throwing injuries of the Elbow
There are some injuries that occur in the thrower's elbow that do not occur in other elbows. There are other conditions that also occur in non-throwers' elbows as well, but just not as often. Thus the elbow surgeon diagnosing, treating, and attempting to prevent these injuries must have a specific understanding of this unique spectrum of disorders. Each injury or condition below is followed by a short description, or can be clicked for a more extensive description.
Tommy John Injury (Medial Collateral Ligament Tear)
The main stabilizing ligament on the inner side of the elbow can tear or just wear out in throwers.
Little Leaguer's Elbow (Medial Epicondylar Apophysitis)
This is similar to Medial Epicondylar Fracture, but it is a chronic problem that occurs over time. The growth zone of the medial epicondyle (the apophysis) becomes damaged over time with repeated stress.
Medial Epicondylar Fractures
The bone on the point of the inner elbow is the medial epicondyle. It is where the flexor/pronators and the medial collateral ligament attaches. This bone can fracture and normally requires surgery to return to throwing. If you know a young thrower who has a screw in his elbow, this is probably why.
Valgus Extension Overload
The throwing motion puts a lot of repetitive traction force on the inner (medial) elbow, and at the same time compressive force on the outer (lateral) elbow structures. Over time, those forces lead to insufficiency of the medial soft tissues, and bone changes of the lateral elbow. This can lead to Medial Collateral Ligament Tear or Posteromedial Ulnohumeral Impingement, both or either of which can lead to surgery and over a year to recover from.
Osteochondritis Dissecans of the Radiocapitellar joint
The bones of the outer elbow can form bone chips that can become dislodged and float around in the joint. These bone chips can heal if they are caught before they dislodge, but require surgery if they are very large or if they have become free bodies in the joint.
Panner's Disease (Juvenile Osteonecrosis of the Capitellum)
The bones of the outer elbow can become misshapen and flattened and this can cause problems throwing for very young athletes. It almost never requires surgery.
The main muscles that stabilize the inner medial elbow can tear. This is less common than rupture of the Tommy John ligament, but can require surgery if a complete tear occurs.
The ulnar nerve is the "funny bone" and it can be repetetively stretches in overhead throwers. This leads to numbness and loss of dexterity in the hand which can profoundly affect pitching.
Exertional Compartment Syndrome
The muscles of the arm and forearm are surrounded by a tough sheath. If the muscles swell from overuse, they can compress themselves inside this tight fascial sheath, and actually cut off their own blood supply.