21 years old male Baseball pitcher for local university came in to be treated today. Patient says last summer I was able to throw the ball at 95 miles per hour, now for the past 4 months I have dropped to 85 miles per hour and it is painful when I throw. His past medical history is unremarkable and he is otherwise a very athletic male and very healthy. Essentially unless he plays the American past time , he has no discomfort, hence no need for medications. He is some what concerned since next year is time for drafting for MLB (Major League Baseball). He has brought with him the result of MRI which shows possible tear at the level of Ulnar- Collateral ligament.
Discussion: Tear of ulnar collateral ligament is a very common problem with Baseball Pitchers. The ulnar collateral ligament (UCL) of the elbow is very important since it stabilizes the elbow. This ligament about inch long supports the inside of elbow In fact this Ligament is the primary stabilizer of elbow. As such, the UCL plays an important role in most throwing sports, repetitive overhead activities can certainly contribute to chronic pain (pain lasting more than 3-6 months). Patient typically complaints of Medial elbow tenderness and swelling. In severe cases Loss of range of motion (ROM) is occasionally seen, and sometimes Pain may be reproduced on making a clenching the fist. MRI and Ultrasound can help with diagnosis, unless the problem is very severe X-Rays do not play a role, but it may be important for differential diagnosis (to rule out a fracture). Physical therapy may play a role, but it may take up from 6 months to 1 year for complete healing, which produces a predicament for these patients who want to go Pro since they need to contentiously train, which in turn disrupts the healing process. Athletes in sports such as baseball and javelin, as well as racquet sports and ice hockey are especially prone to this condition.