quote:“We took our son to the physical therapist for intermitten pain in his pitching elbow”
How old biologically is your son, not chronologically?
Was the pain at the outside of the elbow (lateral)?
Was the pain at the inside of the elbow (medial)?
Was the pain at the back of the elbow (posterior)?
quote:“the PT said he had some "rotator cuff fatigue" - pitching shoulder was weaker than the other”
This usually means he did a laxity test on him that tells you he actually has a loose shoulder capsule always diagnosed as weakness helped caused by static stretching and overuse by youth pitchers. Always the more used shoulder will actually be stronger but all youth pitchers have this problem to some degree and do not train for shoulder fitness especially “sport specific “ fitness performed by overload training.
quote:"looseness" in his elbow tendon”
This is impossible to determine being that there are many tendons in the elbow and all are life trained differently so you can not cross check the right side against the left side for comparison!! Ligaments determine range of motion not differing tendon length The flexor tendons either micro tear (pain) fully tear (severe pain) or avulse by detaching from the bone (severe pain).
quote:“While we expected a diagnosis on the elbow”
If he has medial pain he is unfit to perform with the pronator flexors to with stand the stress.
The fix is to keep using this muscle group and strengthen them.
If he has lateral pain he was not fit enough to perform a bad mechanic with the supinator flexors. Since you have now said “tennis elbow”also known as LL elbow we now know how he performs his mechanics and how to fix them, read the next paragraph and his pain will disappear.
The fix is to quit supinating all pitches!!!! and quit using this muscle group because it leads to other mechanical problems like slamming ballistically the Olecranon process against the Humeral Fossa (hyper eccentric extension) causing loss of range of motion in both directions, bone spurs and bone chips that are actually later hardened pieces of cartilage that break off and lodge between bone plus this resulting inflammation and pain.
If he has posterior pain he uses his supinator flexors to pitch with that slams two bone at the back of the elbow together, the Humerus and the Ulna.
This can easily be fixed by having him strengthen his pronator flexors in the forearm that attach with tendons at the elbow by voluntarily pronating every pitch he throws and exercising “sport specifically” with wrist weights and iron balls with the correct mechanic. This injury is a direct result of supinating the Curve ball, fastball Cutter or Slider slurve and is entirely mechanical and fixable.
quote:“the shoulder discovery was a surprise”
All kids have this problem and it has nothing to do with elbow problems! If the shoulder was stronger the elbow would have been delivered more stress not less. The ability for the elbow to withstand any amount of stress is mechanical because if you supinate your drive the elbow hyper extends instead of hinges. This is why centripetal mechanics are so injurious at the elbow.
quote:”We have a at home routine and he will be seeing the PT 3x a week in preparation for the spring HS season”
While he is an athlete and over biologically 16 he should never shut down this training.
If he remains with the same mechanic expect a repeat of the same.
quote:”Interested to hear if anyone has experience with a similar condition”
The diagnosis and explanations you were given are typical and do nothing to change the mechanic that is the real problem here.
TPM,
quote:“Yardbird will probably come on and tell you it's for some reason”
If no injuries other than muscle pulls were produced by the traditional pitching motion, I would have no reason to post!
Standballdad,
quote:“The other point here is that a lot of shoulder and elbow issues are a result of poor throwing mechanics.”
This is really the only point! If the mechanic is non-injurious even unfit athletes can perform without problems other then muscle fatigue.
quote:“Might be good idea to go and have pitching lessons from a good instructor to see what is going on”
This will only solidify the problem in that most instructors still teach the destructive traditional centripetal supination mechanics but I must admit things are changing faster now with some? Give it another 5 years and it will be 50/50 guaranteed.