Effects of Soft Tissue Mobilization Followed by Blood Flow Restriction on Reducing Elbow Pain and Improving Mobility in Throwing Athletes with Ulnar Collateral Ligament Strain

Abstract

Background: Throwing athletes are at increased risk of medial elbow injury, particularly grade I–II ulnar collateral ligament (UCL) strain, which can impair pain-free range of motion and delay return to sport. Although soft tissue mobilization (STM) is commonly used in conservative management, the incremental benefit of adding blood flow restriction (BFR) to enhance clinical recovery remains unclear. Objective: To determine whether STM followed by BFR provides superior improvements in elbow pain and mobility compared with STM alone in throwing athletes with grade I–II UCL strain. Methods: In this assessor-blinded randomized controlled trial, 42 throwing athletes aged 17–30 years with clinically diagnosed grade I–II UCL strain were randomly allocated to an experimental group (STM + BFR) or control group (STM only) for four weeks (two sessions/week). Pain intensity was measured using the Numeric Pain Rating Scale (NPRS), and elbow flexion and extension were assessed with a universal goniometer. Within- and between-group analyses were conducted using paired and independent t-tests with 95% confidence intervals. Results: Both groups demonstrated significant improvements in pain and range of motion (p < 0.001). The experimental group showed a greater improvement in elbow flexion (mean difference 3.09°, 95% CI 0.84–5.35; p = 0.008; d = 0.54), while no significant between-group differences were observed for NPRS (p = 0.206) or extension deficit (p = 0.506). Conclusion: STM effectively reduces pain and improves mobility in athletes with low-grade UCL strain; the addition of BFR provides a moderate, statistically significant advantage in elbow flexion but not in pain or extension recovery.