Medial Apophysitis (Pitcher’s Elbow)


The ulnar collateral ligament (UCL) is the most commonly injured ligament in throwers. Injuries of the UCL can range from minor damage and inflammation to a complete tear of the ligament. Athletes will have pain on the inside of the elbow, and frequently notice decreased throwing velocity.


On both the inside and the outside of the elbow, there are ligaments that hold the elbow joint together and prevent dislocation. The ligament that runs on the inside of the elbow is known as the ulnar collateral ligament. This ligament runs from the inner side of the humerus, down to the inner side of the ulna, and it stabilizes the elbow during overhand throwing.


This is an injury that is common to athletes that participate in repetitive overhead throwing or swinging activities such as baseball, badminton, and tennis. Such high-velocity throwing motions place a lot of strain on the structures on the inside of the elbow, leading to microtears and possibly to the development of a repetitive strain injury.


The main symptom of pitcher’s elbow is pain on the inner side of the elbow. It may be difficult to move the elbow, so it can greatly affect the performance of athletes.


In order to correctly diagnosis pitcher’s elbow, your doctor will probably order a diagnostic test such as an MRI or an X-ray to accurately view the elbow structures and to make sure there is no other underlying conditions. They will also need to get a detailed medical history about what activities performed that could be the source of the elbow injury.


The first course of treatment is to stop performing any repetitive throwing activities and to allow the elbow time to rest. Physical therapy can be helpful as your therapist can evaluate the motions that are causing the injury and help to modify them. Your therapist can give you exercises to build back up your strength and range of motion, and also help with icing the elbow to reduce pain and swelling.

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