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Where exactly did he feel the pain? Inside or outside? Was it sharp or dull?

Try this when you start throwing again.

Take a baseball and draw a green stripe around it with a Sharpie such that when he is holding the ball with a four-seam grip, the stripe runs between his index and middle fingers under his palm and back around the ball. In other words, draw the line such that it splits the ball in half.

Now play catch with him and watch the line as the ball comes toward you (and as you throw it back toward him). This takes some getting used to but is pretty cool once you learn to do it.

Also, and as an aside, this will teach you and him to really watch the ball and will make you both better hitters.

Anyway, in the ideal case what you will see is a constant vertical green line coming toward you. That means he released the ball with a vertical forearm and with pure backspin. If the line is solid but tilted, then you know that he is throwing with pure backspin but with a non-vertical arm slot. This can also be used to check a 12-6 curveball. It will look the same but the ball will be spinning with topspin and not backspin.

If you don't see any line, then you know that the ball is twisting and/or tumbling in flight. This indicates that he either twisted his wrist when releasing the ball or did not release it with uniform pressure.
Ghoti- the best advice you have received here is in 2 areas:
1] shut him down
2] try to find another doc, who specializes in sports med or who will send you to one

XRAY is for bones, MRI is for soft tissue

"MRI is the method of choice for the diagnosis of many types of injuries and conditions because of the incredible ability to tailor the exam to the particular medical question being asked. By changing exam parameters, the MRI system can cause tissues in the body to take on different appearances. This is very helpful to the radiologist (who reads the MRI) in determining if something seen is normal or not. We know that when we do "A," normal tissue will look like "B" -- if it doesn't, there might be an abnormality. MRI systems can also image flowing blood in virtually any part of the body. This allows us to perform studies that show the arterial system in the body, but not the tissue around it."

ALSO

"Why would your doctor order an MRI? Because the only way to see inside your body any better is to cut you open. MRI is ideal for:
Diagnosing multiple sclerosis (MS)
Diagnosing tumors of the pituitary gland and brain
Diagnosing infections in the brain, spine or joints
Visualizing torn ligaments in the wrist, knee and ankle
Visualizing shoulder injuries
Diagnosing tendonitis
Evaluating masses in the soft tissues of the body
Evaluating bone tumors, cysts and bulging or herniated discs in the spine
Diagnosing strokes in their earliest stages"

You can't do any of this with an X-ray. X-rays show bone issues.

Try to find a doc to refer you to a sports med doc to get an MRI. Resting is good, only if that will cure the problem. Coach Chris is correct in that you have to find the root of the problem [i.e the cause], but until you find out WHAT is wrong, you might have a hard time figuring out what caused the problem to begin with. Very few of the people on this site are certifiable experts in anything outside of baseball, and most of those are self-proclaimed Big Grin, [although many of us are certifiable, period]. Ask for advice, but be wary of email/remote diagnoses of health related issues, especially as they relate to your children.

REPEAT - find a doc who is willing to work with you, to get the MRI or at least to explain WHY you don't need one.

CAVEAT: MRI's don't always tell the whole story, although they do a great job. I had a 30% tear in my rotator cuff - X-ray showed nothing, MRI was inconclusive. After a full year of rehab and minimal results, the tear was only discovered when they cut me open.

Good luck
Just for the record, let me reiterate that I am not a doctor and never have been one (or have claimed to be). As such, I am not contradicting the advice of the people who are telling you to go see a doctor.

They are correct.

What I am is an educated parent, which is something that I suggest that the parent of every pitcher (at least) should become. The problem is that many doctors and coaches have only a minimal (or worse yet incorrect) knowledge of the impact of pitching on the body or injury mechanisms and as such often give out bad advice (e.g. what they have heard, not what the studies say). As a result, it is in your interest to learn everything that you can about the physiology of pitching.

One place to start is in the Q&A files of Dr. Mike Marshall (http://www.drmikemarshall.com). In these files he talks in depth about the physiology of pitching. Once you have done that you might want to start googling around for phrases like "little league elbow" and "reduce risk injury pitching." You will come across multiple studies that are accessible over the web and that help to explain what happens to young pitchers and why.
1) How old was your son when he first started pitching?

2) Has your son ever (intentionally) thrown a curveball or slider? If so, at what age did he start?

3) You said your son plays Feb-Aug but it looks like you first posted in Nov. Does he have pain in the off season?

4) When you talked to the first MD, did you get any kind of formal diagnosis? Can you get your hands on the notes of the person who read the X-Ray (or the X-Rays themselves)? Do you have a diagnostic code (see if one is listed on the EOB if your insurance company sent you one)? Did the MD say anything about "medial epicondylitis?"

5) Can your son throw a football without experiencing pain?

6) I would suggest that you go to the Q&A portion of Dr. Mike Marshall's web site...

http://www.drmikemarshall.com/Question-Answer2005.html

...and search for the keyword "medial epicondyle".

The bottom line is that this is something to take seriously. Ideally, your son has just irritated his medial epicondyle, which will heal itself over time (this is the same basic thing as "golfer's elbow"). However, in the worst case he could have an avulsion fracture of the medial epicondyle or a growth plate injury, both of which are very big deals.
I agree that doctors usually do a good job of determining what happened. The problem is that they are often at a loss to explain why something happened or what to do about it. Something about their training seems to give them tunnel vision and focuses them on solving the problem rather than preventing it. Of course, it might be the case that they have a perverse incentive to not fix the problem. In the same way that I don't know who will invent a gadget that will eliminate the need for shaving, but I'm pretty sure it won't be the people at Gilette, I don't know who will eliminate the need for Tommy John surgery, but I'd be willing to bet that it won't be Frank Jobe or James Andrews.

As an example I give you this study...

http://mednews.wustl.edu/tips/page/normal/6099.html

They explain that pitchers lose range of motion in their pitching elbows but don't seem interested in why or what to do about it.

The only person who even attempts to answer these deeper questions (but still not to my complete satisfaction) is Dr. Mike Marshall. To find out what he says about this subject, Google "mike marshall range motion pitching elbow".
he started at 8yr.old 2inn. and 8 thru 11 maybe 20-25 innings total.at 12 may 30 inn 13-45, 14-50,15,maybe 60.at a young age 8,9,10 his fastball looked like a slider dot in the center. worked hard to correct that he never tried to throw a curve till he was 13 and never in a game just played with a little i wouldn't let him throw it to me but i know he did. threw it some in games at 14 but not much and alittle more at 15.

we were going to a camp at vanderbilt dec 3rd so we started throwing a little early only threw about 5 days.

i didn't take him to the doctor my wife did.

he threw a football all fall and had no problem at all.

ill check dr marshall web.
"(A)t a young age 8,9,10 his fastball looked like a slider dot in the center."

This is the most telling fact, in my opinion. I would bet a non-trivial amount of money that what your son is doing is throwing an involuntary (or not) slider some of the time that he thinks/says he is throwing a fastball. Does your son's fastball seem especially wicked compared to those of others? Does it move more? Is it harder for catchers to catch? Is he a great strike-out, ground-out pitcher even though he doesn't always keep the ball down? If so, then that suggests that the ball is diving right at the end of its flight.

"(I)ll check dr marshall web."

Be warned that he is undoubtedly the most opinionated person you will ever meet. He also thinks he's smarter than everyone else. This rubs a lot of people the wrong way, but I work with programmers so it's just par for the course for me. Of course, having a PHd and a Cy Young will do that for you.
Elbow problems with pitchers-hang in there..if you and they love the sport, chances are they've been overthrown for years. As kids get older those joints etc aren't rubber anymore and problems arise whether it be from overuse, mechanical flaws etc. They stive to win the game no matter what it takes...........

Having one child now (18) that had Tommy John at 17 and hoping and praying the next one won't. It all started with a sprained elbow medial epocodolytis(sp)xrays, MRI's,nerve tests scoped, rest, ice, PT (hours and hours). What we didn't do in the beginning was stop throwing completely and letting it heal. Ligament was replaced but since no damage to the nerve it wasn't moved. This fall with college ball the nerve got involved and slipped.no nerve damage thankfully...finally after 6 weeks resting and again rehab...(for life after TJ) hopefully a lesson learned.

My advice ..rest...go see an ortho dr. who will hopefully refer you onto a sports PT and begin with exercised to strength those muscles. Purchase an exercise ball for your son...

One good thing--older sibling in now in athletic training and plans to go on into physical therapy.
quote:
pain was inside and dull he never showed discomfort on his face or with his body movement when we threw. i just ask him why he was taking some advil and he said his arm had hurt when he made some throws. thats when i shut him down and ask for some advice.


ghoti, kids will rarely tell you the true pain they might be experiencing. Number of reasons. Denial, they think it will get better, they don't know better, don't want to disappoint a parent...lots of reasons. Mine separated his growth plate pitching in a high school game when he was 15. Started to ache about a week before but ne never said anything. Pitched 4 innings before he finally told the coach the pain was too intense to continue. Even if you have to pay the cost yourself, the conscensus advice given here is the right. You are not going to find the answer on the internet. Your son deserves to be evaluated by a sports medicine orthopedist...now.
Been...I think you might have meant ob/gyn??? Eek

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