Elbow pain is very common. There are various conditions that affect the elbow, including muscular strains, overuse injuries (repetitive strain) and fractures to name a few. Golfer’s elbow and tennis elbow are extremely common conditions that affect the elbow. Perhaps a less common injury that affects the elbow is pitcher’s elbow which is the topic of this week’s blog.
Many throwing athletes experience elbow pain. Although pitcher’s elbow typically affects baseball pitchers, any sport that requires repetitive high velocity throwing can put an athlete at risk for pitcher’s elbow. Pitcher’s elbow affects the inside of the elbow where the ulnar collateral ligament is (UCL). The UCL “holds together” the humerus and the ulna (which is the bone on the inside of your forearm). The ligament keeps the inside of the elbow stable. Obviously, when this ligament is damaged it can lead to a type of instability at the inside (medial side) of the elbow.
The motion of throwing can be broken down into different components. The rapid acceleration phase is when this ligament is really tested. If you’ve ever seen a slow motion replay of a baseball pitcher throwing a fastball, you’d understand how the forearm and upper arm get twisted in a sense and the majority of that tension is placed on the inside of the joint. Pitcher’s elbow is defined as damage or tearing to the ulnar collateral ligament. It can be caused by repeated throwing, whereby the tissue slowly elongates and gets damaged over time. It can also happen after an acute event. Sometimes an athlete can hear a ‘pop’ with immediate pain at the inside of the elbow which can be related to an acute tear of the UCL. In either case, acute or chronic onset, the throwing athlete will often complain of pain at the inside of the elbow, weakness, instability and loss of throwing speed.
Pitcher’s Elbow Treatment
There are various treatment options for pitcher’s elbow. As with many conditions, it is desired to attempt conservative treatment options at first. This would include treatment at a clinic like Burlington Sports Therapy done by a chiropractor, physiotherapist or athletic therapist. Treatment might consist of various modalities such as soft tissue release, laser therapy, acupuncture or interferential current depending on the case. Eventually, strengthening is an important aspect of recovery from pitcher’s elbow. In some cases, it is required that the athlete abstain from throwing during the healing process with a gradual return to throwing as the condition improves. Perhaps the most commonly discussed treatment for ulnar collateral injury is Tommy John surgery. This surgery involves a repair of the ulnar collateral ligament which unfortunately is required in very severe cases.
Do you have elbow pain? Unsure if you have pitcher’s elbow? Give us a call, we can help! Since 2005 Burlington Sports Therapy has served the Burlington, Oakville and Hamilton area.
Rossy WH, Luke S. Pitcher’s elbow: medial elbow pain in the overhead throwing athlete. Current Reviews Musculoskeletal Medicine 2016; 9: 207-214.