Jock Doc

Pitcher’s pain in elbow may require ‘Tommy John’ surgery

High school pitchers can tear a ligament in their elbow, which would require Tommy John reconstructive surgery.
High school pitchers can tear a ligament in their elbow, which would require Tommy John reconstructive surgery. MIAMI HERALD FILE PHOTO

Q. My son is a pitcher who just injured his right elbow throwing a baseball last week. He is 18 and is scheduled to play in college. He felt a pop, has pain on the inside of his elbow and has not been able to go back to throwing. We went to the emergency room and X-rays showed nothing broken and he was told he had a sprain. It still hurts and he is really concerned. What is his next step to get better?

A. There is an important structure that stabilizes the inside of the elbow, the Ulnar Collateral Ligament (UCL). This is frequently injured in the throwing athlete and can result in pain, weakness and inability to throw with normal velocity. There are other causes of pain on the inside of the elbow such as cartilage damage, a stress fracture or ulnar nerve instability.

I recommend you see an orthopedic surgeon immediately to determine the extent of your injury. An exam of your elbow, X-rays and an MRI scan will likely be needed to establish the diagnosis. If the UCL is torn, then reconstructive “Tommy John” surgery will probably be necessary to return your son to competitive pitching. Recovery takes about a year but most pitchers can return to their previous level of performance.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net.

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