the glove, too early. Again, this is the other way. It's really not cooperating with me. So and I'm gonna stop him when I'm gonna see him literally. What this all leads to is essentially throwing up hill. So you'll see now the shoulder the elbows now are abducted away, and there's there's our inverted W, right? Early abduction. You'll see the wrinkling of his shirt, right? So right now the upper traps are on, right? And they should be off. The arms should be what I teach the ball should not be out of the glove at this point, okay. We are taking the ball out way too early, okay, disrupting the scapula humoral rhythm and causing injury. Okay, so the ball doesn't have to be out until front foot strike, right? So now when we get the front foot strike, because it's already out, right? And we'll stop it once we get there, you're going to see that he is so now there we go. There's front foot strike. Okay, we're dragging the back foot. We got layback, but okay, so the layback, it's a little excessive, but he has to accelerate from there because he has got the body's got to turn on the proper deceleratory muscles, right? So it's got to start the arm early to reverse this movement pattern that he started off this bat. He's got to get back on the proper scapular humor rhythm. So he has to accelerate the ball from where uphill. You'll see and you'll see the blur of the arm that he's doing it against gravity. There's no way he can essentially throw downhill here because he has started off incorrectly. Okay, so that is essentially the mechanical reason why he got hurt. Okay. So now we what we want, and even here, he's still this is uh you know, midway through he's working on my three-tap drill, right? And I can tell you that my comments were keep the ball in your glove. Okay, but what he does here at the end, he he has worked so much on scapular depression that you still you saw him accelerate the ball, right? From that spot, right? So he accelerated the ball downhill, even though he took it out too early. So the system works and you can not be exact and still be good, right? So he comes, he comes out a little early in front foot strike. Right, so he gets there, he drifts a little a touch, but he's doing so much more right here than he was in that last one. Right? So his arm is in a much, much better position than it was in the last video. And then as we continue, you'll see right there, he accelerated the ball just past noon, right? And the arm and leg, the you'll see the leg came off the rubber, the arm and leg are in a linear line, okay, still a little bit uphill, but significantly better than what it was. And now he's even significantly better than that. But it all started from a proper, you know, the root cause of this all started from disruption of the basic kinesiological function of the scapula and humerus, the scapular humor rhythm. And when you start it off bad, the body still has to decelerate itself, it still needs to get to the right position, and it does that by cheating. So it's gonna speed something up, it's gonna slow something down. Something's gonna happen that the body's got to get back to its position. So in pitching, it's gonna the ball's gonna come out early and we're gonna accelerate early because we can't wait to accelerate downhill because the body's like, oh my god, there's no way I can continue on this path because the arm's gonna come out of its socket. I don't have the proper muscles on, okay, and that's basically it. So when you're talking about fixing mechanics, you have to start with fixing functional movement first. Okay, so even here, right? So if we pause this, let's right. So even here, just watch his shirt, like his arms are abducted away, but because we have done so much work on the scapula depressors, there was no change in shirt, no, no shrug there, like there was in the in his first pitching video, right? And then, you know, much better position there than the last one, right? It's not even close, okay. And now that is the reason why, and of course, the leg comes with great finish, back foot finishing ahead of the front foot. That is why he is throwing now with greater velocity and less elbow pain. So, you know, here's a thing of it's a little cut off here, but you have to move proximal to distal, meaning we have to work on the movement around the spine. Okay, here's another in fast motion again in the same position that Russ was in, right? Same exact thing. This is Tyler Rule, who's going uh division one, two two-way athlete. Same thing, arm issue, fix that throwing much harder than he was, throwing downhill. Why? Because we fixed his fundamental movement first, making him a better moving human being, and thus a safer pitcher on the mound. So that's how we got a um a person who has an ulnar collateral ligament disruption back on the mound, throwing with greater velocity and no pain. Okay, but you know, I look at an athlete or or athletic movement being in the penthouse of a building, right? An athlete's like a building, right? And everyone wants to be in a penthouse, it's nice up there. We got a hot tub, we have an open bar, but if you don't correct the basic fundamental movement, which I call the parking garage, that building is coming down. Not if when. It's never a matter of if, okay. Only Vegas luck, if it's an if he's going the player is going to get hurt. It's not just baseball, it's any, it's any sport, but baseball, especially overhand throwing, is so specific, and there's such basic movement principles of the shoulder that are teaches take the ball out, point at the center field, right? You're literally destroying arms because you're you're violating the most basic principle of the shoulder and you know, shoulder blade, and it's complex. You are killing arms, okay, because you're making them move neurologically incorrect. So that's how we got a UCL back to throwing without pain and greater velocity. For more information or to work with me directly, please visit velocityrx.org. Help me save one million arms, starting with yours. Um, I hope you enjoyed this. Like and subscribe. I'll see you soon. Thanks for listening.