Injuries to the elbow in your pitching arm are common at all levels of play, from Little League to Major League Baseball. In fact, pitchers were injured at an alarming rate in the early days of the pandemic thought to be due to stops and starting in training and a later-than-usual season.
David Lintner, MD, has served as Team Physician for the Houston Astros since 1994. He’s treated and prevented hundreds of elbow injuries at our Baytown and Houston, Texas, Houston Methodist Orthopedics & Sports Medicine clinics, in athletes of all levels.
If you have recurring elbow pain, you’re at risk for a serious injury that could take you out of the game for months — even permanently. This can be a warning sign that something could or has gone wrong. Even though Dr. Lintner is an expert at Tommy John reconstructive surgery, he encourages you to treat your elbow pain now to prevent future complications and re-injuries.
Heal the cause of pain
Your recurrent elbow pain could be caused by damage to any of the ligaments, tendons, muscles, and bones that control your complex elbow joint. If you are still growing, it could be your growth plate undergoing a stress fracture. The first step to getting relief from pain and getting back into the game is to undergo a thorough exam, which includes an evaluation of your pitching technique, imaging studies, and a physical assessment of not just your arm but your core, thoracic spine, leg strength and balance. At Houston Methodist we have developed a proprietary Throwing Readiness Inventory © that allows us to assess whether an injured athlete is physically ready to resume throwing or if doing so would pose a heightened risk of injury.
The most common causes of injuries in pitchers’ elbows vary by the age of the pitcher. Adolescent pitchers are most likely to injure the bony growth plates on the inside of their elbow, a condition known as medial epicondyle apophysitis. Adolescents can also develop osteochondritis dissecans with pain on the outer “lateral” side of the elbow. These can be treated without surgery if caught early. If left untreated, however, they may require surgery.
Older athletes may experience:
- Flexor tendinitis
- Ulnar collateral ligament injury
- Valgus extension overload
- Olecranon stress fracture
- Ulnar neuritis
To stop pain, subdue inflammation, and encourage healing, Dr. Lintner may prescribe several therapies. He may inject injured tissues directly with cortisone steroids or a biologic preparation such as PRP. Platelet-rich plasma (PRP) therapy uses a concentrated serum made from your own blood to stimulate healing and tissue rebuilding. If necessary, I recommend this be done under ultrasound to ensure it is injected at exactly the right location.
If you’ve stretched or torn a ligament, tendon, or muscle, or if you have a hairline fracture in your elbow joint, you may need to undergo surgery to repair the injury and reduce the risk of recurrence. In addition to Tommy John surgery, Dr. Lintner may remove bone fragments or repair injured tissues through minimally invasive arthroscopic surgery. Also, a newer surgery is emerging as a viable option for a particular type of UCL injury. For the right patient, this “Primary Repair with Internal Brace©” can shorten the recovery time by 50%! However, it is only recommended for those with a very specific type of UCL tear, so it is not appropriate for all (or even most ) UCL injuries. This is something to discuss with Dr. Lintner.
Strengthen your elbow and foundation
Physical therapy should be part of any athlete’s regimen. If you have recurrent pain or injuries, working with a physical therapist is more important than ever. By strengthening and increasing flexibility in the muscles and tendons in your elbow, shoulder, core, and spine, you reduce the risk of injury. We have multiple therapists who are specialists in treating throwers and optimizing your foundation for throwing at your best.
Improve your technique and prepare for your season
The way you throw may increase your risk of injury. Dr. Lintner can facilitate an evaluation of your throwing technique and makes recommendations to improve your body mechanics to reduce the risk of injury. He also conducts rehab labs that allow you to gradually recover full range of motion and strength after surgery.
In addition, Dr. Lintner recommends pre-season training that includes a graduated throwing program to build up your strength and power but is not a substitute to whole body conditioning.
The pre-season graduated throwing program is for athletes who are not currently injured. The program helps prevent future injuries, including recurrences of past injuries. Prepare for your season! Prepare to excel while remaining healthy.
If you have elbow pain or need Tommy John or other elbow surgery or rehabilitation,
contact our office nearest you in Houston or Baytown, Texas, for an in-depth evaluation, diagnosis, and treatment today. Call our friendly staff or schedule an appointment online.