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What Causes Elbow Injuries in Baseball?

Feb 21, 2022

While it is not a contact sport, baseball still carries risks for its players. Rather than blunt force trauma or traumatic brain injuries, the most common issues that baseball players face are related to repetitive use or other strain on joints such as the elbow. Pitchers are especially prone to these issues, which develop over time. For any baseball player, it is important to take steps to prevent elbow injuries and work with College Park chiropractors to ensure no damage is done to the body.

About the Elbow

The elbow is a joint in our arms where three bones meet: the upper arm bone (humerus) and the two bones in the forearm (ulna and radius). It is both a hinge joint, which lets the arm bend and straighten, as well as a pivot joint that enables the lower arm to twist and rotate.

On the inner and outer sides of the elbow, thick ligaments called collateral ligaments hold these joints together, preventing dislocation. The ligament closer to the body on the inner side is the ulnar collateral ligament, running from the inner side of the humerus to the inner side of the ulna. It must withstand extreme stress in order to stabilize the elbow during certain movements, like overhand throwing.

The elbow is also a cross-section of many muscles, nerves, and tendons. The forearm and wrist muscles begin at the elbow, while the ulnar nerve in the inner elbow provides sensation to the pinky and ring fingers.

Common Elbow Injuries in Baseball Players

Most elbow problems that baseball players encounter are overuse injuries as a result of the repetitive stress placed on the joint. The inner elbow is particularly susceptible to these issues due to the considerable force concentrated in this area during throwing. The rate of injury is highly correlated with the number of pitches thrown, the number of innings pitched, and the amount of time spent pitching each year.

Flexor Tendinitis

In some people, repetitive throwing irritates and inflames the flexor/pronator tendons where they attach to the humerus. This can cause pain on the inside of an athlete’s elbow during throwing, but in severe cases, they may also experience pain when resting.

Ulnar Collateral Ligament Injury

The UCL, or ulnar collateral ligament, is the most commonly injured ligament for throwers. UCL injuries can range from minor damage and inflammation to a complete tear of the ligament requiring surgical repair. An athlete with a damaged UCL may experience pain on the inside of the elbow and notice a decreased throwing velocity.

Valgus Extension Overload

During the act of throwing, the olecranon and the humerus bone are twisted and forced against each other. When this is repeated over time, it can cause VEO, a condition in which the protective cartilage on the olecranon is worn away. Meanwhile, abnormal growth of bone known as bone spurs may develop. This can lead to swelling and pain at the site of maximum contact in the back of the elbow.

Olecranon Stress Fracture

When a muscle becomes fatigued over time and fails to absorb added shock, it can lead them to transfer the overload of stress to the bone, causing a tiny crack called a stress fracture. In throwers, this most commonly occurs in the olecranon. They may notice an aching pain over the surface of the olecranon on the underside of the elbow. Pain is usually worse during throwing and other activities, though it may be present at rest.

Ulnar Neuritis

When the elbow is bent, the ulnar nerve stretches around the bony bump that sits at the end of the humerus. In a throwing athlete, it is stretched repeatedly and may slip out of place and cause painful snapping. This will ultimately lead to irritation of the nerve and a condition called ulnar neuritis.

The pain associated with ulnar neuritis is often described as feeling like an electric shock that begins in the inner elbow and runs along the nerve, passing into the forearm. It may be accompanied by tingling, numbness, or pain in the pinky and ring fingers. This will occur during or immediately after throwing and occasionally during periods of rest.

Treating Elbow Injuries

It is important to address any elbow injuries as soon as possible, as continuing to throw on an injured elbow can worsen the problem and turn a minor injury into a serious and chronic condition.

In most cases, non-surgical treatment can be used on these elbow injuries. This can be a combination of practices that directly address symptoms and others that aim to prevent further injury. Some treatments include:

  • Physical therapy to restore flexibility and strength
  • Evaluating and adjusting throwing position and technique
  • Anti-inflammatory medications
  • Injections of platelet-rich plasma

If symptoms are not relieved, surgical treatment may become necessary. The exact type of surgery can vary depending on what injury is present and if the person plans to continue throwing. Examples include:

  • Arthroscopy for removal of bone spurs or fragments
  • UCL reconstruction to repair the ligament
  • Ulnar nerve anterior transposition, which moves the nerve to the front of the elbow as a way to prevent snapping and stretching

Preventing Elbow Injury in Throwers

Rather than managing symptoms after the fact, it is ideal for baseball players to adopt techniques and health practices that reduce their risk for injury occurring. The key to this is to never encourage playing “through the pain,” which can allow a minor issue to become a full-blown injury.

It is also important to note that younger players, especially those between 9 and 14 years old, are at greater risk for permanent injury as their bones and muscles are still growing. These players should take extra precautions, especially when throwing curveballs or participating in other sports like golf or tennis.

Physical therapy and chiropractic care can help the body to stay in alignment and function properly, preventing injuries down the line. At AICA College Park, our experts work with athletes to keep their bodies in shape for the future. Make your appointment today!


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