I am finally able to throw since my Tommy John Surgery. My doctor took a conservative approach, and I didn't get to throw for the first time until 9 months. I felt really good throwing the first time, and today was the second time throwing. I might have started to throw a little harder than I was supposed to for a couple of throws. Now, I feel some pain in my elbow when i put my arm back in the throwing motion. I know some pain might be common the first couple of times I throw, but I just wanted to get some feedback. I do not have any pain when I try to pronate or supinate my arm. There is a little tightness when I bend my elbow all the way (hand touching shoulder).
Is it common to feel some pain as I progress? Or should it only be soreness/tightness?
Post by Michael Bagwell, PT, DPT, CMPT on May 30, 2017 15:35:47 GMT -6
Elbow pain can occur with return to throwing especially if you think you were throwing hard. You have to remember the throwing program is sub-maximal throwing around 50-60% intensity. It takes time for the arm to develop a tolerance to the stresses of throwing again. The most important thing now is to communicate the response to your PT and rehab staff when you see them next. They will likely evaluate the elbow and determine the best course of action. Typically it is recommended that you take a break from throwing and decrease the intensity of treatment until it is appropriate to resume throwing again and normal treatment intensity. The full course of action is dependent on the severity and the assessment of how you're doing at your next appointment. Try not to worry yourself and stay confident. The throwing program unfortunately isn't always smooth sailing but you've worked hard up to this point. Keep working diligently towards the end goal.
The pain has not gotten any better. I can throw a baseball with low to medium intensity with no problem, but higher intensities bothers it. I visited the doctor and am going to physical therapy at the moment, and I found out my Ulnar nerve is gliding over my elbow. My doctor did not move my ulnar nerve during the surgery. However, I do not have radiating pain down my forearm, which seems to be one of the symptoms of this problem. The pain is very localized on the medial epicondyle, and it is most noticeable when my elbow is at 90 degrees and I press on it.
This pain has been present been before I started throwing. Bicep curls, throwing, and chin ups are the three exercises that I notice bother it the most.
Have you discussed all of these details with your physical therapist? What does he/she say?
It is leaning towards being a scar tissue/tendinitis issue and not a nerve issue, although that nerve does slip over the elbow. The only relief from the pain comes when I or the therapist massages the pain (going across the tendon where it connects at the elbow) for 5-10 minutes. The pain becomes nearly non existent for a rough 10 minutes until it returns. Doing a valgus stress test does not bring any pain unless my arm is bent at 90 degrees. Then there is pain if enough stress is applied. The pain when present is very localized right on the end of the knob on the elbow, and does not radiate anywhere else. The pain spot is smaller than a dime.