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May 22, 2013, 8:08pm

ASMI Sports Medicine Forum :: Baseball :: Youth & High School Baseball :: Elbow Pain/When to return to throwing?

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Topic: Elbow Pain/When to return to throwing? (Read 864 times)

scottms
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Elbow Pain/When to return to throwing?
« Thread Started on Jun 1, 2011, 8:20am »

I have a son who turned 13 years old in April and is having elbow pain. He just finished the 7th grade and is a catcher on the varsity team (pitches occasionally). Four weeks ago he complained of arm pain during a game and we took him the following week to see an orthopedic doctor who specializes in sports medicine. The doctor took x-rays of both elbows and performed physical exam. The doctor diagnosed the injury as widening of the growth plate (medial apophysitis). The first question the doctor asked was how much has my son grown lately. He has grown 5 inches in the last 8 months or so (currently 5’9”and weighs 160 lbs). He put my son’s arm in a brace and we stopped all activity involving the arm. My son retuned for a follow-up visit to this doctor last week (3 weeks after getting the brace). The doctor examined him (no x-ray) and wants him to start throwing with the brace still on for another 3 weeks. The number of throws is 20 at 30 feet (soft throws) and if no pain increase the distance by 15 feet every other day until 90 feet is reached. Then start at 30 feet again (same program) at greater velocity. He also released him to start weight lifting (upper body work). Also, told him he could start playing again as long as he played on the right side of the field.
I’m concerned about him throwing in this brace since it restricts his throwing motion. Will this cause other issues? Should he be bench pressing with this injury? The doctor has said nothing about any physical therapy. Wanting to make sure he has healed before getting back on the field.

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Glenn Fleisig, Ph.D.
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Re: Elbow Pain/When to return to throwing?
« Reply #1 on Jun 1, 2011, 5:06pm »

Scott,
I think you concerns are reasonable.

Please tell me what brace it is. Many braces would not be goodfor throwing.
Let me know who the doctor is (either here or click on my name and send a private message).
Based upon what you explained, physical therapy is a better plan than weightlifting (bench press, etc.)
Let me know what city you live near and I can recommend someone for a second opinion.

« Last Edit: Jun 1, 2011, 5:06pm by Glenn Fleisig, Ph.D. »

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daque
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Re: Elbow Pain/When to return to throwing?
« Reply #2 on Jun 2, 2011, 7:37am »

When most of the smoke from the acute injury has cleared, it is important to correct the throwing technique flaw that caused the injury. Addressing the injury without addressing the cause of the injury will likely result in a recurrence.

« Last Edit: Jun 2, 2011, 7:39am by daque »

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Glenn Fleisig, Ph.D.
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Re: Elbow Pain/When to return to throwing?
« Reply #3 on Jun 2, 2011, 8:48pm »

Scott,

I received your private message. I also talked to a couple of sports medicine physicians. The plan that you explained below is inconsistent with that of most experts in treating pitching elbow injuries. The typical recommendation for non-surgical treatment is rest (possibly with a hinged brace), followed by physical therapy, and then rehab throwing without a brace. Weightlifting like benchpress is not recommended for baseball pitchers.

I strongly suggest you get a second opinion from Dr. James O'Mara, an expert with these injuries who is also at Misssissippi Sports Medicine. Dr. O'Mara was trained by Dr. Andrews at ASMI. Tell Dr. O'Mara that I recommended him for you.

Something else to consider - once your son is healthy, you can drive 3.5 hours to Birmingham for an evaluation of his mechanics (www.asmi.org/asmiweb/evaluation%20options.htm).

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Glenn Fleisig, Ph.D.
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Re: Elbow Pain/When to return to throwing?
« Reply #4 on Jun 3, 2011, 10:46pm »

scottms,

I got your message that Dr. O'Mara only does knees and you are willing to drive to see the right person. I think it is time to make an appointment to see Dr. Dugas or Dr. Cain at Andrews Sports Medicine in Birmingham (www.andrewscenters.com). They are the best; if it were my son, I would make the car-ride and get to the bottom of this. If you do make an appointment to come to Birmingham, be sure to tell them that you want time to meet with our physical therapy too.

Finally, if you are coming, be sure to let Becky Bolt (, 205-918-2116) and me () know. Even though your son is in no condition for a 100% pitching evaluation, you should come by the lab (next door to Andrews Sports Medicine), meet us, and see the facilities.

I will be out of town next week, so please communicate with the others while I am gone.

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