arm issues

A quick Google search pulled up a Dr. Patrick J Fernicola from the Hughston Clinic. According to your location, that's in town for you. (229) 276-0107.

You may start there and see. Otherwise, you may start looking toward Columbus or Tallahassee..

Go to this site - ASMI:

http://asmiforum.proboards.com/index.cgi?

Ask on the board. These guys are the premier health care facility for baseball related injuries. They are headquarted in Birmingham, AL so you can go there if you want, or they will be able to recommend you a doctor close to where you live with the credentials you want out of a doctor for baseball related problems.

Good luck.

I do beleive that Andrews has a clinic on the west coast of FL in the panhandle?

The Andrews Institute is an option, within driving distance. I recommend it to anyone on the face of the earth that can get there. Its a one-of-a-kind facility.

https://maps.google.com/maps?s...dre&t=h&mra=prev&z=8

Obviously Dr. Andrews does absolutely fantastic work. He's the best of the best no doubt in baseball arm injuries. But I have a difficult time referring somebody to travel 4.5 hours to see him for something that isn't a surgical case.

Let me describe this from the medical office aspect of it. I was actually in on a conversation today with a PA from one of the orthopedic surgeons we work with. They moved to a new clinic back in May and he said they are still having scheduling problems with the schedulers identifying which patient should be seeing the PA and which one should see the surgeon. If it's a clear surgical case, obviously patient needs to see the surgeon. But in this particular case if it's a chronic knee pain in an elderly patient, all they'll do is inject it and if that doesn't fix it, refer to another surgeon.

From my standpoint as an athletic trainer, I'm going to first recommend seeing a local sports medicine doctor. I have enough faith in them that they are going to be able to either treat the injury or identify when they can't treat it and then we can collectively refer to a specialist for that particular injury.

Now going the long way about it here's my thoughts on this particular case...

15 year old with arm pain that is "getting better but slowly." That to me does not jump out as "let's do surgery!" so I'm not going to waste the time driving nor am I going to waste the time of the highly sought after expert yet. First thing he's going to do is order an MRI if he believes that's warranted. Well guess what, your local orthopedic or sports medicine doctor is going to do the same thing. Get the MRI if warranted and then listen to what they have to say. If you then want to get the opinion of Dr. Andrews, you are more prepared to do that and he's going to be able to better address it right away...

If you're in the medical field treating others, I think it's a little easier to have a more distant view. As a father with a child that needs medical attention, I think you view it differently. If there's a specialist available to help that has the respect and credibility of Dr. Andrews, it would be hard for me to say a short drive like that to get the best advise available isn't worth the trip. But doing that as a second opinion (if you plan to get 2 opinions regardless) isn't a bad idea.

Tx-Husker, I completely understand what you're saying and I can't really disagree with you. BUT to realize you may travel all the way down there (4+ hours is a pretty long trip IMO) to be seen for only a few minutes and likely have to return to really get answers seems strange to me.

Earlier I mentioned a physician out of the Hughston Clinic. The Hughston Clinic is actually based out of Columbus but it appears to have some offices spread throughout Georgia. The Hughston Clinic is not as well-known as the Andrews Institute, but they are a big sports medicine and orthopedics name as well. One of its founders actually has a few orthopedic special tests named after him.. something Dr. Andrews does not have..

I don't disagree. I like the idea of getting two opinions with Andrews being the second.

Andrews was my third opinion. The secretary I spoke to on the phone informed me that if the school sent a copy of my MRI directly, Dr. Andrews would evaluate it. I didn't actually meet him until my pre-op appointment.

I'm certainly not saying he is the be-all and end-all option, but he was incredibly accommodating to me as a New York resident and is the top of the top in the profession.

Good gracious folks. Everyone doesnt need to see Dr Andrews for a little arm soreness. Come on.

Just find a good local sports doc for a first look.

younggun-

My son was diagnosed with growth-plate issues as a 14 year old and a sprained UCL as a 16 year old. We sought out local sports physicians in both of these cases, and to be honest, his arm never felt like it was 100%. Fastforward three years later, he's 19, and he just had TJ surgery this past Monday. We chose a surgeon from the Kerlan-Jobe Clinic, it wasn't local, but we wanted it done right.

Take care of your son's arm. If you need to drive 4.5 hours to seek advice from the best, do it! There's also a very good possibility that you can receive a referral from Dr. Andrew's Clinic to a colleague's office in your area? It's certainly worth a try...good luck to your son.

thanks to all for your advice. i have an appt scheduled on monday pm with a local orthopoedic. once he examines son's elbow, we will proceed with his recommendations. depending on the severity of the problem, we very well may head over to birmingham to consult with dr. andrews. i don't want to put the cart before the horse, so to speak, but i also don't want to put off an issue that could get worse over time. after reading JH and bsbl247 stories, i am even more inclined to be safe rather than sorry.

younggun- Just as a note, Dr. Andrews is predominantly based in Pensacola now. As far as I know he's only in Birmingham once a week.

Good luck, hopefully its nothing.

as an aside, son just found out that he was selected to the mid atlantic team USA as a OF/P. this was very unfortunate timing to say the least. like i told my son, God is in control and things will work out for the best. hopefully it is just a sprain that will heal with rest. we are praying that surgery is not required.

JH thanks for that information. Pensacola is not really an issue as far as distance is concerned.

YG,

Let us know how it goes for your son on Monday...I'm hoping for the best for him.

Well unfortunately we received the news I feared but deep down expected. Son has a partial tear to his UCL. Local orthopeodic has referred us to see Dr. Andrews. We are in the process of setting up the appointment. As a dad, I am struggling with did I do something wrong? I always tried to be conscious of pitch counts and limited his innings when he was younger. I always coached him, not because I was an expert, but mainly because I was afraid no one else would be as concerned with his health as I was. Now I find myself wondering where did I go wrong. Son is handling the situation okay as we just found out a few hours ago. Obviously he has lots of questions, most I don't have answers for. The look on his face when he got the news broke my heart. He is struggling because he has no pain. Even during the physical with the MD, there was very little discomfort. I know there are many who have gone through this same ordeal, but trust me it's completely different to read someone else's account than it is to go through the process yourself. Sorry to be so long-winded. Now the long, difficult procedure begins. People like JH that have experienced this are very helpful, even if they don't know it and are complete strangers.

Sorry to hear that, hope your son will have a speedy recovery with or without surgery. Unfortunately, there is no way to know without looking at the rearview mirror. If you don't mind sharing your experiences with others, what is his pitch count per week, does he pitch all year round and what type of pitches?

quote:

Originally posted by bball123:
Sorry to hear that, hope your son will have a speedy recovery with or without surgery. Unfortunately, there is no way to know without looking at the rearview mirror. If you don't mind sharing your experiences with others, what is his pitch count per week, does he pitch all year round and what type of pitches?

Since January 2012, son has pitched approximately 50 innings I guess. He threw 23 innings during school ball which ran late Feb thru the end of April. Our school plays "summer ball" during the month of June. This is the only time there was, in my opinion, an issue with "overuse". Our "brilliant" coaches would run out the pitcher for 7 inning complete games. This was not just my son but whomever pitched. The problem was I was unable to attend most summer games because they were played in the mornings or early afternoons. On the one occasion I did make a game, after the game I was headed to the dugout to talk with the coach when my son stopped me. He didn't want me to confront the coach. He told me his arm was fine. I tried explaining to him that the arm issues may not show up now but possibly could in the future. I sent him to the coach to get a pitch count, and the coaches' reply was that he threw less than 100. To me, this meant the coach didn't know his count. I'm generally he type parent that is seen but not heard, but after three games that followed this pattern I felt it necessary that I confront the coach to protect my kid. Son asked me not to so I didn't. After a lengthy conversation, he and I agreed that he would remove himself from the game if this issue came up again. While to many this may not seem the best way to handle the situation, all I can tell you is that not all coaches are approachable nor are they all interested in parents' opinions. This is precisely why I had kept my mouth shut up until this point. In his next outing, son told coach his arm was hurting after 3rd inning. The coaches response was to sit him defensively for the remainder of the game as well as the second game of the double header. I tried to see the positive in that they were protecting him, but I'm not sure this was the case because the pitcher in game 2 removed himself after 4 innings and was put at ss. Go figure. I kind of digressed but I wanted to give everyone an accurate description of how we got to this point. He started with his summer team in July and threw 10 innings in 3 appearances from July through the injury two weeks ago.
As far as types of pitches, he throws a 2 and 4 seam fastball, curve and change up. He didn't start throwing curve balls until age 14. He threw a "palm all" for a change up until he could grip a circle change. Interestingly enough, the coach he played for from age 12-14 basically kept him in CF. He probably didn't throw 30 innings over those 2-3 years. I really don't see overuse as a problem. The injury occurred during a try-out from the outfield. Sorry the reply was so long but I hope this helps give a glimpse into our situation.

I'm sorry that I didn't give you pitch count information. I truly don't know what the pitch count was during the regular season because his 9th grade coach seemed to have a much better appreciation of pitch count. Son pitched every Saturday game during he regular season. He would tend to pitch 5-6 innings which would put him in the 75-85 pitches thrown based on the type pitcher he is(very good control and a hard thrower for his age). Also of note, the pitchers threw bullpens during season but mysteriously no bullpens nor throwing between starts during the month of June "summer ball".
His summer coach basically shut all the pitchers down at 75-80 pitches and kept kids on 4-5 days rest depending on number of pitches thrown.

YG,

I will be hoping for the best for your son. I certainly don't want to give you any false hope, but the first ortho that my son saw diagnosed a partial tear, and I'm convinced now that he was mistaken. He used the standard valgus stress test and an MRI with contrast.

This was at the end of 2015's 13u season. I did more research and found a highly regarded doctor in our region who had a different opinion. He saw it as a strain. After 8 weeks of very specific stretching and exercises, son was able to start a throwing program (that was about 9 months after the injury). We're now 2 years out; he still doesn't pitch, but he does catch and the elbow is doing very well.

Again, your son's condition may be very different, but I'm hoping for the best for him.

The video link below may be helpful for some who are wondering if their son could be heading for an injury. Pay particular attention to internal and external shoulder rotation. Dr. Andrews and others use the term kinetic chain. I believe the thinking is that out of balance bio-mechanics contribute to injuries. Have your son stand and face the wall. Do his shoulders look symmetrical? If not, throwers' exercises and stretching can bring things back into balance. I'm not trying to play doctor, just trying to give people an idea of what orthos look at.

Throwing shoulder exam Dr. Hawkins
http://youtu.be/KJHe7reTNsE

quote:

Originally posted by MidAtlanticDad:
YG,

I will be hoping for the best for your son. I certainly don't want to give you any false hope, but the first ortho that my son saw diagnosed a partial tear, and I'm convinced now that he was mistaken. He used the standard valgus stress test and an MRI with contrast.

This was at the end of 2015's 13u season. I did more research and found a highly regarded doctor in our region who had a different opinion. He saw it as a strain. After 8 weeks of very specific stretching and exercises, son was able to start a throwing program (that was about 9 months after the injury). We're now 2 years out; he still doesn't pitch, but he does catch and the elbow is doing very well.

Again, your son's condition may be very different, but I'm hoping for the best for him.

The video link below may be helpful for some who are wondering if their son could be heading for an injury. Pay particular attention to internal and external shoulder rotation. Dr. Andrews and others use the term kinetic chain. I believe the thinking is that out of balance bio-mechanics contribute to injuries. Have your son stand and face the wall. Do his shoulders look symmetrical? If not, throwers' exercises and stretching can bring things back into balance. I'm not trying to play doctor, just trying to give people an idea of what orthos look at.

Throwing shoulder exam Dr. Hawkins
http://youtu.be/KJHe7reTNsE

Thanks mid-Atlantic dad. I am still holding out hope that it won't require surgery. We will be seeing Dr Andrews in September for a second opinion. But if it requires surgery, I know he will be in the hands of the best. I'm just glad we are fortunate enough to live close to Dr Andrews and he is willing to see us.

YG,
I am sorry to hear the news of your son.

Do not beat yourself up over what has happened.

I think that the biggest challenge for all pitchers is to remain healthy for as long as they can as to not disrupt their progress. There is never a good time for any injury to occur, you can only move forward from this point.

Let us know about your visit with Dr Andrews. Best of luck.

Thanks for sharing the experiences. It does not seem excessive except for the summer ball but again there are a lot of variables and unknowns in pitching. Hope it is nothing major with the UCL and it would recover in the next few weeks before the doc appointment.

quote:

I find myself wondering where did I go wrong. ... The look on his face when he got the news broke my heart.

I know exactly how you feel. My 2012 just had TJ in June. That broken heart feeling is hard to understand just how much it hurts unless you faced it. I turned my son onto Josh's blog. He didn't dig into it a lot at first. But now that he's post op and into therapy, I see him looking at it almost daily. Josh's blog is a great support tool for those working through their recovery...physically and emotionally. Good luck...focus on the wonderful success rates this surgery comes with!

YG,

I'm sorry man, but don't beat yourself up about this. Sometimes you can do everything right and you're still bit by the injury bug. I've been given excellent advice over the last six weeks regarding my son's situation, and I'll echo those sentiments to you...Whatever happens over the next few weeks, Stay Positive for your son! Bsbl-son will be two weeks Post-Op from TJ surgery this Monday, and after reading TX-Husker's post and following Josh's blog last year, we have plenty of people to see advice from...good luck to your son next month!

thanks to everyone for there words of encouragement. it really means a lot. tx, it is so true that you can't really appreciate the emotions until you are the one going through it. again thanks to all who have shared and we are praying for the best but preparing for the worst. i'll keep everyone posted as we move along through this process.

younggun, let me know if you have any questions for me. I've got a volleyball/softball player going through a Grade 2 sprain on her non-dominant arm right now.. Any questions just let me know..

Glad to hear my experience is helping others . That was 100% my intention when writing the blog posts, and its extremely gratifying to find out that its working.

younggun- PM me if you have any specific questions, I'd be glad to help. Make sure to tell Jeremy Geus I said hello down in Pensacola, he is like a saint.

quote:

Originally posted by J H:
Glad to hear my experience is helping others . That was 100% my intention when writing the blog posts, and its extremely gratifying to find out that its working.

younggun- PM me if you have any specific questions, I'd be glad to help. Make sure to tell Jeremy Geus I said hello down in Pensacola, he is like a saint.

JH you have a PM

If you are not afraid to drive to Atlanta, Dr. Myers at Myers Sports Medicine (www.myerssportsmedicine.com) is worth the drive. He came here from Dr. Andrews practice in Birmingham. He specializes in ACL tears and shoulders.

He did some clean-up surgery on my son's throwing shoulder this last Monday and does great work.

He is a Harvard Graduate. Graduated from Johns Hopkins University School of Medicine. He has a great demeanor with the players.

My son went in for the first exam and Dr. Myers moved my son's arm around and with about 50 different moves was able to determine what the issue was. (He sent him for an MRI to confirm his findings which was spot on.)

Son started rehab on Wed after surgery on Monday.
I would highly recommend him.

quote:

Originally posted by 2014_Lefty_Dad:
If you are not afraid to drive to Atlanta, Dr. Myers at Myers Sports Medicine (www.myerssportsmedicine.com) is worth the drive. He came here from Dr. Andrews practice in Birmingham. He specializes in ACL tears and shoulders.

He did some clean-up surgery on my son's throwing shoulder this last Monday and does great work.

He is a Harvard Graduate. Graduated from Johns Hopkins University School of Medicine. He has a great demeanor with the players.

My son went in for the first exam and Dr. Myers moved my son's arm around and with about 50 different moves was able to determine what the issue was. (He sent him for an MRI to confirm his findings which was spot on.)

Son started rehab on Wed after surgery on Monday.
I would highly recommend him.

thanks for the response leftydad. i already have an appointment scheduled with dr. andrews next month but thanks for the info. we are still hoping for best, whatever that entails. i really don't look forward to my 16yo having to have major surgery, but if this is what it takes for him to continue on his journey, then we are just glad that we will be in the hands of one of the best in the world.