Valgus Extension Overload, also known as Pitcher’s elbow, is a condition characterized by posteromedial elbow pain related to repetitive microtrauma in throwing athletes. In children, this presents as medial epicondyle apophysitis and Little League elbow. It is a painful repetitive-use injury that occurs in both adults and children. It can usually be managed by conservative treatments but sometimes requires surgery.
What Is Pitcher’s Elbow?
Pitcher’s elbow, or baseball elbow, is a repetitive motion injury that affects the inner elbow. It occurs mostly in people who regularly perform overhead throws.
“Pitcher’s elbow is a common overuse injury among baseball pitchers or really any sport where you use repetitive overhead movements. The repetitive throwing motions can lead to inflammation and pain on the inner side of the elbow. Rest, learning proper overhead mechanics, and physical therapy are essential for recovery, and early intervention is key to preventing long-term damage to the elbow joint,” says Dr. Christopher Houdek, Sports Medicine surgeon at EmergeOrtho.
What Are the Symptoms of Pitcher’s Elbow?
Pain is the most common symptom of a pitcher elbow injury, which often occurs during and after overhead throwing. Pitcher’s elbow pain may run down the arm to the wrist. There may also be some numbness or tingling in the arm. People with this injury often find they cannot throw as fast as they previously did.
What Causes Pitcher’s Elbow?
Pitcher’s elbow results from the repetitive stress put on the elbow during overhead throws. It is the most common of baseball elbow injuries.
Pitcher’s elbow occurs in professional baseball players but can also occur in amateur athletes and young baseball players. One of the biggest risk factors is the amount of pitching. The risk increases with the total number of pitches per game, innings per season, and months of pitching per year.
While it is mostly associated with baseball, this injury can also affect softball, tennis, volleyball, and football athletes, as well as swimmers and javelin throwers in track and field.
Is Pitcher’s Elbow Preventable?
If you play baseball recreationally or have a young pitcher in the family, it is important to understand how to prevent or reduce the risk of this painful injury. Limiting the number of pitches is one of the best ways to lower the risk. If you have a young pitcher, use the MLB’s Guidelines for Youth and Adolescent Pitchers to ensure they are not overdoing it.
Other preventative measures include strengthening supportive muscles used in pitching, improving shoulder flexibility, and warming up adequately before pitching. It is also a good idea to include plenty of recovery time between pitching and to avoid pitching with a sore elbow.
Overhead-throwing athletes should also include elbow-strengthening exercises. These are best guided by a professional trainer or physical therapist and may include biceps curls, wrist flexor roll-ups, external and internal rotation of the elbow with a resistance band, and weighted wrist pronation and supination.
How Is Pitcher’s Elbow Treated?
Treatment for a pitcher’s elbow injury usually begins with rest. If rest is not adequate, an orthopedist will typically recommend nonsurgical options like bracing, injections, pain medications, and physical therapy. Exercises and stretches for pitcher’s elbow can help the elbow recover from injury and manage pain.
If pain continues, arthroscopic surgery may be required.
How Long Does It Take to Recover From Pitcher’s Elbow?
Recovery through rest and conservative treatments can take weeks or months. It all depends on the individual and the severity of the injury.
The initial treatment usually consists of 2 weeks of rest followed by a throwing therapy program. However, this may go on for weeks if symptoms do not improve.
Recovery from surgery requires rest, the use of a brace or sling, and structured physical therapy. Many patients can begin physical therapy within a few days. They may need to wear a brace for six weeks or longer.
While it is not ideal to get this injury, the many cases of pro players who overcame it provide hope for amateurs and young athletes. With the right treatment, pitcher’s elbow does not have to end a sporting career.
Evaluating and Treating Elbow Pain
According to Dr. Houdek, “It’s important that if you have pain in your elbow, you don’t ignore it. Seeking out an expert evaluation and treatment can help you recover faster and also ensure you don’t injure yourself by pushing through the pain.”
Our orthopedic elbow specialists and sports medicine providers will examine your elbow, listen to your symptoms, and use imaging tests to diagnose a condition and suggest treatment options. Learn more about pitcher’s elbow and contact us online to request an appointment with an EmergeOrtho-Foothills Region orthopedist.
