Elbow Injuries in the Throwing Athlete
An athlete uses an overhand throw to achieve great speed and distance. Repetitive throwing in sports such as baseball place a lot of stress on the joints of the arm and can lead to injuries to the structures in the elbow. These overuse injuries may include:
- Inflammation or tears of the ulnar collateral ligament (medial collateral ligament)
- Inflammation of the flexor tendons (tissue connecting muscles of the forearm to the upper arm bone) at the inner side of the elbow
- Wearing of cartilage (spongy protective tissue lining bones in a joint) over the olecranon (pointed elbow bone) and development of abnormal bony growths (bone spurs)
- Tiny cracks (stress fractures) of the olecranon or medial epicondyle
- Irritation of the ulnar nerve
Throwing injuries can produce pain, numbness or tingling, reduction in the throwing velocity, and loss of throwing control. When you present with symptoms of a throwing injury, your doctor will review your medical history, discuss your athletic activities, and perform a thorough physical examination to examine the strength, range of motion, and stability of your elbow. Imaging tests (X-ray, MRI, and CT scans) may be ordered to confirm the diagnosis.
Your doctor may suggest a non-surgical approach to treatment such as rest, ice, physical therapy, anti-inflammatory medications, and a modification of activity and throwing technique. If symptoms persist, surgery may be performed to repair or reconstruct the injured tissues either through an open surgery or a less invasive technique (arthroscopy) where a camera and instruments are inserted through narrow tubes. Surgery may be performed to reconstruct the ulnar collateral ligament (Tommy John Surgery). This can be performed using tissue from one’s forearm (autograft) or from cadaver tissue (allograft). 10 to 12 months of rehabilitation is usually necessary following surgery to return to full-speed throwing. Your doctor will discuss when it safe for you to return to your activities based on the injury and how well you recover.