Walker Kessler’s elbow injury is usually a serious one for baseball players. Here’s why it’s less so for him.

An orthopedic surgeon who also serves as the team physician for the Los Angeles Angels explains why an injury that usually means a year of rehab for MLB pitchers might require only two weeks of rest for the Utah Jazz center.

(Francisco Kjolseth | The Salt Lake Tribune) Utah Jazz center Walker Kessler (24) strains his elbow caught by Sacramento Kings forward Domantas Sabonis (10) in the season's second minute as the Utah Jazz host the Sacramento Kings, during NBA basketball in Salt Lake City on Wednesday, Oct. 25, 2023.

Utah Jazz center Walker Kessler not only got hurt in the first game of the season, it appears his injury occurred less than a minute and a half into the game.

He picked up Kings big man Domantas Sabonis near the 3-point line, and then Sabonis suddenly drove into the paint. However, as the Sacramento star spun to the right, Kessler was caught out of position, reached across his back to try and dislodge the ball, and his arm bent awkwardly as Sabonis powered through the bucket-and-one.

Kessler could be seen grabbing at his arm, grimacing in pain, and gingerly shaking it out afterward, but he remained in the game.

Kessler wound up playing eight somewhat ineffectual games before the Jazz diagnosed him with a sprain of the ulnar collateral ligament (UCL) in his left elbow, and opted to sit him out for two weeks before a re-evaluation.

Avid sports fans will, of course, recognize a UCL injury as one common to baseball pitchers — as a torn UCL ligament frequently requires “Tommy John” surgery, in which a healthy tendon is extracted from an arm or sometimes a leg and used to replace an arm’s torn ligament. Rehabilitation from such a procedure typically takes up to a year, and sometimes requires up to two years for the player to regain full efficacy.

A UCL injury is basketball, meanwhile, is far more rare. While Kessler’s injury being diagnosed as a sprain rather than a tear is a good sign, the fact is a sprain technically is, at best, a stretching of the ligament, and, at worst, a partial or full tear of it.

Lest that sound a bit worrisome to Jazz fans concerned about just how long Kessler’s injury might wind up taking, Dr. Brian Schulz is here to assuage you.

He has not evaluated Kessler, but he is an orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, and he is a Major League Baseball team physician, so he’s well-versed in UCL injuries.

“I take care of the Los Angeles Angels, and unfortunately, we’ve had our share,” Schulz told The Salt Lake Tribune. “It’s a pretty common injury in professional baseball.”

It’s far less common in basketball — but that’s apparently a good thing.

“It’s definitely not the same kind of concern you would have with a baseball player and his throwing arm,” Schulz added.

He reviewed video of Kessler’s injury, and agreed to a Q&A with The Tribune to discuss USCL injuries generally, and perhaps what to expect with the Jazz big man.

What does the ulnar collateral ligament do?

“The UCL is the ligament on the inside of the elbow that stabilizes it on the inside. It basically keeps the elbow from opening up on the inside.”

It’s a common baseball injury but not one typically associated with basketball. Why?

“It happens in baseball from overuse, because every time you throw a baseball, you’re stressing the inside of the elbow. That repetitive throwing over time damages the ligament to a point where it no longer can work. In basketball, more than likely it was an acute trauma where his elbow got bent the wrong way, and either partially or fully tore the ligament.”

He injured it Oct. 25 but wasn’t ruled out until Nov. 8. What are the symptoms of a UCL sprain, and how might they have led to the eventual decision to put him on the shelf for a bit?

“For him it’s a little different because in basketball, you’re not constantly stressing [the ligament]. I guess if you were going to throw overhand, which occasionally would be happening, but not that much. It’s probably more of a pain thing than anything. Because you have an initial injury, there’s a lot of pain there. Depending on the degree of the injury, there can be some instability of the elbow, but again, that only comes into play if the elbow’s getting stressed in the direction where the ligament would normally work.

“My guess is that after the injury, he had some inflammation, some swelling, it was more of a pain thing and even some decreased range of motion from the swelling and pain that prevented him from playing.”

Pitchers’ UCL injuries often require surgery and long rehabs. The Jazz said that “rest with non-contact activities” were recommended to aid healing. Is that all it comes down to here?

“Yes. Because basketball’s not a sport where you’re constantly stressing that ligament, it’s probably more [a situation of], get the inflammation down, get his pain better, make sure he’s strong enough just to do what he needs to do. It would be extremely unusual for a basketball player to need any kind of surgery for this.”

The team also said he’d be re-evaluated in two weeks. What’s a typical timeline?

“I think [two weeks is] realistic for him to be good enough to play. He might not feel normal, it may still be uncomfortable — these soft-tissue injuries sometimes can take six to eight-plus weeks to fully heal. But if he’s got his motion, and less pain — or not enough to bother him or limit him — and he’s got his strength back, then you can play with these. Because you’re not constantly stressing it playing basketball.”

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