Elbow Issue, YOU GOT TO READ THIS, SEE BELOW!!!

In that location, it is most likely tendonitis.  The UCL runs on the medial or inside of the elbow.  But I would definitely suggest having it checked out.  Good luck and I hope all goes well.

  Just a thought, you might want to invest in some elbow armor for his left elbow (arm) which for him would be his front side. If he takes a pitch there, it could side line him for several weeks. I always have my pitchers protect their pitching arm if it is the front arm and more likely to get hit with a pitch.

I am hoping for that prognoses. Location is definitely not on the inside but rather the opposite side just below the elbow point at the top of Forearm. Doc said MRI will confirm Osteochondritis dissecans (OCD) or not. Certainly hoping for the NOT! 

Yes he has been wearing that for years, thanks.

I'm not clear on why you think batting right handed has anything to do with this unless he has been hit repeatedly in the (front) left elbow?

Overuse, inflammation or tendonitis would be my first thought as a LHP and OF position player. Definetly have it checked out by an orthopedist.  The causes for the inflammation or tendonitis such as a bone spur or improper excercises could be the cause. 

Good luck and I hope your news is good.

I hope not also.  OCD, also known as little league elbow, was pretty much the end of my LH pitcher/RH hitting OF/1B pitching career.  The condition was probably around for a year or so when it popped pitching in a freshman high school game.  He wound up have outpatient surgery to try and get blood flow back in the area and the bone regenerate.  It was a partial success.  He did pitch a little in high school after, and his freshman year in college, but he was always leery of pushing it everyday on a college pitcher workout.  He increased his efforts on the hitting front though, and even though doctors in STL and Dr. Andrews' clinic said it could go any time, or it may be fine, he completed all fours of college with no more bad occurrences.  He still can't straighten his left arm completely out though, and probably never will at this point.  Good luck.

Thanks Guys, MRI was yesterday, back to the Doc on Monday for results, hoping for the best.

Okay this is an interesting situation. We went back to original Non Operative Rothman Orthopedic Doc on Monday to discuss the MRI Results. Doc tells us no OCD, however Olecranon stress fracture in the Elbow. All Ligaments, cartilage and tendons look great, no signs of bursitis or tendonitis what so ever. 4 to 6 weeks in splint then Rehab and ROM. Okay wasn't the best news however certainly wasn't the worse. High School season over but possible be ready by Summer. Yesterday we had an appointment with Dr. Craig Morgan from Wilmington DE. Recognized nationally for his achievements in the arthroscopic treatment of orthopedic problems. Basically he makes his money cutting professional Athlete's. He’s known as an Authority on the East Coast for Shoulder and Elbow issues specifically with Professional pitchers. I am going to this appointment with an open mind because I am aware of a procedure, Cannulated Screw Fixation of Refractory Olecranon Stress Fractures . Basically they put a screw in your elbow for support especially for competitive pitchers. 4 to 6 months rehab. Well to our surprise and certainly to our pleasure the diagnoses goes completely opposite. He is diagnosed with a tight posterior shoulder capsule which in retrospect caused the elbow inflammation. He does not even have any shoulder pain??? Dr. Morgan says 110% positive no stress fracture. Says tight shoulder muscles altered his mechanics and caused the elbow to become inflamed and swollen inside. Treatment is no throwing for a week ( which he hasn’t done in two weeks anyway, next visit next week) Sleeper shoulder stretches twice a day, a cortisone injection which was given in his elbow. If shoulder loosens up next visit and elbow pain is gone he will release him to throw again. You can't make this stuff up. Of course we are delighted and very excited to get his season back however I would be lying if I wasn't a bit skeptical. I am almost afraid to ask for your opinions but please what are your thoughts.

I'm glad you got what you consider good news. Here's my problem. The doctors have simply looked at an MRI and maybe moved his arm around a bit. He was given a couple of stretches and to come back in a week for potential clearance to get back into activity?

I'm not surprised that the surgeon has indicated shoulder dysfunction as a cause of elbow pain. The two are very interrelated. Now what was the other doctor looking at if there was no stress fracture on MRI? Hard to say. I'd still be a little concerned about the potential for the stress fracture in the elbow.

Take it slowly and see what happens! Get the arm figured out now rather than trying to piecemeal through things..

LeftyDad22,

You have a Dialog.

I would be curious as to what his mechanics look like.  NOT to raise a red flag but I would certainly take it easy on his throwing and ask the ? as to what caused a tight post. shoulder capsule and ask the questions to the therapist with respect to ROM excersies/strengthening can be done.

Which doctor read the MRI himself?  That's the one I would go with.  The "reports" can be terribly misleading.  I would also tend to trust the guy who specializes in pitching arms vs. some general guy who sees everything.  Good luck. 

At the very least, glad to hear it wasn't OCD

If there are two different opinions, get a third opinion before he throws again. You can ask your primary doctor to make a call to either David Altchek in NYC (THE BEST ELBOW AND SHOULDER DOCTOR ON THE EAST COAST) or contact Dr. Andrews. They would be happy to read the mri themselves. I am assuming it is on a disc, so get a copy and send it to either one.

My son had a variety of opinions from good doctors but Doc Altchek solved the issue.

Also, if it were my player, I would lighten his load for the summer, possibly just play position.

Be smart.

I believe that what caused was this,  2 starts ago he pitched 5 innings and 72 pitches, later that night he got involved in a school sponsored Dodge Ball Tournament in which his team played 5 games. I'm an idot for allowing this however I didn't understand the complexity of the tournament. His next start which was 5 days later he started feeling elbow pain in the 3rd inning, he didn't say anything and pitched the remaining game which was over in the 5th due to mercy, total 81 pitches due to 12K's. After that is when he started really complaining and I took him to the 1st Doc. I got to believe the Dodge Ball had something to do with it.

Thanks, Yes I have a disk and I am considering doing just what you suggest. Do you think I can just and explain everything and ask them to review the disk without even seeing him??

Dodge Ball seems suspicious.  #5 below if from Googling "How to hurt your pitching arm".  Not trying to start an argument about the site this comes from.  If this the cause, it seems like good news.

5 Throw tennis balls Working with extremely light balls (tennis and wiffle) is said to be worse than weighted balls - there isn't enough resistance to keep the arm from whipping on follow-through.

When I contacted the Andrews Institute, the stipulation was that the MRI had to be sent directly from the athletic training office at my college, or from another orthopedist. I didn't question why, but I assume this was to avoid any liability and legitimacy issues. Once my school sent the film to Pensacola, I received a phone call directly to my cell phone from Dr. Andrews letting me know I needed surgery. It was scheduled two weeks later and my father and I flew in. I didn't actually meet him face-to-face until the morning before surgery, when I went through my pre-op appointment.

The people at the Andrews Institute were extremely helpful and made themselves available. I can't speak for the individuals at Dr. Altchek's office because I didn't have direct contact with him, but I will echo TPM's sentiment as to the extent of his reputation- he is known to be outstanding. He is at the Hospital for Special Surgery in NYC, while Andrews is, of course, at the Institute in Pensacola.

Hope this helps. Good luck.

I am not sure of the protocol but I know of two folks here who sent the info to NY for second opinion and did not use him as the surgeon. 

David took his films himself both times to NY. 

There might be a charge, so I would call in advance and ask what is the protocol. 

Thanks JH and TPM

Interesting, thanks.

Funny, last year we had this happen to one of our kids playing dodgeball.  Sore elbow for 2 weeks.    The dodge balls are not the rubber playground balls the used back in the day that would welt you up.  Now their the harder foam ones that don't sting when they make contact.  More politically correct I guess.   Imagine that a bunch of teenagers using a lite ball throwing it has hard as the can prob. 30-40 +/- throws per match especially if he's good a good arm. Teenagers would never do that.   So basically he threw 150-200 times............ after he threw the 72. 

Pitchers should not play dodgeball during the season at all.  Too stressful on the arm and is a likely contributor to the injury.  Kids always want to throw the ball as hard as possible and there is a huge number of reps in a short period of time.

I hope for your sake that the current diagnosis is correct.  But, unless they have actually opened the arm up, all they are doing is making an educated guess.  (Some more educated than others).  Be patient, and consider that 3rd opinion.    

Thanks again all, I am working on that Third opinion for next week. Son says since day after cortisone injection by Dr. Morgan elbow feel just like normal. Of course he has not done any throwing whatsoever just the stretches. If it were a stress fracture would the Cortisone have such an effect??

He is not throwing so yes obviously he would feel better. 

Did the doc tell you he had to lay off throwing for awhile then start on a gradual throwing program?

TPM he wasn't throwing for two weeks before injection and elbow didn't really improve. Go Back to Doc number 2 tomorrow hopefully for release to gradually start throwing again. He' has been doing bands and so far he feels great.

LeftyDad,

I'm curious if you have an update on your son's elbow issues.  We've been dealing with an identical situation with my lefty 2018 since last Fall although his was classified as a stress reaction (the precursor to a stress Fx).  He took 6 weeks off from all throwing and slowly started up but felt pain again from only light throwing.  Took another 6 weeks off and had another MRI that showed the stress reaction was better but another area of the olecrenon has flamed up.  Extremely frustrating that when complete rest doesn't fix it... then what will?

My son took off 2 1/2 weeks try to throw lightly then felt the pain so rested another 3 weeks and will start Rehab with Therapist/Trainer on Monday. ReHab will go about 4 to 6 weeks and they will decide when to start throwing again as he progresses. It a weird thing, I have heard of another kid with identical issue as my son so far he his going thru the same things as our kids with doctors with differing opinions. Our doc says it related to the growth plate with the muscles pulling on the bone.

Important to mention that he has zero pain even to the touch unless until he throws. The initial 2 1/2 weeks may have been too soon, I am hoping the additional 3 weeks plus Rehab does the trick but we'll see...

LeftyDad,

I'm curious if you have an update on your son's elbow issues.  We've been dealing with an identical situation with my lefty 2018 since last Fall although his was classified as a stress reaction (the precursor to a stress Fx).  He took 6 weeks off from all throwing and slowly started up but felt pain again from only light throwing.  Took another 6 weeks off and had another MRI that showed the stress reaction was better but another area of the olecrenon has flamed up.  Extremely frustrating that when complete rest doesn't fix it... then what will?

 

 

younglefty, 

 

I don't want to tell people what to do, but you did mention your son is a2018 and the problem started last fall.How old was a 2018 last fall? 10 or 11?

 

My question is this... What is the big rush? if something, anything, is wrong, why would he be in a hurry to pitch. Many of the best pitchers who ever lived didn't pitch at that age. Why is it so important that he pitch?

 

Often young kids experience problems as their body starts to mature.  Solution is to allow the body to mature without causing any major problems. There is no 11 or 12 year old game that is so important. Personally I would take the whole year off and play another position. Then reavaluate the next year.

 

I understand that every team, even 12 year old teams, need a pitcher.  However, any young pitcher that has any type of arm issues should not even think about pitching at that age. It is just likely to compound the problem. And it's so much more important that he is healthy at 16-17-18. Just my opinion, TIFWIW!

Actually rereading your post, it is obvious you are not pushing your son.  But it does sound like you just want him healthy.  Once again, I think it might be best to take a year off of any pitching at his age, no matter what the doctor might say. All doctors don't fully understand baseball unless they were once a pitcher/player. Usually when you see the very best, he will be the one performing surgery. I have seen too many to count cases where even the good ones diagnose serious problems as simple tendonitis.

PGStaff,

Thanks for your input.  Indeed, every decision we make is with his 15/16/17 year old season in mind.  The unfortunate dilemma is the our team was formed with the specific purposes of challenging them to compete against the top  talent in the country... which they can benefit from since we are still unbeaten locally and playing up means 13 year olds are playing 60/90.  I'm as concerned with the extra workload this is placing on our OTHER pitchers now that my son is not pitching.  We had planned to compete in the ESPN/Disney Elite 32 in August but with 1 pitcher down, that is currently being reconsidered.  His coaches are very understanding and since this is a college showcase team (in the future) they understand the importance of being healthy then vs now.

Fortunately, my son's bat is even stronger than his pitching so he's able to compete and help his team.  My singular concern at this time is - what if he would take an entire season off and the pain returns when he begins throwing at age 14? We're seeing a qualified physician (group works with our local MLB team) and it took it took 3 months to diagnose the stress reaction, which seems long but is actually reasonable because they first ruled out UCL, growth plate, osteochondritis plus every other problem you would suspect with a pitcher before the MRI revealed the stress reaction.  What no one can seem to tell us is WHY this occurred.  His mechanics have never raised concern among many good baseball people but obviously SOMETHING is going on and it's that unknown that has me searching sites like this and ASMI for answers.  I appreciate all your advice.

younglefty,

I understand your concern. That said, I think we both agree, your son should not pitch until he is completely ready to pitch. I would continue checking with medical experts and rest him until you get to the bottom of this.

I know the team thing sounds important and it would be a lot of fun, but maybe you can find another pitcher for this year. Have fun watching your son hit the heck out of the ball. best of luck!

Actually, this is none of my business. We are talking about your son and I'm sure you will make the right decisions.

YoungLefty you have a new Dialog

If it were none of our business parents wouldn't be asking questions.  So I think that you have a right to question or give your opinion.

Unless you have some type of tool that can look into the body, or a surgeon goes looking, there is no way of knowing 100% what is really going on, even with MRI.

It took 2 years for two top ranked surgeons to figure out what exactly was happening with son even after a scope.

I am with PG, don't allow your son to continue to pitch. If it that means a year off, then so be it.

I am very glad that from 10-15 the teams son played on had everyone being able to pitch. This way if anyone was not feeling well, sick or hurt (funny thing is no one was ever hurt), we were not short on pitching and no one threw more than they had to.  Young players should be playing multiple positions and not catching or ss if they pitch regularly.

Do people really think that challenging young players (by playing up or more) will make them better players, or will it just produce more issues either sooner than later?

Keep in mind the more you play the more one is prone to injury.  Especially for very young players.

I wish your sons the best and hope that everything works out in the end.

What I meant by it not being my business is really how I feel.  I'm willing to give an opinion, but people don't have to pay attention. The final decisions belong to the parents. A sore arm is not likely to be life threatening. 

Everyone has their own lives to live. Who is to say I know what is best for someone else or their child? That is what I meant by it not being my business.