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Throwing To The Breaking Point: Elbow Pain In A Division 1 Pitcher - Page #1
 

Author: Jessica Nelson, DO, MBA
Co Author #1: Jessica Nelson, DO, MBA
Co Author #2: David Olson, MD
Co Author #3: Chris Ashton, MS, LAT, ATC
Senior Editor: Justin Mark Young, MD, FAMSSM
Editor: Chelsea Cole, MD

Patient Presentation:
Patient is a D-I 18-year-old left-handed male pitcher who initially felt left elbow pain in March of 2024. Pain onset gradually with no associated trauma. Pain persisted and worsened in June of 2024 when he felt a "jolt" of pain near the lateral elbow while warming up for a game. He was initially seen at an outside facility where an XR and MRI were obtained and they did not reveal any acute abnormalities. Patient was then referred to physical therapy. The patient then began college with ongoing intermittent posterolateral pain which worsened with ramping up throwing activities. He was seen in clinic December of 2024 and a new MRA did not identify any internal derangement. It was recommended he continue with his rehab plan and progression to throwing under his athletic trainer. Patient was throwing mid-January of 2025 when he felt a sharp, painful pop about the elbow with ball release. X-ray images were obtained at that time showing an acute fracture of the olecranon.

History:
No past medical history.

Physical Exam:
Vitals within normal range.

Cervical spine: Normal range of motion. No radiculopathy.

Left shoulder: intact skin, no deformities.
Active range of motion 170/80/90/T10.
Rotator cuff strength 5/5/5/5. Flexion/extension/pronation/supination.

Left elbow: moderate effusion. Tenderness at the olecranon. No other bony tenderness. Range of motion limited to 10-130 degrees of flexion, compared to 0-145 on the right. Full pronation and supination. Ulnar nerve stable without subluxation on exam. Negative elbow flexion and Tinel's testing. Unable to tolerate varus and valgus stress testing. Distal biceps and triceps intact. Neurovascularly intact.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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