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In this day & age of Tommy John, parents & kids are understandably concerned about elbow health, but is there such a thing as too cautious?

There is a kid on my team who doesn't pitch, who experienced elbow pain/soreness for the first time after practice last week.  Then again Saturday during & after practice it was sore.  Right exactly in the area of the UCL which freaked him out a bit and freaked his Dad out more.

No swelling, no restriction in range of movement, but sore.  2 days later the area is completely pain free.  But I suppose the key is to see how he feels next time he throws

Dad wants to schedule a Doctors appointment right away.  I would never get in the way of what a parent thinks is best if they are being cautious.

What I told the Dad is that the kid should be 100% pain free when he throws, period.  

My question for you guys is:  do we take our kids to a Doc every single time an elbow gets sore?

I recommended the Throwers 10 program for the kid.  http://www.ortho.ufl.edu/sites...uts/Throwers-Ten.pdf

Last edited by 3and2Fastball
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How old is the kid? Both of my sons had issue with growth plate irritation in the elbow.  Most people know it as little league elbow and if you read about it causes are listed as over use.  My youngest S would get it after pitching very few innings and definitely not over used.

There are a few different things that can cause discomfort in the elbow and not have to have TJ.  After a few sore elbows we don't go every time, but I would never tell a parent not to go get it checked out if there are questions. Especially if still sore after a day or two. 

MidAtlanticDad posted:
3and2Fastball posted:

 

My question for you guys is:  do we take our kids to a Doc every single time an elbow gets sore?

Not every time, but I would when it's the first time. I would get the opinion of a good ortho who specializes in upper extremities.

Agree. 

While it may be a bit overly cautious the first time, you need to know what you are up against (hurt or injured?). Once you find out, you know what the treatment plan is and how to proceed.

 

Good question.

There is a difference between being sore and being in pain. Best remedy, if there is concern, is a visit to the pediatrician. Ice followed by heat for discomfort.

Give tylenol or motrin do not administer aspirin or aleve unless recommended by a doctor.

Last edited by TPM

I'd go right way to an ortho to have it checked.  They'll do an X-ray to rule out growth plate issues and work from there.  MRI would be next if they suspect ligament issues.  Have them check with there insurance company, as they can usually get a good deal on an MRI.  No harm in ruling out sever damage and starting a rehab program.   

3and2Fastball posted:

Isn't severe damage a fairly remote possibility if it doesn't hurt in the slightest 2 days later.? He was at practice today and I wouldn't let him throw but I pressed right on his UCL area and zero pain.

We arent doctors or should we try to diagnose. 

Again, if there are concerns seek a professionals advice.

3and2Fastball posted:

Isn't severe damage a fairly remote possibility if it doesn't hurt in the slightest 2 days later.? He was at practice today and I wouldn't let him throw but I pressed right on his UCL area and zero pain.

It is possibly an irritated flexor tendon.  Rest and rehab will help.  But you want to rule anything serious out.  

When my son was 14, he broke his elbow at the growth plate on a throw down from catcher to second.  Essentially, the ligament ripped the bone right off at the growth plate on the throw.  He was a little sore before it actually broke, but was able to keep playing (it was in a tournament) with ice.  On the throw down, he felt it pop and that was the end of him throwing for that summer.  We took him to a children's orthopedic dr for the diagnosis and he followed up with 2 months of PT after it healed in a throwing program.  The best guess reason why it broke was due to overuse (he also would occasionally pitch and catchers need to watch their arms just as much as pitchers) and his physical development (i.e. he was 6'1" and his bones hadn't fully caught up with his growth).  In hindsight, as soon as my kid complains of pain, we've learned to check it out immediately.....it's not worth the risk.

blhays9697 posted:

When my son was 14, he broke his elbow at the growth plate on a throw down from catcher to second.  Essentially, the ligament ripped the bone right off at the growth plate on the throw.  He was a little sore before it actually broke, but was able to keep playing (it was in a tournament) with ice.  On the throw down, he felt it pop and that was the end of him throwing for that summer.  We took him to a children's orthopedic dr for the diagnosis and he followed up with 2 months of PT after it healed in a throwing program.  The best guess reason why it broke was due to overuse (he also would occasionally pitch and catchers need to watch their arms just as much as pitchers) and his physical development (i.e. he was 6'1" and his bones hadn't fully caught up with his growth).  In hindsight, as soon as my kid complains of pain, we've learned to check it out immediately.....it's not worth the risk.

I have seen this twice, once from an outfielder once from a pitcher. the tendon or ligament was stronger then the bones...they were both out 6 months or so rehab. pitcher didn't pitch till the following season.

  If this were me I would tell the parents that in my opinion nothing he has done on the field should cause his arm to hurt, either his throwing mechanics are WAY off and or he has a medical issue.  It is not normal to feel any pain after a practice, especially if the kid didn't put in a bullpen session.  Normal routine throws should not cause pain or soreness, it isn't something to work through, and it isn't what the other 13 kids out here have going on.  I'm not a doctor, I would suggest you take him to a medical specialist and then to a throwing mechanic specialist if the doctor doesn't see anything wrong. However, when he is on my field I need him 100% pain free, or i can't play him.

I'd suggest going to see the doctor right away.  

In fall ball last year my son developed a "tight" elbow.  Didn't seem too serious, but it lingered so we shut him down early.  Figured he was going to rest it for almost 3 full months so didn't see a doctor.  During the fall he was very active with band work, pullups and indoor track, which included rigorous weight lifting.  Never felt anything in the elbow.

When he started throwing just after Christmas had the same tightness so we went to an ortho.  Turns out he has a deep bone bruise that is very slow to heal.  Had we known this we would have taken it more slowly in the fall/winter...the doctors think that the weight work has prevented full healing.  He can play in the field but has to limit throwing and probably won't pitch all season.

old_school posted:
blhays9697 posted:

When my son was 14, he broke his elbow at the growth plate on a throw down from catcher to second.  Essentially, the ligament ripped the bone right off at the growth plate on the throw.  He was a little sore before it actually broke, but was able to keep playing (it was in a tournament) with ice.  On the throw down, he felt it pop and that was the end of him throwing for that summer.  We took him to a children's orthopedic dr for the diagnosis and he followed up with 2 months of PT after it healed in a throwing program.  The best guess reason why it broke was due to overuse (he also would occasionally pitch and catchers need to watch their arms just as much as pitchers) and his physical development (i.e. he was 6'1" and his bones hadn't fully caught up with his growth).  In hindsight, as soon as my kid complains of pain, we've learned to check it out immediately.....it's not worth the risk.

I have seen this twice, once from an outfielder once from a pitcher. the tendon or ligament was stronger then the bones...they were both out 6 months or so rehab. pitcher didn't pitch till the following season.

I've seen this twice, too. Both pitchers. One was bad enough to require a screw, the other didn't. In both cases the guys were pitchers, and both are pitching in college right now. Neither has had any further serious elbow problems. In my simple way of thinking, based on two cases, this is a good indication of sturdy elbow ligaments since the growth plate failed instead of the ligament.

Agree with the majority, although I take my son to a really good PT who works with a ton of athletes. If he thinks there is something that requires an ortho...then he will refer. If not, he will treat and prescribe rehab/prehab exercises. I would also caution against referring something like the Florida throwing plan. The exercises are great but if you have an 8th grader going home and doing those on his own, there is a good chance that he could be doing them incorrectly. I work with high school athletes in the weight room daily and all we do is coach movement the entire session. Many of these athletes have been with us for an extended period of time, yet they still need to be reminded about body position and proper technique. Just my 2 cents.

My son had cartilage replacement in his elbow (from knee)  in October. (He's a 2020)

He came home from practice and his elbow was swollen, couldn't bend, etc. He dealt with a  sore arm off and on through traveling ball, but this was different,  He could pinpoint where it hurt.

Ortho said he was probably genetically pre-disposed to get the injury, along with possible overuse.  He's playing school ball now, but needless to say it's always in the back of my mind. 

I would at least get it checked now, if it keeps re-occurring at least you'll  have a starting point.  Just my two cents.

Good luck.

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