Moses KaneAmerican tennis player Caty McNally is one of the most compelling stories at the 2026 Miami Open. On March 22, she faced World No. 1 Aryna Sabalenka in the third round — a match that would have been unthinkable just two years ago. After two separate injury comebacks, elbow surgery in March 2024 for a partially torn ulnar collateral ligament (UCL), and a ranking that plummeted outside the Top 1,000, McNally fought back to reach the Top 100 and now plays on the biggest stages in women's tennis. Her story is a masterclass in sports medicine — and a lesson for every recreational tennis player who has ever played through pain.
From rank 1,400 to Miami Open: the full comeback story
McNally's troubles began in the summer of 2023 with subtle elbow pain during the European clay swing. What felt like a minor issue spiralled into a diagnosis of a torn ulnar collateral ligament — an injury more commonly associated with baseball pitchers than tennis players. She opted initially for platelet-rich plasma (PRP) injections to avoid surgery, but by early 2024, an MRI revealed a partial re-tear. The damage was worse than expected.
In March 2024, she underwent an internal brace repair procedure — a newer surgical technique that reinforces the UCL without the lengthy rehabilitation of traditional Tommy John surgery. She was cleared for full forehands and backhands by June 10, 2024. By November 2024, she made her comeback ranked outside the Top 1,000.
The turnaround was remarkable. She won her third tournament back — an ITF W50 in Tampa — and then captured the WTA singles title in Newport, her first tournament victory since returning. At Wimbledon 2025, she became the only player to win a set against eventual champion Iga Świątek. By March 2026, she was ranked comfortably inside the Top 100 and defeating seeded players in Miami.
What is a UCL injury and why should tennis players care?
The ulnar collateral ligament is a band of tissue on the inner side of the elbow that stabilises the joint during throwing and hitting motions. In tennis, it is stressed with every serve, every forehand, and every overhead smash.
UCL injuries in tennis are classified into three grades:
- Grade 1: Mild sprain — ligament is stretched but intact. Conservative treatment (rest, physiotherapy) is usually sufficient.
- Grade 2: Partial tear — significant pain and weakness. May require 6-12 weeks of rest with targeted rehabilitation; sometimes PRP injections are used.
- Grade 3: Complete rupture — often requires surgical intervention, particularly for players who want to return to competitive play.
According to research published in The American Journal of Sports Medicine, UCL injuries in recreational tennis players have been increasing steadily over the past decade, driven by more players taking up the sport later in life and training more intensively without adequate preparation.
Signs that your elbow pain needs professional attention
Most recreational tennis players experience some degree of elbow discomfort at some point — but not all pain is the same. These are the warning signs that warrant a consultation with a sports medicine doctor:
Pain on the inside of the elbow (medial epicondyle area) during or after hitting. Lateral (outer) elbow pain is typically "tennis elbow" (epicondylitis); medial pain is more likely ligament-related.
Reduced grip strength. If you notice that your racket feels less secure in your hand, or that your forehand has lost power without an obvious technical reason, this can indicate a UCL issue.
A "pop" or snapping sensation during a hit, followed by immediate pain and swelling. This is a medical emergency — seek evaluation within 24 hours.
Pain that worsens progressively over a season. A UCL injury that is not treated rarely resolves on its own and typically deteriorates with continued play.
Stiffness and limited range of motion in the elbow the morning after playing.
Conservative vs surgical treatment: what the evidence says
The majority of tennis players with UCL injuries do not require surgery. A 2023 review in the British Journal of Sports Medicine found that 75-80 percent of amateur athletes with Grade 1-2 UCL injuries returned to full sport activity within 12 weeks through a structured physiotherapy programme alone.
The programme typically includes:
- Rest from hitting for 4-6 weeks
- Targeted strengthening of the forearm flexors and pronators
- Eccentric loading exercises for the UCL
- Gradual return-to-hitting protocol with biomechanical assessment
Surgery, as in McNally's case, is usually reserved for Grade 3 tears in athletes who want to return to competitive play, or for Grade 2 cases that fail to respond to 3-6 months of conservative management.
Prevention: the most important investment you can make
McNally's story is inspiring, but prevention is always better than a year-long rehabilitation. For recreational tennis players, sports medicine specialists recommend:
Strength training for the forearm and shoulder. The UCL is protected by the muscles around the elbow — the stronger those muscles, the less load falls on the ligament during a powerful serve or forehand.
Proper technique assessment. A faulty serving motion or an extreme grip can dramatically increase stress on the medial elbow. A single session with a tennis coach reviewing your biomechanics can reduce injury risk significantly.
Manage playing volume. After periods of reduced activity — holidays, illness — do not immediately return to your full playing schedule. The ligament needs time to adapt.
Listen to the first warning signs. McNally admits she played through early elbow pain before her injury became serious. Many amateur players do the same. The cost of a sports medicine consultation is far less than months of forced rest.
If you are experiencing persistent elbow pain or reduced performance on court, an online consultation with a sports medicine specialist can help you understand whether you need imaging, physiotherapy, or simply a modified training plan. You can find qualified specialists through Expert Zoom Health.
Conclusion: McNally's comeback is a blueprint
Caty McNally's road from elbow surgery to facing Aryna Sabalenka at the Miami Open in March 2026 is more than a feel-good story. It is a detailed case study in how a UCL injury should be identified, treated, and rehabilitated — and how, with the right medical support, a return to competitive tennis is not only possible but potentially career-defining.
For the millions of recreational players who love the game and want to keep playing well into their fifties and beyond, the message is simple: take elbow pain seriously, seek specialist advice early, and do not play through injury. Your game — and your long-term health — will be better for it.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. If you are experiencing elbow pain or any other injury, please consult a qualified healthcare professional.
