A year after injuring her left ulnar collateral ligament (UCL) falling on the uneven bars, Hadley doesn’t remember thinking much after she landed – at least beyond asking her coach to hold her uninjured hand.

“At first, it felt like I had dislocated my elbow,” Hadley said. “Like something went out of place. But that was the ligament tearing and taking off a little piece of bone.”

Ultimately, in search of a second opinion on her prognosis and treatment plan, Hadley and her family found their way to Children’s Hospital of Philadelphia (CHOP). 

And less than two months later, Hadley underwent UCL reconstruction at CHOP, cared for by a team of multi-disciplinary orthopedic and sports surgery experts led by Joseph L. Yellin, MD, and Apurva S. Shah, MD, MBA.

Elbow injury

“I was supposed to be catching a high bar but missed and then when I went to like, catch myself, that's kind of when it happened,” Hadley said.

Jennifer, Hadley’s mom, did what she could to gauge the severity of the situation over the phone – not so easy with a 16-year-old as tough as Hadley.

“In true Hadley fashion, she was like, ‘I'm fine, I'm fine,’” Jennifer recalled.

In fact, Jennifer was on her guard – it was only a few years before that Hadley had tried to simply shrug off a fracture, after all.

“I could tell based on the way that she was guarding it that there was something wrong,” Jennifer said.

On the night of the injury, only X-rays were available, meaning Hadley and Jennifer went home from their local hospital with an incomplete diagnosis – and maybe a bit of misplaced hope too.

As Jennifer recalls, they could tell it wasn't a major fracture, but there was still that small fleck of bone.

“It turns out after getting an MRI that it was related to the way the ligament tore,” Jennifer said.

Diagnosis of a torn UCL 

The UCL, which runs across the inner aspect of the elbow joint, is a key structure for stabilizing the elbow joint in certain sports.

UCL injuries are less frequently associated with gymnastics – baseball pitchers suffer them more commonly – so, initial guidance from the first doctor her family saw was that Hadley’s injury should heal on its own.

That meant months of waiting to see if the pain and weakness would eventually subside.

And it also meant that Hadley’s days of competing might be all but over.

None of this sat well with the family.

A friend whose child suffered a similarly uncertain injury offered Jennifer what would turn out to be vital advice.

“They highly recommended that we get a second opinion [from CHOP],” Jennifer said.

CHOP prognosis

Jennifer submitted an online request and within days connected with the orthopedic intake team, setting an appointment with the first CHOP doctor available – Joseph Yellin, MD.

A stroke of luck perhaps because, as it turned out, Dr. Yellin had experience treating similar injuries.

And athletes.

“The night before the appointment, I started to look up his background, and I started sending [Hadley] articles,” Jennifer said. “I'm like, ‘Oh my gosh, he knows gymnasts!’”

From the very first appointment, Dr. Yellin was thorough, compassionate and knowledgeable.

Perhaps most importantly, he was also understanding as, months after the initial injury, Hadley and Jennifer finally saw Hadley’s ruptured UCL on an MRI. 

“He didn't make a decision and just be like, ‘Oh, [the UCL]’s torn, let's do surgery,” recalled Jennifer. “It was, ‘Let's go through this whole pathway.’”

That open approach meant everything to Hadley.

“Even knowing that I may not be able to go back [to competitive gymnastics] if we didn't get surgery, [Dr. Yellin] still didn't push it,” Hadley said. “He still left it very open.” 

UCL reconstruction

“I don't know what kind of guardian angel was looking over us to get us connected with [Dr. Yellin], but he knew exactly what to do and how to troubleshoot it; we had a very clear plan,” Jennifer said.

Of course, as relieved as her mom was, Hadley was conflicted.

“Sad doesn't begin to describe it,” she said, recalling that, at first, she didn’t even want a second opinion. 

Ultimately though, if surgery would get her back to competing, Hadley knew that’s what she’d do.

“I didn't want to believe that [the injury] could be worse. So, I really didn't want to go [to CHOP],” Hadley admitted. “Now I'm so glad we did.”

Dr. Yellin performed Hadley’s UCL reconstruction alongside Dr. Shah, a pediatric hand surgeon, in May.

“Everyone from Dr. Yellin to Dr. Shah, the [physician’s assistant], the athletic trainers, the physical therapy team, even the nurses in the operating room holding my hand and the MRI people – the care was just really, really amazing,” Hadley said.

Recovery and return to sport after elbow surgery

Vault, bars, beam and floor – Hadley's brought unique artistry to each of the four main gymnastic events for almost a decade now.

Fitting for a level 10 gymnast and fierce competitor who finds peace in preparation and performance. 

Of course, in “true Hadley” fashion, pain wasn’t her biggest post-op problem – it was slowing down.

“The first day I let myself rest and then I think the next day I was on the treadmill,” Hadley said.

Dr. Yellin gave Hadley the green light to get herself moving again, so long as she followed some specific –and firmly but kindly delivered – guidelines.

“[Dr. Yellin] was like, ‘Don't mess up my arm,’” Hadley said.

Treadmill walks. Stomach crunches. Slowly, but surely, moving her body; and clearing her mind.

“I was being very gentle,” Hadley said, adding with a laugh, “I wouldn't mess up his arm, I promise.”

Nearly a year after UCL reconstruction surgery, Hadley will return to competitive gymnastics soon.

Drs. Yellin and Shah have kept a close eye on Hadley as she’s healed, and on Jan. 22 she “graduated” from her CHOP treatment program.

Hadley was so excited, in fact, that she kept their parking ticket as a memento; and maybe a reminder too.

“I think [injuries] really, more than anything, make you appreciate what you can do and how special it is to be doing that.”