By Jared Packer, DPT, CSCS

Persistent inner elbow pain in pitchers is not uncommon, but it is not normal. Often while playing baseball, pitchers push through this type of discomfort, believing that it is typical with throwing. It does not necessarily mean that something is terribly wrong, but it should be investigated further.

If there is an injury, it is usually one of the following things:

• Medial epicondylitis (also called baseball elbow)

• UCL injury, or ulnar neuropathy

It can be difficult to distinguish between them, which is why it is important to seek advice from a specialist to help you navigate the situation. Diagnosing any of these injuries early on can save you a lot of trouble in the long run. 

Below I will provide some tips on when it is time to talk to a specialist about your inner elbow pain for baseball players and pitchers.

Signs and Symptoms 

For pitchers suffering from inner elbow pain, there are certain symptoms and signs to look for. If you have experienced any of the following symptoms, it could be related to a UCL tear, medial epicondylitis, or ulnar neuropathy, you should see an elbow specialist:

• Felt/heard a pop in your elbow

• Pain shooting down from your elbow to your hand

• Decreased grip strength

• Numbness/tingling down your ring finger or pinky

• Elbow swelling

• limited elbow range of motion outside of your norm

Sometimes, the signs and symptoms in baseball players are not so clear. Here are some other guidelines pitchers can follow to know when to seek an evaluation from an elbow specialist:

• Significant loss of control and/or velocity while throwing

• Any soreness/discomfort > 3/10 on inner elbow 

• Soreness on your inner elbow/forearm while throwing that does not go away as you continue to throw

• Soreness on your inner elbow/forearm that comes and goes but has lasted for 2 weeks or more.

• Stiffness in the forearm that will not go away

• Soreness in the forearm that has lasted for 2 weeks or more

Soreness in the front center of the forearm may just be a forearm flexor strain. However, these muscles can become overworked if they have to substitute for an insufficient UCL.

Team Approach

Depending on the specifics of your injury, it may be helpful to expand your team. The following specialists can help guide baseball players and pitchers with inner elbow pain through diagnosis and recovery:

Orthopedic Elbow Specialist

In receiving a medical evaluation, your best bet is seeing a doctor with specific training and experience for the elbow. They will be your go-to for diagnosing your elbow injury and deciding if imaging is necessary.

Physical Therapist

You will also benefit from finding a physical therapist with experience seeing elbows and who understands the unique needs of baseball players. They can help you determine if you should seek a medical evaluation from an orthopedist, provide education, and guide you through the rehabilitation process.

Strength & Conditioning Coach

A good strength coach will help pitchers and position players to stay strong and work around your injury, regardless of the severity. This is important to achieve a seamless return to throw and high performance.

Pitching Coach

A good pitching coach can evaluate a motion to determine if anything is contributing to an injury to the elbow, and work with the natural movement that is unique to every individual. 

Things to Remember

Since UCL injuries are what pitchers fear the most when experiencing inner elbow pain, here are a few things to keep in mind:

• Many partial UCL tears can be managed without surgery, so it's important to respond early. 

• Minor UCL tears may be more common than you think. Some studies have shown that up to ~50% of professional pitchers have asymptomatic partial UCL tears.

• If you do have a UCL tear, how to proceed depends entirely on the type and location of the tear. This is best evaluated by an elbow orthopedist, who can determine if your particular injury can be managed with physical therapy and rest, or if surgery is your best option.

   

THIS BLOG IS NOT A SUBSTITUTE FOR MEDICAL ADVICE. CONSULT YOUR HEALTHCARE PROVIDER IF YOU SUSPECT YOU HAVE AN INJURY.

Are you a pitcher or baseball player experiencing elbow pain? Get evaluated by one of our Massachusetts Physical Therapists at Move Strong PT. Click HERE to get started!