Lyle Cain, MD I Knee & Tommy John Surgeon I Andrews

E. Lyle Cain, Jr., MD

Elbow, Knee, Shoulder, Sports Medicine

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Biography

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Nationally Recognized Orthopaedic Sports Medicine Surgeon

E. Lyle Cain, Jr., MD, is a board-certified, fellowship-trained orthopaedic sports medicine surgeon at Andrews Sports Medicine & Orthopaedic Center in Birmingham, Alabama.

He is nationally recognized for treating complex knee, shoulder and elbow injuries in athletes and active individuals.

For more than 25 years, Dr. Cain has cared for patients at every level of competition—from youth and high school athletes to collegiate, Olympic and professional competitors.

His clinical expertise includes complex knee surgery, ligament reconstruction, cartilage restoration, Tommy John surgery and the treatment of sports-related injuries in overhead-throwing athletes.

Dr. Cain combines advanced surgical care, evidence-based treatment and extensive experience working with competitive athletes.

Whether treating an elite athlete pursuing a return to competition or an active adult seeking to regain strength and mobility, his goal is to provide individualized care that supports long-term health, performance and Victory Over Injury®.

National Leader in Complex Knee, Shoulder & Elbow Injuries

Dr. Cain is nationally recognized for treating complex knee injuries, including ACL tears, multiligament knee injuries, meniscus tears and articular cartilage damage.

His surgical expertise includes:

ACL Reconstruction
Multi-Ligament Knee Reconstruction
Meniscus Repair & Meniscal Transplantation
Articular Cartilage Restoration
Knee Arthroscopy
Treatment of Complex & Revision Knee Injuries
Return-to-Sport Care for Competitive Athletes

Dr. Cain’s approach begins with a careful evaluation of each patient’s injury, activity level and long-term goals. When surgery is necessary, he develops an individualized treatment and rehabilitation plan designed to restore stability, protect the joint and help the patient safely return to competition or an active lifestyle.

His work in knee surgery is supported by decades of clinical experience and continued research into ligament reconstruction, cartilage restoration, biologic treatment options and long-term outcomes following complex athletic injuries.

Tommy John & UCL Reconstruction

Dr. Cain is also a nationally recognized authority on ulnar collateral ligament injuries of the elbow, Tommy John surgery and UCL reconstruction in baseball players and other overhead-throwing athletes.

UCL injuries require an individualized treatment strategy. Dr. Cain evaluates the location and severity of the tear, ligament quality, throwing demands, competitive level and long-term performance goals before recommending treatment.

Depending on the injury, treatment may include structured rehabilitation, UCL repair in appropriately selected cases or traditional UCL reconstruction—commonly known as Tommy John surgery.

Dr. Cain has contributed to some of the field’s most important research on UCL reconstruction and throwing-elbow injuries. He served as lead author of a landmark study examining UCL reconstruction in 1,281 athletes, including 743 athletes with a minimum two-year follow-up. Published in the American Journal of Sports Medicine, the study remains an important contribution to the understanding of surgical outcomes following Tommy John surgery.

He also co-authored research examining long-term outcomes following UCL reconstruction in competitive baseball players and a 2025 study comparing UCL repair with Internal Brace augmentation to traditional UCL reconstruction in competitive athletes.

Through his clinical practice, research and physician education, Dr. Cain continues to help advance the evaluation, surgical treatment and rehabilitation of UCL injuries in throwing athletes.

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Comprehensive Shoulder & Elbow Care

Dr. Cain has spent more than 25 seasons serving as Head Team Orthopaedic Surgeon for The University of Alabama Athletics, helping care for Crimson Tide student-athletes competing at the highest levels of collegiate athletics.

In addition to his nationally recognized work in knee surgery and UCL reconstruction, Dr. Cain treats a wide range of shoulder, elbow and sports-related injuries.

His areas of expertise include:

Rotator cuff tears
Shoulder Instability
Labral Tears & Complex Shoulder Injuries
Elbow Ligament Injuries
Baseball & Overhead-Throwing Injuries
Sports-Related Shoulder, Elbow & Knee Conditions
Youth Sports Injuries & Overuse Conditions
Biologic Treatment Options, including Bone Marrow Aspirate Concentrate
Return-to-Sport Care for Athletes & Active Adults

Whenever appropriate, Dr. Cain considers non-surgical treatment before recommending surgery. Every treatment plan is tailored to the patient’s condition, lifestyle, performance demands and recovery goals.

Trusted by Athletes at Every Level

For 26 years, Dr. Cain has provided sports medicine coverage for high school, collegiate and professional teams throughout Alabama. His long-standing work with athletes on the sidelines, in the clinic and throughout rehabilitation has given him an exceptional understanding of the physical and competitive demands involved in returning safely to sport.

Dr. Cain has spent 26 seasons serving as Head Team Orthopaedic Surgeon for The University of Alabama Athletics, helping care for Crimson Tide student-athletes competing at the highest levels of collegiate athletics.

He also serves as Medical Director for Jacksonville State University Athletics, The University of West Alabama Athletics, Tuskegee University Athletics and Shelton State Community College Athletics. He also serves as an orthopaedic consultant for the Birmingham Barons and ACE Cheer Company.

Dr. Cain has served as team physician for numerous Alabama high schools and helps lead a sports medicine outreach program through The University of West Alabama that provides medical services to more than 40 schools across West Alabama.

From Friday nights at local high schools to championship-level collegiate competition, Dr. Cain has dedicated his career to helping athletes receive specialized care, recover safely and return to the sports they love.

Advancing Sports Medicine Through Research & Education

In addition to his clinical practice, Dr. Cain has dedicated much of his career to advancing orthopaedic sports medicine through scientific research, physician education and mentorship.

His research interests include:

ACL & Multi-Ligament Knee Injuries
Articular Cartilage Restoration
Meniscus Repair & Transplantation
UCL Injuries & Tommy John Surgery
Shoulder & Elbow Injuries in Overhead Athletes
Biologic Treatment Options
Youth Sports Injury Prevention
Return-to-Play Outcomes

Dr. Cain serves on the Board of Directors of the American Sports Medicine Institute and previously served on the Board of Directors of the American Orthopaedic Society for Sports Medicine. He has presented nationally and internationally and has contributed to numerous peer-reviewed journal articles, textbook chapters and scientific publications.

He has also served on editorial review boards for leading orthopaedic and sports medicine journals and remains actively involved in educating and mentoring the next generation of sports medicine physicians.

Education, Fellowship Training & Leadership

A Birmingham native, Dr. Cain earned his Bachelor of Science in Chemical Engineering from The University of Alabama before receiving his medical degree from the University of Alabama School of Medicine.

He completed his general surgery internship at The University of Tennessee in Memphis and his orthopaedic surgery residency at Campbell Clinic, where he served as Chief Resident.

Dr. Cain subsequently completed an orthopaedic sports medicine fellowship at the American Sports Medicine Institute in Birmingham under the direction of James R. Andrews, MD, and William G. Clancy, Jr., MD.

Following fellowship, Dr. Cain joined Alabama Sports Medicine & Orthopaedic Center and later co-founded Andrews Sports Medicine & Orthopaedic Center. Through his leadership, clinical practice and commitment to research and education, he has helped build one of the country’s most respected orthopaedic sports medicine programs.

Sports Medicine & Orthopaedic Care in Birmingham, Alabama

Dr. Cain sees patients at Andrews Sports Medicine & Orthopaedic Center in Birmingham, Alabama. His practice welcomes athletes and active individuals from Birmingham, communities throughout Alabama and across the country seeking specialized care for complex knee, shoulder and elbow injuries.

Patients have access to comprehensive evaluation, advanced imaging, surgical and non-surgical treatment options and coordinated rehabilitation. Dr. Cain works closely with each patient’s athletic trainers, physical therapists, coaches and support team to develop an individualized recovery plan and support a safe return to activity.

By the Numbers

25+ Seasons – Head Team Orthopaedic Surgeon for The University of Alabama Athletics
25+ Years – Caring for athletes at the youth, collegiate, Olympic and professional levels
40+ Schools – Served through sports medicine outreach programs across West Alabama
Fellowship-Trained – American Sports Medicine Institute (ASMI)
Co-Founder – Andrews Sports Medicine & Orthopaedic Center
National Leader – Orthopaedic sports medicine research, education and physician mentorship

A Patient-Centered Approach to Victory Over Injury

Dr. Cain believes exceptional sports medicine care begins with understanding the individual—not simply treating an MRI or a diagnosis. Every treatment plan is built around the patient’s injury, goals, competitive demands and long-term health.

When an operation is the best path forward, Dr. Cain combines advanced surgical techniques with coordinated rehabilitation and clearly defined return-to-activity goals.

From championship athletes to active individuals seeking relief from pain, Dr. Cain is committed to helping every patient recover safely, restore performance and pursue Victory Over Injury®.

Medical Training & Education

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Leadership Honors Certifications Research Publications Memberships Patient Handouts

American Sports Medicine Institute (ASMI) - Board of Directors & Fellowship Director
American Baseball Foundation (ABF) - Board of Directors

RESEARCH/PUBLICATIONS

Outcomes of Surgical Treatment for Multiligament Knee Injuries in a Cohort Including Competitive Athletes With Long-Term Follow-Up.
Mussell EA, Crawford AE, Ithurburn MP, Layton Bo, BS, Fleisig GS, Rothermich MA, Emblom BA, Ryan MD, Dugas JR, Andrews JR, Cain EL, Jr.
Orthopaedic Journal of Sports Medicine. 2024;12(9).

Return to play following metacarpal fractures in football players.Etier BE, Scillia AJ, Tessier DD, Aune KT, Emblom BA, Dugas JR, CAIN EL Jr. Hand. 2015 Dec;10(4):762-6. Epub 2015 May 21.

Torsional Fracture of the Humerus after Subpectoral Biceps Tenodesis with an Interference Screw: A Biomechanical Cadaveric Study.  Beason DP, Shah JP, Duckett JW, Jost PW, Fleisig GS, CAIN EL Jr. Clin Biomech. 2015 Nov;30(9):915-20. Epub 2015 Jul 26.

Risk Factors for Revision Anterior Cruciate Ligament Reconstruction. Ponce BA, CAIN EL JR., Pflugner R, Fleisig GS, Young BL, Boohaker HA, Swain TA, Andrews JR, Dugas JR. J Knee Surg. 2015 Aug 1.

Return to play after chondroplasty of the knee in National Football League athletes. Scillia AJ, Aune KT, Andrachuk JS, CAIN EL, Dugas JR, Fleisig GS, Andrews JR. Am J Sports Med. 2015 Mar;43(3):663-8. Epub 2015 Jan 8.

Visualization and reduction of a mensical capsular junction tear in the knee: an arthroscopic surgical technique.
Plymale M, Fleisig GS, Kocaj SM, Cooney WP, Evans TJ, CAIN EL JR. , Dugas. Am J Orthop. 2014 Nov;43(11):498-500.

Deficiencies in pitching biomechanics in baseball players with a history of superior labrum anterior-posterior repair.
Laughlin WA, Fleisig GS, Scillia AJ, Aune KT, CAIN EL Jr, Dugas JR. Am J Sports Med. 2014 Dec;42(12):2837-41. Epub 2014 Oct 15.

Ulnar collateral ligament in the overhead athlete: a current review.
Dugas J, Chronister J, CAIN EL Jr, Andrews JR. Sports Med Arthrosc. 2014 Sep;22(3):169-82.

Return to Play After Partial Lateral Meniscectomy in National Football League Athletes.
Aune KT, Andrews JR, Dugas JR, CAIN EL Jr. Am J Sports Med. 2014 Jun 9;42(8):1865-1872.

Long-term Outcomes After Ulnar Collateral Ligament Reconstruction in Competitive Baseball Players: Minimum 10-Year Follow-up. Osbahr DC, CAIN EL Jr, Raines BT, Fortenbaugh D, Dugas JR, Andrews JR. Am J Sports Med. 2014 Apr 4;42(6):1333-1342

The recognition and treatment of superior labral (slap) lesions in the overhead athlete.
Wilk KE, Macrina LC, CAIN EL, Dugas JR, Andrews JR. Int J Sports Phys Ther. 2013 Oct;8(5):579-600.

Return to athletic activity after plate fixation of displaced midshaft clavicle fractures.
Meisterling SW, CAIN EL, Fleisig GS, Hartzell JL, Dugas JR. Am J Sports Med. 2013 Nov;41(11):2632-6. Epub 2013 Aug 27.

Traumatic full-thickness infraspinatus and teres minor tendon tears.
CAIN EL, Andrachuk J, Wilk KE. J Orthop Sports Phys Ther. 2013 Aug;43(8):583. Epub 2013 Jul 31.

Surgical repair and rehabilitation of a combined 330° capsulolabral lesion and partial-thickness rotator cuff tear in a professional quarterback: a case report. Wilk KE, Macrina LC, Yenchak AJ, CAIN EL, Andrews JR. J Orthop Sports Phys Ther. 2013 Mar;43(3):142-53.

Cannulated screw fixation of refractory olecranon stress fractures with and without associated injuries allows a return to baseball. Paci JM, Dugas JR, Guy JA, CAIN EL Jr, Fleisig GS, Hurst C, Wilk KE, Andrews JR. Am J Sports Med. 2013 Feb;41(2):306-12. Epub 2012 Dec 6.

The ulnar collateral ligament procedure revisited: the procedure we use.
Andrews JR, Jost PW, CAIN EL. Sports Health. 2012 Sep;4(5):438-41

Rehabilitation of the Overhead Athlete's Elbow. Sports Health.
Wilk KE, Macrina LC, CAIN EL, Dugas JR, Andrews JR. 2012 Sep;4(5):404-14.

Ulnar Collateral Ligament Reconstruction With Gracilis Tendon in Athletes With Intraligamentous Bony Excision: Technique and Results. Dugas JR, Bilotta J, Watts CD, Crum JA, Fleisig GS, McMichael CS, CAIN EL Jr, Andrews JR: Am J Sports Med. 2012 May 11.

Recent advances in the rehabilitation of anterior cruciate ligament injuries.
Wilk KE, Macrina LC, CAIN EL, Dugas JR, Andrews JR: J Orthop Sports Phys Ther. 2012 Mar;42(3):153-71.

MRI of the reconstructed ulnar collateral ligament.
Wear SA, Thornton DD, Schwartz ML, Weissmann RC 3rd, CAIN EL, Andrews JR: Am J Roentgenol. 2011 Nov;197(5):1198 204.

Thromboembolic phenomena after arthroscopic shoulder surgery.
Kuremsky MA, CAIN EL Jr, Fleischli JE: Arthroscopy. 2011 Dec;27(12):1614-9.

Outcome of ulnar collateral ligament reconstruction of the elbow in 1281 athletes: Results in 743 athletes with minimum 2-year follow-up. CAIN EL Jr, Andrews JR, Dugas JR, Wilk KE, McMichael CS, Walter JC 2nd, Riley RS, Arthur ST: Am J Sports Med. 2010 Dec;38(12):2426-34.

Shoulder injuries in the overhead athlete. Wilk KE, Obma P, Simpson CD, CAIN EL, Dugas JR, Andrews JR: J Orthop Sports Phys Ther. 2009 Feb;39(2):38-54. Review

The effect of neuromuscular electrical stimulation of the infraspinatus on shoulder external rotation force production after rotator cuff repair surgery. Reinold MM, Macrina LC, Wilk KE, Dugas JR, CAIN EL, Andrews JR: Am J Sports Med. 2008 Dec;36(12):2317-21. Epub 2008 Aug 29.

Avulsion of the medial epicondyle after ulnar collateral ligament reconstruction: imaging of a rare throwing injury. Schwartz ML, Thornton DD, Larrison MC, CAIN EL, Aaron DG, Wilk KE, Andrews JR: Am J Roentgenol. 2008 Mar;190(3): 595-8.

Debridement of small partial-thickness rotator cuff tears in elite overhead throwers. Reynolds SB, Dugas JR, CAIN EL, McMichael CS, Andrews JR. Clin Orthop Relat Res. 2008 Mar; 466(3): 614-21.

Anatomy of the anterior bundle of the ulnar collateral ligament. Dugas JR, Ostrander RV, CAIN EL, Kingsley D, Andrews JR.: J Shoulder Elbow Surg. 2007 Sep-Oct;16(5):657-60.

SLAP lesions, 2007. Lebolt JR, CAIN EL, Andrews JR.: Am J Orthop. 2006 Dec;35(12):554-7.

Current concepts in the rehabilitation following articular cartilage repair procedures in the knee.  Reinold MM, Wilk KE, Macrina LC, Dugas JR, CAIN EL. J Orthop Sports Phys Ther. 2006 Oct;36(10):774-94.

Allograft Reconstruction for Massive, Irreparable Rotator Cuff Tears. Moore DR, CAIN EL, Schwartz ML, Clancy WG Jr.: Am J Sports Med, Oct 31;2005.

Diagnosis, treatment, and rehabilitation of the thrower's elbow. McCall BR, CAIN EL: Curr Sports Med Rep. Oct;4(5):249-54; 2005.

Effect of tibial tunnel dilation on pullout strength of semitendinosus-gracilis graft in anterior cruciate ligament reconstruction. CAIN EL, Phillips BB, Charlebois SJ, Azar FM: Orthopedics. Aug;28(8):779-83;2005.

Correlation of interference screw insertion torque with depth of placement in the tibial tunnel using a quadrupled semitendinosus-gracilis graft in anterior cruciate ligament reconstruction. Phillips BB, CAIN EL, Dlabach JA, Azar FM: Arthroscopy. Dec;20(10):1026-9;2004.

History and examination of the thrower's elbow. CAIN EL, Dugas JR: Clin Sports Med Oct.;23(4):553-66;2004.

Ulnar collateral ligament reconstruction in high school baseball players: clinical results and injury risk factors. Petty DH, Andrews JR, Fleisig GS, CAIN EL: Am J Sports Med. Jul-Aug;32(5):1158-64. 2004.

Posterior olecranon resection and ulnar collateral ligament strain. J Shoulder Elbow Surg. Levin JS, Zheng N, Dugas J, CAIN EL, Andrews JR: Jan-Feb;13(1):66-71. 2004

Posterior lateral corner reconstruction. Clancy WG Jr, Shepard MF, CAIN EL: Am J Orthop. Apr;32(4):171-6. 2003

Ulnar Nerve Injury in the Throwing Athlete. CAIN EL, Dugas JR, and Andrews JR: Sports Med and Arthroscopic Review. 11: 40-46, 2003.

THE ELBOW, Elbow Arthroscopy in the Throwing Athlete. CAIN EL, Andrews Jr: Operative Arthroscopy, 3rd Ed.; Chapter 46; 697-707, 2003.

Management of Intraoperative Complications Associated With Autogenous Patellar Tendon Graft Anterior Cruciate Ligament Reconstruction, CAIN EL, Gillogly SD, Andrews JR: Instructional Course Lectures (52); 359-367,2003.

Effect of Fibular Plate Fixation on Rotational Stability of Simulated Distal Tibial Fractures Treated with Intramedullary Nailing. Kumar A, Charlebois SJ, CAIN EL, Smith RA, Daniels AU, Crates JM. Journal of Bone and Joint Surgery. 85: 604-608, 2003

Elbow injuries in throwing athletes: a current concepts review. CAIN EL, Dugas JR, Wolf RS, Andrews JR: Am J Sports Med 31(4);621-635, 2003.

Posterior Cruciate Ligament Reconstruction: Two-Bundle Technique. CAIN EL, Clancy WG: The Journal of Knee Surgery 15(2);108-113,2002.

THERAPIES & MODALITIES Stimulating Treatment. CAIN EL: Orthopedic Technology Review 4(4); 32-33, July/August 2002.

Anatomic Endoscopic Anterior Cruciate Ligament Reconstruction with Patella Tendon Autograft. CAIN EL, CLANCY WG: Orthopedic Clinics of North America; Oct;33(4): 717-725, 2002.

Thrower’s Elbow: Part I. CAIN EL, ElAttrache N, Dlabach JA, Azar FM:  Am J Orthop 30(10);761-767,2001.

Thrower’s Elbow: Part II. CAIN EL, ElAttrache N, Dlabach JA, Azar FM: Am J Orthop 30(11);821-825,2001.

Treatment algorithm for osteochondral injuries of the knee. CAIN EL, Clancy WG: Clin Sports Med 20(2);321-342,2001.

Arthroscopic management of posterior elbow impingement in throwers. CAIN EL, Andrews JR: Tech Shoulder Elbow Surg 2(2);118-130,2001.

Open treatment of anterior shoulder instability in the overhead athlete. Andrews JR, CAIN EL: Op Tech Orthop 11(1);9-16,2001.

Medial Collateral Ligament Injuries. Rohrbough JT, Altchek DW, CAIN EL, Andrews JR: In: Altchek DW, Andrews JR, eds. The Athlete’s Elbow, vol 1.Philadelphia, Lippincott, Williams & Wilkins, 2001: 153-173.

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Jenny Degnan, PA-C, ATC View Bio

E. Lyle Cain, Jr., MD

Orthopaedic Surgeon

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E. Lyle Cain, Jr., MD

Comeback Stories

In 2025, injuries robbed me of my freshman season at the University of Alabama. It felt like everything I’d worked so hard for was put on hold. But now, thanks to Dr. Lyle Cain and the amazing team at Andrews Sports Medicine, I'm stronger, more motivated and ready to compete with fierce joy.
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Love Birt | Camden, DE
In March 2024, University of Alabama wide receiver Jalen Hale suffered a devastating knee injury during practice — one that left his football career in doubt. Thanks to the expert surgical care of long-time Crimson Tide team physician, Dr. Lyle Cain and the dedicated team at Andrews Sports Medicine, Jalen underwent successful knee surgery and an intensive rehabilitation process.
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Jalen Hale | Longview, TX
Barbering is my career, but golf is my passion. After a major knee injury, Dr. Lyle Cain and Andrews Sports Medicine helped me return to the game I love.
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Roosevelt Phillips | Pleasant Grove, AL
Alabama Crimson Tide star pitcher, Riley Quick, sustained an elbow injury in his first start of the 2024 season against Manhattan College, delivering three hitless innings before experiencing discomfort and being removed from the game.

This led to a diagnosis requiring UCL reconstruction, commonly known as Tommy John surgery, which was performed by Dr. Lyle Cain. After an extensive rehabilitation, Riley successfully returned to the mound for the Tide's 2025 season opener.

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Riley Quick | Trussville, AL
My husband, Chandler, and I immediately knew where to turn for help — Dr. Lyle Cain at Andrews Sports Medicine. The diagnosis was devastating —an ACL tear. At just 13 years old, Embry faced a challenge unlike any she had encountered before, and as her mother, I worried not just about the physical pain but about the emotional toll it would take on her.
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Embry McGarrah | Homewood, AL