Beyond the Bruise: Identifying and Treating Stress Fractures in Your Throwing Arm

David Lintner, MD, is one of the nation’s leading sports medicine specialists, with extensive experience treating throwing-arm injuries in baseball, softball, and other overhead athletes. 

At his practice in Houston, Texas, he combines advanced diagnostics, athlete-specific rehabilitation, and, when needed, expert surgical care to restore performance and protect your arm.

Bone bruises vs. stress fractures — what’s the difference?

When an athlete complains of arm pain after throwing, it could indicate myriad issues, including pulled muscles, strained ligaments, and joint problems. 

Two of the most common possibilities are bone bruises (bone contusions) and stress fractures. While they may feel similar, they have different implications, healing timelines, and treatment plans.

Characteristics of a bone bruise:

• Caused by a traumatic impact or compression of the bone 
• Involves bleeding and swelling within the bone, but no crack line or full break
• Usually heals in 4-8 weeks if properly rested and managed

Characteristics of a stress fracture:

• Caused by repetitive overload, repeated high-velocity throws, or improper mechanics 
• A tiny crack in the bone due to fatigue outpacing the bone’s ability to repair itself
• Often slower to heal, requiring a more deliberate return-to-throwing plan 
• Sometimes requires imaging beyond standard X-rays

Because symptoms overlap, distinguishing the two matters. Dr. Lintner uses a combination of clinical exam, imaging (MRI or advanced scans), and your athletic history to determine what you’re facing.

How stress injuries happen in the throwing arm

Throwing places enormous repetitive stress on your arm, especially your elbow, forearm, and upper arm. Here’s why:

1. The rapid acceleration and deceleration phases generate sustained loads on the humerus and elbow. 
2. Fatigued muscles stop absorbing force properly, so more load shifts to bone or joint structures. 
3. Subtle changes in your mechanics, workload increases, or inadequate recovery can tip a “bruise” into a stress fracture.

In athletes, common sites include the tip of the elbow and the distal humerus shaft.

Signs you might have more than a bruise

If you notice any of the following while throwing, it’s smart to have Dr. Lintner take a look:

• Pain that starts gradually and worsens with throwing rather than after a specific blow
• Tenderness over the bone (not just the soft tissue)
• Pain that continues at rest or with less activity than usual

Bone bruises typically respond to rest and modification, but stress fractures require more structured intervention to prevent escalation or worse return outcomes.

How Dr. Lintner treats your throwing arm and your road to recovery

As past President of the Major League Baseball Team Physicians Association and a member of the Baseball Commissioner’s Medical Advisory Committee, Dr. Lintner understands how to identify and treat throwing arm injuries. 

As a former athlete, he knows what you’re going through and how important your recovery is.

After assessing and diagnosing, Dr. Lintner creates a plan based on your injury, sport, and level of play. Here’s what you can expect:

• A detailed evaluation OF your throwing mechanics, workload, and arm fatigue factors
• Imaging and diagnostic work-up to differentiate bruise vs. stress fracture
• A throwing program with graded load, arm strength work, and mechanics correction
• If needed, advanced treatments such as minimally invasive surgery
• Post-return monitoring to ensure you’re safe to ramp up and protect your arm long-term

Because Dr. Lintner focuses on athletes and overhead motion, the plan is about optimizing your arm for performance, reducing re-injury risk, and getting you back to your sport.

Don’t ignore arm pain 

If you’re dealing with persistent arm pain or fear that the “bruise” in your arm might be something more, now is the time to act. The sooner you’ve evaluated whether it’s a stress fracture, the better chance you have of returning to full strength.

Contact David Lintner, MD, in Houston today or book your consultation online to get an expert throwing-arm assessment, imaging, and a custom recovery plan that keeps your arm ready for the season ahead.