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My son will be turning 14, has been complaining on and off about a 'shock' type pain in his throwing arm. This happens only when he throws hard, and not every time he throws, but more often that not, and at least for the past 2 years of Travel Ball.  

 

I have tried to get a better understanding of what exactly he means by shock, wither he means shooting pain? or throbbing pain? but the answer is always 'shocking pain' and not shooting/throbbing pain. He gets a 'shock' around his elbow area starting 2 inches above the elbow (midway to shoulder) and 2 inches below say midway down his arm forearm. Like I stated it only happens when he throws hard and lasts for a few minutes after. The after pain according to him is also very painful. Over the past 2 years we have cut his pitching down tremendously but he has been throwing a practice ball pin with his pitching instructor once a week and long toss. When this pain happens it happens both with long toss and pitching.

 

I am taking him to a sports physiotherapist to get checked out. 

 

Wanted to get opinions from the forum members.

 

Thanks in advance.

 

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Your son has severe and persistent pain in his arm. A medical doctor has the tools, training, and experience to diagnose what is causing the pain.  The medical specialty most closely associated with this type of potential injury is Orthopedics.  An MD who specializes in sports medicine may be of help, so that would be a good alternative, but he might end up asking for the orthopedist's opinion.

A good sports physical therapist would be my first stop.  Mechanical issues at the elbow can irritate and entrap the nerves at the elbow.  The poor old elbow will get beat up because of mechanical issues above and below the elbow.  It isn't as simple as an "elbow injury" typically.  The difference between a good sports physical therapist and a good orthopod, is that the orthopod will typically focus on the elbow only (which is his/her job) and focus on the "symptomatic" area (which is a needed assessment).  A good sports physical therapist will not only look at the elbow, but will look above the elbow (shoulder, scapula, spine) and below the elbow (forearm, wrist) and look for the "cause" of the elbow malfunction.  He/she will look for normals not only at the elbow, but above and below, will watch him move, look for abnormal movement patterns, postures, weaknesses, imbalances, etc.  A lot of times the ortho is not needed at first.  If just depends on what you are comfortable with, what your insurance dictates, and your state rules and regulations are regarding physical therapy and direct access.  When an ortho is needed, it typically means that good conservative, non-surgical methods of care did not work.  I would hope that at 14 y/o, good, conservative, hands-on sports physical therapy care would correct the problem.  Good luck!

If he has been having issues for this long, I would also offer that he may be doing something incorrect mechanically that is stressing his elbow. You may want to have his motion evaluated by someone other than his current pitching coach.  I say that because if he does have some sort of mechanical fault - it is obviously something his current coach is not seeing.

 

There are a couple of advertisers here that might be able to offer that type of service remotely.

Definetly sounds like ulnar nerve.
I strongly suggest that you send him to an ortho before you do anything.    Because you have let this go for a long period of time there may be damage to the nerve.
The nerve sits in a groove in the elbow.  Sometimes the nerve will not stay in the groove and slips in and out of the groove. This action causes irritation to the nerve.  A test should be done to determine if the nerve is still viable.  The doctor may also consider if there has been any other issue that may have caused the pain.
The doctor will then make the determination on pt or surgery to move it. 
My son had this surgery and quite common for pitchers but your son is young. 
If you have any questions you can send a dialog.
The specialist is Dr Ahmed in NYC.  He is the one AROD
Let the buyer beware .  Call Dr Andrews office for assistance. This is a youth player not a full grown adult.
BTW doctors bid out for the rights to treat a teams players and you will find them in every city where the team has an affiliate. Mine got a bad diagnosis from the doc who treats the team he was on. He was not the team specialist.
Just a suggestion but a doc affiliated with a team is not always the best.  Why do u suppose most players do not have the team docs operate on them!!!!
Yes they will refer those they have trained with.  Thats why I say call them.  This is a youth player having elbow issues. So I would see who they may refer to in area.
Keepin mind many of these team docs specialize in certain body parts. If my son is having elbow issues go to a guy who specializes in elbows.  FYI when son was with the cardinals it took another doctor in NYC to diagnose his issue...rare cortacoid impingement...took 3 seasons of pain discomfort and dl and doc alchek got it right in 10 minutes.  He also made sure sons ulnar nerve was not anything involved with then thoracic nerve system.  You HAVE to be careful...especially so young.

So I followed the advice and took my son in to see an Orthopedic Surgeon in Tampa.

He took X-rays of both shoulders and deducted that the pain was due to "Little Leaguers Shoulder". My son has been asked to ice his arm at least 3 times a day and NOT do any throwing/pitching for at least 6 weeks, at which point we will see him again.

 

Thanks everyone for your comments and suggestions. It was what made me take him to the doctor in the first place :-)

Glad you started the process, and have some direction.  Six weeks is how long it takes the body to heal up.  My concern is that in six weeks, you are still in the same boat, as nothing that caused the flair up (in the first place) has been corrected.  Again, the Doc is treating the symptom only, the elbow pain, with this approach.  Noting that it does need rest, and he is correct, and not cutting on him in any way what so ever.  Highest respect for those docs.  I am completely on board with that.  However, at the same time (IMHO), you should be seeing a good sports rehab guy, and correcting the underlying causes in that six weeks resting period.  This way, you are actually ready to go, and resume a throwing program, at six weeks.  I would lay money that the symptoms will return with rest and ice only.  Just some food for thought.  Hope it works out for you. 

Originally Posted by Max S:

So I followed the advice and took my son in to see an Orthopedic Surgeon in Tampa.

He took X-rays of both shoulders and deducted that the pain was due to "Little Leaguers Shoulder". My son has been asked to ice his arm at least 3 times a day and NOT do any throwing/pitching for at least 6 weeks, at which point we will see him again.

 

Thanks everyone for your comments and suggestions. It was what made me take him to the doctor in the first place :-)

Was this an ortho who specializes in sports medicine?

 

Ohio Dad,

It may just be that he needs 6 weeks to completely heal whatever it is, then begin a rehab program after he sees him in 6 weeks. Remember he is only 14.  

 

However, I do not see the benefit of icing 3 times a day for 6 weeks.

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