Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Throwing Injuries

What are Throwing Injuries of the Elbow?

Throwing injuries typically occur in players with poor body form or those who do not allow enough time between sporting activities to allow their bodies to heal.

Common injuries include ulnar collateral ligament tears, flexor pronator muscle strain or tendonitis, valgus extension overload, olecranon stress fractures, and osteochondritis dissecans of the capitellum.

Types of Throwing Injuries

Repetitively throwing objects makes it possible to overwork your elbow and the muscles supporting it. While it’s possible for anyone to sustain these injuries, they are most often linked to throwing balls, such as pitcher’s elbow.

Repetitive throwing movements can cause:

  • Flexor tendinitis: A condition where the tendons at the inner elbow (medial epicondylitis) or muscles in the front of the forearm become strained or torn.
  • Ulnar collateral ligament injury: A condition where the UCL, an elbow ligament on the inner side, has large or small tears.
  • Valgus extension overload: A condition where the humerus and the elbow are pushed against each other and summarily wear the cartilage down, causing bone spurs.
  • Olecranon stress fracture: A bone fracture that results from overuse impact behind the elbow.
  • Ulnar neuritis: A condition that develops when the ulnar nerve is stretched too many times, causing inflammation and sensory and motor deficits in the wrist and hand.
  • Medial apophysitis : Sometimes called Little Leaguer’s elbow, this condition is caused by repetitive throwing that pulls on the tendons and ligaments at the inner aspect of the child’s growing elbow, damaging one of the growth plates and wearing the bone.
  • Osteochondritis dissecans : This condition occurs when bones are pushed together repetitively and the cartilage and underlying bone become damaged and sometimes loose.

Characteristics and Clinical Presentation of Throwing Injuries

In many cases, different throwing injuries have similar symptoms. This is why it is so important to be seen by a specialized hand surgeon so that you can be assured that you are receiving a correct diagnosis and an effective treatment plan.

Common characteristics and clinical presentations of throwing injuries include:

  • Inner elbow pain
  • Forearm pain
  • Wrist pain
  • Pain while shaking hands
  • Limited range of motion
  • Weakened grip
  • Numbness and weakness

Causes of Throwing Injuries

When throwing, force is centered on your inner elbow, causing the muscles around the elbow to fatigue. This may result in other injuries such as torn tendons, stretched ligaments and nerves, or cracked bones and cartilage.

Overuse of your elbow and repetitive motions that strain the joint are the cause of most throwing injuries. However, the entire kinetic chain from the ground up has to be part of the analysis.

Getting a Diagnosis for Throwing Injuries

Most throwing injuries are diagnosed from a limited range of motion, pain, or tenderness isolated to specific areas. X-rays or MRIs may be ordered to delineate the injury.

Pain may be intermittent, leading players to believe the injury resolved on its own. However, this may or not be the case and you should always see a surgeon to assess the damage and its causes.

Treatment Options for Throwing Injuries

As often as possible, Dr. Jason Pruzansky and Dr. Mark Pruzansky prioritize conservative treatment measures to surgical ones. This is due to the fact that most injuries can be healed through conservative methods like physical therapy and modified intensity and rest.

Conservative Treatments

Typically, throwing injuries can be treated with rest, not using the elbow, or with gentle physical therapy. Splits or slings may be recommended to rest the arm until the injury is resolved.

Sometimes, patients may be recommended to temporarily rest their arm following an injury, undergo treatment and cause analysis, then resume sports related rehab and a gradual return to sports. The R.I.C.E method is also helpful:

  • Rest : avoid strenuous use of your elbow while it is healing.
  • Ice : use an ice pack episodically for 15-20 minutes a day.
  • Compression : compression bandages can help reduce acute swelling.
  • Elevation : keep your elbow above your heart to reduce swelling.

Surgical Treatments

The specific surgical procedure required for throwing injuries depends on the injury.

However, the most commonly performed surgeries performed in throwing injuries include medial collateral ligament reconstruction and arthroscopic debridement.

Preventing an Injury from Throwing

In order to try to prevent injuries from happening, you should take the following preventative steps:

  • Rest your arm after sports activities and protect the elbow
  • Maintain proper body form when playing sports
  • Ensure your sports conditioning is adequate
  • Monitor the duration of pitching episodes

Prognosis for Throwing Injuries

In most cases, the prognosis for throwing injuries to the hand, wrist, and elbow is good.

Depending on the type and severity of the injury, and the type of treatment recommended by the surgeon, recovery periods may range from a few weeks to more than a year. However, most patients are able to return quickly to their daily routine.

If You Believe You Have a Throwing Injury, Contact HandSport Surgery Institute.

Please contact us as soon as possible to schedule an appointment with our talented  team. People who have been hurt while throwing an item should be evaluated to try and prevent further injury and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.