According to the American Academy of Orthopaedic Surgeons, or AAOS, it's common for doctors to treat increased numbers of baseball players each spring as baseball season begins. Along with shoulder injuries, elbow problems are one of the most common complaints of ballplayers of all ages. The Medco Sports Medicine website states that injuries in professional or collegiate baseball players may be the product of years of repetition and overuse.
Medial Apophysitis
The AAOS states that medial apophysitis, also known as Little Leaguer's elbow, is a common elbow problem in young ballplayers. Pitching or repetitive throwing places significant stress on the elbow tendons and ligaments, especially on the medial or inside aspect of the elbow. According to the Hughston Clinic, a Columbus, Ga.-based sports medicine clinic treating musculoskeletal injury and disease, young ballplayers who develop Little Leaguer's elbow may experience a worsening ability to throw the baseball, often followed by pain, elbow joint swelling and an inability to straighten the elbow. Tenderness on the inside of the elbow is common. The symptoms associated with Little Leaguer's elbow may worsen if pitching or throwing are not temporarily discontinued. One of the more serious aspects of Little Leaguer's elbow is the possibility of damage to the growth plate on the medial side of the elbow, including stress fractures and complete fraction with avulsion--the ripping away of a bone fragment from its attachment--and bone displacement.
Older baseball players, especially pitchers, may suffer a similar injury called ulnar collateral ligament injury. A procedure known as ulnar collateral ligament reconstruction, or Tommy John surgery, can correct the problem. According to a 2003 article published online by USA Today, about one out of every nine big league pitchers has had Tommy John surgery.
Osteochondritis Dissecans
According to the AAOS, a less common, yet no less serious condition that develops on the lateral or outside aspect of a ballplayer's elbow is called osteochondritis dissecans, or OCD. The Hughston Clinic states that repetitive throwing generates compressive forces on the lateral aspect of the elbow that can unfavorably alter the blood supply to the elbow's articular or joint cartilage and underlying subchondral bone, resulting in OCD. Loss of blood flow causes the subchondral bone to die, in a process known as avascular necrosis. OCD typically affects 10- to 14-year-old ballplayers. A ballplayer with OCD may notice loss of elbow range of motion, especially extension, swelling and joint locking. X-rays are a helpful tool in cases of OCD, as they can definitively diagnose the underlying problem. According to the Hughston Clinic, conservative treatment of OCD in ballplayers involves discontinuation of sports and immobilization of the injured area. Range of motion exercises are appropriate for those players in which the affected bone segment stays in its usual location and no evidence of bone fragments is detected inside the joint.
Avulsion and Stress Fractures
Along with the medial and lateral aspects of the elbow, the posterior or back portion of the elbow is also exposed to significant stress during the overhand throwing motion. Like the medial side of the elbow, the posterior side is susceptible to injuries such as stress fractures and avulsion fractures. If such an injury occurs, a ballplayer may report pain or discomfort in the back of the elbow and elevated pain when trying to extend the elbow against resistance. According to The Hughston Clinic, X-rays of the problematic area may reveal a widening or fragmentation of the growth center. The typical treatment for avulsion and stress fractures includes immobilization of the injured segment until the patient experiences a resolution of their pain and tenderness. If the bone fragment drifts away from the bone, surgery may be necessary to re-approximate the fracture fragment.
Member Comments