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What is Thrower’s Elbow?
Throwing your hands over your shoulders can put a lot of pressure on your elbows.
For pitchers in baseball and other athletes in the throwing motion, this pressure is repeated over and over again and can cause injury from overuse.
Injuries from overuse occur slowly.
In many cases, overuse injuries occur when the athlete’s movements are repeated over a period of play, and when those periods of play become so frequent that the body does not have sufficient time to rest and heal.
Thrower’s Elbow Causes
Elbow injuries to throwers are usually the result of overuse and repeated high pressure.
In most cases, the pain will go away when the athlete stops throwing. In a baseball pitcher, the number of injuries is closely related to the number of throws made, the number of matches played, and the length of the match each year.
The taller and heavier the pitcher, the faster the throw, the higher the risk of injury. Athletes who experience arm pain or throwing when exhausted have the highest risk of injury.
Thrower’s Elbow Common Injury
The location of the problem most often occurs in the inner elbow, because the force is concentrated on the inside of the elbow when throwing.
1. Flexible Tendinitis
Repeated throws can irritate and cause inflammation of the flexor / pronator tendon that attaches to the humerus on the inner side of the elbow. Athletes will feel pain on the inside of the elbow when throwing, and in cases of severe tendinitis, pain will also be felt when resting.
2. Ulnar Collateral Ligament Injury (UCL)
This ligament is injured most often. Athletes will feel pain on the inside of the elbow, and often feel a decrease in speed when throwing.
3. Valgus Extension Overload (Pitcher’s Elbow)
In a throwing motion, the olecranon and humerus are twisted and pushed toward each other.
Over time, this can lead to valgus extension overload (VEO), a condition in which the protective olecranon cartilage weakens and there is abnormally large overgrowth of bone – known as a bone spur or osteophyte.
Athletes with VEO will experience pain and swelling at the site of maximum bone contact.
4. Olecranon Stress Fracture
Stress fractures occur when muscles become fatigued and unable to absorb additional shocks.
Ultimately, the exhausted muscle exerts excessive pressure on the bone, causing a small fracture called a stress fracture. Athletes will feel pain on the surface of the olecranon below the elbow.
5. Ulnar Neuritis
When the elbow is bent, the ulnar nerve stretches around the bony ridge at the end of the humerus. In throwing athletes, the ulnar nerve is repeatedly stretched and can slide out of place, causing pain. This stretching causes nerve irritation called ulnar neuritis.
A throwing athlete with ulnar neuritis will experience pain like an electric shock that starts on the inside of the elbow and travels along the nerve to the forearm.
Numbness, tingling or pain in the ring finger and little finger can occur with throwing or immediately after throwing, and does not go away with rest.
Thrower’s Elbow Risk Factor
Age – young athletes (9-14 years) are at greater risk of permanent injury because their joints, bones, growth plates and ligaments are still growing.
Overuse – If you experience pain while playing, you should stop immediately and seek medical help if the pain does not improve or returns after starting back throwing activities.
Throwing curveballs – Throwers in baseball who throw curveballs and breakers exert additional stress on the growth plate and can cause elbow injuries. This type of throw should be avoided especially in young athletes.
Thrower’s Elbow Treatments
In most cases, management of thrower’s elbow begins with rest for brief periods. Other thrower’s elbow treatments will be varied depending on the causes of the elbow pain.
Thrower’s Elbow Phsyiotherapy
Specific exercises can restore flexibility and strength. The rehabilitation program includes a gradual return to throw. Improved strength and mobility will improve your performance when you return to competition.
Continuously throwing the wrong way can cause repeated pain, even after the pain has been treated. A skilled trainer or therapist can use the video to analyze wrong throws and can provide advice on correct technique.
Medications can reduce pain and swelling
Regenerative Injection Therapy
This therapy uses the patient’s stem cells to promote healing of damaged tissue. This procedure takes less time than surgery, and can be very effective.
The olecranon bone spur and any fragments of bone or cartilage in the elbow joint can be removed with arthroscopy. Because the arthroscopes and surgical instruments used are small, the surgeon can use very small incisions.
Ulnar collateral ligament (UCL) reconstruction
Athletes who do not respond to nonsurgical management or experience a UCL tear or unstable UCL are candidates for ligament reconstruction.