PRP Injections for UCL Injuries: What Does the Research Actually Say?
- undefeatedptandper
- Aug 23
- 7 min read
PRP for Baseball Players, Throwing Athletes & UCL Injuries in Pittsburgh
By Dr. Carmen Jansante, PT, DPT, CSCS
Undefeated Physical Therapy and Performance | Greater Pittsburgh, PA
If you are a baseball player, parent, coach, or athlete in the Pittsburgh area dealing with a UCL injury, there is a good chance PRP has come up in the conversation.
I hear it all the time:
“He has a partial UCL tear. Should we get PRP?”
PRP has become increasingly popular in sports medicine, particularly for throwing athletes. And I understand why.
The concept sounds great.
Take something from your own body, concentrate the components that may help with healing, inject it into the injured tissue, and hopefully help the ligament recover without surgery.
But there is one question I think needs to be asked more often:
What does the research actually show?
At Undefeated Physical Therapy and Performance in the Greater Pittsburgh area, we work with a lot of baseball players and throwing athletes recovering from elbow and shoulder injuries. I am not against PRP. I think it can have a role in certain situations.
But I also think athletes and parents deserve to understand exactly what we know—and what we don’t know—before making a decision.
What Is a PRP Injection?
PRP stands for platelet-rich plasma.
The process starts with your own blood.
A small amount of blood is drawn and placed into a centrifuge, which separates the blood into different components. The goal is to isolate and concentrate the portion containing a higher concentration of platelets.
That platelet-rich plasma is then injected into or around the injured tissue, often with ultrasound guidance.
The theory is that platelets contain growth factors and other signaling proteins that may influence the biological environment around an injury.
Research has shown that PRP can influence cellular activity, inflammation, collagen production and tissue remodeling.
That sounds promising.
And biologically, it is.
But there is an important distinction:
A treatment can have a biological effect without producing a meaningful improvement in an athlete’s long-term outcome.
That is where the PRP conversation gets complicated.
Does PRP Actually Heal a Torn Ligament?
This is probably the most important question.
The short answer is:
We don’t have strong enough clinical evidence to say that PRP reliably makes a torn ligament heal faster or stronger.
There is evidence from laboratory and animal research that PRP can increase cellular activity and influence collagen production and tissue remodeling.
But human research is much less convincing when we look at meaningful outcomes such as:
Pain
Strength
Function
Stability
Return to sport
Return to throwing
Long-term reinjury rates
This distinction is especially important when we’re talking about a baseball player’s UCL.
Does PRP Reduce Pain?
Possibly—especially in the short term.
Some research has demonstrated improvements in pain following PRP treatment.
However, when researchers look at longer-term outcomes, the advantage becomes much less clear.
For example, systematic reviews examining PRP after ACL reconstruction have found some short-term improvements, particularly with pain, but those benefits have not consistently translated into meaningful long-term improvements in function or stability.
That is important because an athlete feeling better does not necessarily mean the ligament is stronger.
Pain and tissue capacity are not the same thing.
A baseball player may feel better before the injured ligament is ready to handle the forces of throwing.
That is one of the reasons I don’t want athletes using pain alone to determine when they are ready to return to throwing.
Does PRP Make a UCL More Stable?
The research here is mixed.
There are studies showing encouraging findings after PRP treatment for partial UCL injuries, including improvements in clinical outcomes and stability.
One commonly cited study by Podesta et al. followed athletes with partial UCL tears who received PRP along with rehabilitation.
The results were encouraging, with 30 of 34 athletes returning to their previous level of play.
That is a great result.
But there is an important limitation:
It was not a randomized controlled trial.
There was no comparable group receiving rehabilitation without PRP.
So we cannot say with confidence that PRP itself caused the improvement.
The athletes also underwent rehabilitation.
And that matters.
Does PRP Make a Ligament Heal Faster?
This is where I think we need to be the most careful.
The evidence is weakest here.
There is not convincing clinical evidence that PRP reliably produces a faster or stronger-healing ligament in throwing athletes.
We can demonstrate biological changes.
We can find promising case series.
We can find athletes who returned to sport after PRP.
But that is different from proving:
“PRP makes this UCL heal faster than it would have with appropriate rehabilitation alone.”
We simply don’t have strong enough evidence to make that claim.
What About a Partial UCL Tear in a Baseball Player?
This is where the conversation gets very important.
Not every UCL tear is the same.
The location, size, severity and pattern of the tear matter.
So does the athlete’s age, level of play, throwing demands, symptoms, strength, mechanics and previous injury history.
Some partial UCL injuries can respond well to nonoperative management.
A recent review on nonoperative management of UCL injuries emphasizes rest, progressive strengthening of the shoulder and forearm musculature, and a systematic return-to-throwing program. (PubMed Central (PMC))
That is why I don’t think the conversation should simply be:
“PRP or surgery?”
There is a lot in between.
PRP Should Not Replace Rehabilitation
This is probably the biggest point I want parents and athletes to understand.
Even if you choose PRP, you still have to rehab.
PRP does not strengthen your rotator cuff.
It does not improve scapular control.
It does not improve hip mobility.
It does not strengthen your forearm.
It does not improve your throwing mechanics.
And it does not prepare your body to handle the forces involved in throwing a baseball at high velocity.
That still requires rehabilitation.
For a UCL injury, that may include progressively strengthening the wrist and forearm musculature, shoulder and scapular stabilizers, trunk and lower body, while gradually restoring the athlete’s ability to tolerate throwing.
Research on nonoperative UCL management specifically emphasizes the importance of progressive strengthening and a structured return-to-throwing program. (PubMed Central (PMC))
This Is Where I Think Rehab Becomes Extremely Important
Whether an athlete has PRP, surgery, or neither, the tissue around the injury has to become capable of handling the demands of the sport again.
If we’re dealing with a UCL injury, I want the muscles that help protect that elbow to be strong.
That includes the forearm flexors and extensors, but it doesn’t stop there.
We also need to look at:
Shoulder strength
Rotator cuff function
Scapular control
Trunk strength
Hip mobility
Lower-body strength
Single-leg stability
Throwing mechanics
Workload
Throwing volume
Velocity
Recovery between throwing sessions
The goal isn’t simply:
“Does your elbow feel better?”
The goal is:
“Can your entire body handle the demands you’re asking it to handle?”
What If PRP Doesn’t Work?
This is another conversation I think needs to happen before an athlete gets the injection.
If an athlete has a significant UCL tear and ultimately needs surgery, PRP may not prevent that.
And if PRP delays the decision to pursue a procedure that was already indicated, the athlete may simply spend additional months going through a rehabilitation process before eventually having surgery.
That doesn’t mean PRP is bad.
It means we need to have realistic expectations.
PRP should be viewed as one potential tool—not a guarantee and not a replacement for a well-designed rehabilitation program.
And if a young athlete has a UCL tear, I strongly recommend discussing the imaging and injury characteristics with an experienced sports medicine or orthopedic physician.
For higher-grade tears or athletes who continue to have pain and weakness despite appropriate nonsurgical care, surgical options may eventually need to be considered. The decision should be based on the individual athlete—not simply whether PRP worked or didn’t work. (Children’s Hospital of Philadelphia)
My Take on PRP for Baseball Players
I think PRP is an interesting tool.
I think the biological research is promising.
I think some of the clinical results are encouraging.
But I don’t think we should oversell it.
If someone tells you:
“PRP will heal your UCL.”
I’d ask:
“What evidence do we have that it will heal this specific tear faster or stronger?”
That’s a very different question.
And right now, we don’t have enough high-quality evidence to confidently tell every baseball player with a UCL tear that PRP will make the ligament heal faster.
That doesn’t mean PRP has no value.
It means we need to be honest about what the research actually says.
The Bigger Picture: PRP + Rehabilitation
If you decide to move forward with PRP, I believe the rehabilitation process is still one of the most important pieces of the puzzle.
The injection may influence the biological environment.
Rehab is what progressively exposes the athlete to the loads they eventually need to tolerate.
That’s where we come in.
At Undefeated Physical Therapy and Performance, we work with baseball players throughout Pittsburgh and the Greater Pittsburgh region who are dealing with UCL injuries, elbow pain, shoulder injuries and other throwing-related injuries.
Our goal isn’t simply to get an athlete out of pain.
We want to build the strength, mobility, stability and workload tolerance necessary to get them back to throwing and eventually back to competing.
Whether you’re recovering from a UCL injury, have recently received PRP, are trying to avoid surgery, or are coming back after a surgical procedure, your rehabilitation should be specific to you and the demands of your sport.
We work with athletes from youth baseball through high school, collegiate and advanced-level players and build rehabilitation and return-to-throw programs around their individual needs.
If you’re looking for baseball physical therapy or UCL rehabilitation in Pittsburgh, Canonsburg, Washington County, or the surrounding Greater Pittsburgh area, we’d love to help.
Contact Undefeated Physical Therapy and Performance
📞 412-627-2131
Dr. Carmen Jansante, PT, DPT, CSCS
Undefeated Physical Therapy and Performance
Greater Pittsburgh, Pennsylvania
Research & References
Podesta L, Crow SA, Volkmer D, Bert T, Yocum LA. Treatment of Partial Ulnar Collateral Ligament Tears in the Elbow With Platelet-Rich Plasma. The American Journal of Sports Medicine. 2013.
Dai WL, et al. Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. Arthroscopy.
Nonoperative Management of Ulnar Collateral Ligament Injuries in the Throwing Athlete: A Framework for Return to Throwing.
This review discusses rest, progressive strengthening and structured return-to-throwing following UCL injury. (PubMed Central (PMC))
PRP and UCL Injuries in Baseball Players. The existing clinical literature includes case series and observational studies reporting encouraging return-to-play outcomes, but the evidence is limited by study design and lack of strong randomized comparisons.
University of Pittsburgh / UPMC Sports Medicine. Pittsburgh-based sports medicine programs recognize PRP as an orthobiologic treatment being studied and used for damaged tissues including tendons and ligaments. (School of Medicine PM&R)
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