tingling and numbness in throwing arm

Shut him down and get him to a Doc who understands pitching injuries. Sounds like what happens in typical pitching related nerve injuries, sometimes rest resolves it, sometimes not. Tingling typically starts in the pinky to ring finger and moves up the hand. 

Sounds very much like an ulnar nerve compression issue.  There are two different solutions depending on the reading of the MRI - one is a transposition, which moves the ulnar nerve from the outside of the elbow to a channel inside the elbow.  The other is "just" a decompression which slits or removes pressure of the ulnar nerve just above the elbow.  Recovery time for the former is months and weeks for the latter...

 

My oldest son had the first and my youngest son had the second.  Be sure to see an orthopedist and a hand/nerve specialist. My oldest also had a bit of "stuff" on his elbow which the doctor scraped.  That debris was causing a twinge on most pitches where the nerve rubbed against it before surgery.

 

Like BOF says - stop throwing now. Although they say you cannot do more damage - what it does do is cause the pitcher to change his motion to avoid the pain. That then has to be corrected later..

Thanks for your answers.  He is not throwing and has an appointment tomorrow. I hope it is nothing serious.  He has never had any arm issues over the years.  Ironically this summer he has probably pitched the least amount he ever has.  He was wondering if that was actually the cause. He leaves for college in a few weeks. Not great timing, but I guess there never is a good time.

My son also had ulnar nerve transposition surgery. As was said by JohnF in the above post, it can't be stressed enough to go to a hand/nerve specialist.  

I'll repeat it a third time.  This sounds like an ulnar nerve problem.  My son had the surgery in January of this year and was back to playing in June but really not full strength until the end of June.  

 

In terms of injury for a pitcher its certainly not the worst kind.  

Just curious is this an injury that will or should show up on an MRI or is there another way they diagnose it

In my experience ulnar nerve problems create a tingling numbness down the arm and in the fingers at first.  Make sure you get with the correct medical people.  Don't want to scare anyone, but many doctors tend to diagnose these things at first as tendinitis.  Only to find out later it is more serious than that.

My recollection is that the doctor (and his schools trainer before) knew what the injury was as soon as they did some simple testing (measuring strength while squeezing something was one of the tests and comparing it to his non-throwing hand).

 

The only difference, when comparing what you describe your son is feeling, was that my son also had the tingling in his ring and pinky finger of his throwing hand and not in his arm. I know the ulnar nerve is a long nerve that goes from the shoulder to the fingers. 

 

My son was a two-way player in college. He was cleared to begin a throwing program in 6 weeks then played a position (1B, then OF) in 8 weeks. He only missed the very first 2 games of that season. He was cleared to pitch after 3 months, but didn't fully gain his full velocity back until he began playing summer ball in June. (so the same timeline as daveccpa's son). He only threw 5 innings that college season - and not very effective.  

My son also had ulnar nerve transposition, and numbness in the pinky was the giveaway but his lower arm felt kind of dead. After ruling out the ligament, he had a nerve test, which verified the diagnosis.

The prognosis is 3 months back to throwing, but to be honest, and because son had an elbow cleanout, it took much longer to really feel better.

We've seen this before. To pile on with everyone else, it sounds like ulnar nerve compression / ulnar neuritis. Two simple tests that should be performed to analyze it are the milking maneuver and the moving valgus stress test. Any good PT/Ortho will know how to do them and interpret the results.

Also get on a good rehab program and take it slow.  Its not a quick fix and won't heal overnight.  Expect a 4-5 month recovery until fully back to pre-injury.  My son went to see Kyle and his progress was great. His arm is stronger than it was pre-injury.  

Thanks for all of your responses. He is seeing an orthopedic surgeon/ sports medicine doctor in the morning. He is also the team doc for a local independent baseball team so I assume he would be familiar with this. Do these injuries pop out of nowhere? He kind of just woke up with this. He said first he forearm felt tight then the numbness or tingling started. He shakes his arm for a few seconds and it goes away.  I asked him and he said the tingling does not go to his fingers. It seems very localized.  Odd. I guess we'll see what the doctor says.

I'm pretty sure the ulnar nerve effects the pinky and ring fingers, but not the other fingers.

 

This could also be extensor tendonitis, which is not UCL related, but requires 4-5 weeks of rehab.

If your talking about the topside of the forearm, as when the palm is facing the ground, then it is most likely not the ulnar nerve.  Look up radial nerve entrapment and also supinator syndrome to see which symptoms most closely match those of your son. Both are nerve issues (affecting different nerves) and can be difficult to manage in a thrower.  They can pop up without much warning or trauma and can be very tender to pressure that is applied directly to area affected.

 

 

PGStaff - ALWAYS appreciate your posts, and willing to listen to inputs.  Very much appreciated as you continue to grow with Lakepoint (especially since we live in Ga/ATL).  First time poster.

 

What PGStaff is saying is similar advice that we received. PT where my son trains stressed that best way to rule-in/rule-out potential issues is with MR-Arthrogram.  He said that its better to find out good/bad news earlier so you can start the right treatment plan. 

 

My 2018 OF had some similar symptoms, pushed to have MRI done (vs x-rays/rest), and results said it was triceps tendinitis - so I HOPE the orthopedics group got it right!  We were planning for him to rest his arm for a couple months this fall, so resting his arm started a couple weeks early for him.

 

Best of luck with your son baseballmomx4 - hope you get good news too.

 

If it's ulnar nerve, then there are multiple factors, but throwing can exacerbate it. Since I had two with it, I've wondered if it was hereditary. I'm not sure if there could be an 'exact cause', but the doctor(s) are the best to answer that question.

 

An MRI will be able "see" the compression and whether there's any sort of debris (e.g. scar tissue) on the elbow that can rub or create more pressure and "suddenly" make it become an issue.

 

There is also a nerve test that can be done.  They hook up a bunch of probes and "time" the impulses or speed down the nerve. Based on the calculation of normal, comparison of other arm, comparison of other fingers, etc. they can deduce where and whether the nerve is constricted.

I

Looking at the OP again, it would surprise me if her son's injury is something different then an ulnar nerve. The top side of the forearm doesn't quite make sense... 

Ok just back from the doctor.  We do feel fortunate we actually got an appt with this dr. He has 20 years experience as a team physician for an MLB team and his specialty is pitching injuries.  Not really reassuring news as of yet.  He knew my son was trying to minimize symptoms and said he was used to it.  He said he has Gird and feels that he probably has dropped his arm and put more strain on his elbow,  Even though his elbow does not hurt and the tightness is in his forearm he thinks it is probably from his UCL, and the intermittent tingling from inflamation irritating the nerve.  Based on the exam he does not think it is a tear or anything surgical but rather a sprain.  He did an X-ray there and that came back fine. He is doing and MRI to rule out any tear, etc.  If all is ruled out he wants to come to a field to see his mechanics, then deal with the Gird.  So fill me in. Has anyone dealt with Gird.

http://www.throwinginjuries.co...tation-deficit-gird/

 

Article by Dr Lintner, Astros' Orthopedic Doctor

Thanks. He has never complained of shoulder pain nor does he have any now. There was definitely a difference in range of motion between his 2 arms. He has been working with a strength and conditioning coach for years. My son said they do stretches and exercises to try to prevent this. MRI today and follow up with Ortho Friday, so at least they are moving this along quickly.

You can do everything right and still have problems. The cubital tunnel (if it is ulnar-based, which your doctor seems to think it is) can simply be deformed or unfriendly to the nerve, which you can't do much about except have the nerve surgically relocated, which is a fairly common procedure. 

 

So don't stress about it all that much. MRI and other diagnostic tests may be inconclusive and usually are, but they should help to rule out obvious problems (UCL rupture, elbow fracture, etc) which is their main benefit.

Kyle is spot on. Sometimes the human body isnt perfect.

Thanks it is hard not to stress. I do that best anyway.  So the MRI report came to me today.  We don't see the doctor again until Friday but reading the findings it seems to be good, I think.

 

The findings were there is no evidence for compression of the cubital tunnel. No elbow joint effusion is present. Mild sprain of the proximal aspect of the ulnar collateral ligament is present,without tears, Mild distal biceps tendinosis, without tears.

baseballmom,

Thank you for sharing and I am sorry that this happened.

I realize that maybe he didn't pitch that much this summer, but that probably isn't  the reason why this happened.  Most likely you will never know the reason (these things occur from the gym as well) and as posted many times the players genetics get in the way.  My son had two injuries which were biological in nature, one being the small groove that keeps the ulnar nerve in place (at tip of the elbow) was deformed a bit and also corticoid impingement, a condition where the corticoid bone is too large for the space allowed and tendinitis or bursitis is common.  He did suffer from this for awhile before picked up by a top surgeon, even after a scope. 

I am glad all of this did happen later on and not during his recruitment or during his college draft year. But it did all happen before him making a 25 man roster. Things happen, I would rather it happen later rather than sooner.

 

This is why I rant. Injuries are accumulative, but there are better times than others than they can occur and not hurt the college or draft prospect.

 

Hoping for the best for your son, keep us posted!

Son had the follow up today.  Ortho looked at the MRI and agreed that he had a mild ucl sprain. Gave him a choice of PT and trying to throw again in 3-4 weeks and seeing how he feels or getting PRP therapy now and being out for 12-14 weeks.  Of course he went with the more conservative approach. He said it barely hurts and would not have even gotten it checked if I didn't drag him. If it is not better after the month he said he will try the PRP. I just hope he is not making a mistake.  So does anyone have any experience with PRP?  Also my son is headed to a D1. How long is fall ball, when do they usually end? Also how long do pitchers usually shut down?  Thanks.

You need to contact the coaches at the school asap to give them a heads up.

They may just want him to take it real slow and shut down for now.

Barely hurts has nothing to do with it.  But a ucl sprain or strain has to be handled properly.

Hope that this helps.

Thanks TPM, I actually told him to do that earlier today. I'm trying to make him realize that although it may be a minor issue now if he rushes it he could make things so much worse. I think sometimes 18 year olds have a hard time grasping the big picture.

Bb mom.   Sent u pm

After 4 ortho consultations--2 general and 2 baseball-focused--diagnosis was UCL strain (read: partial tear).  Opinions ranged from rest to TJ surgery.  We opted for PRP injections for my 2017 pitcher.  With such varied opinions, hard to know what is the "right" thing to do with intermediate throwing related injuries.  If time was not a factor, most conservative approaches seem most prudent.  Timing, recovery time and seriousness of future play (as a pitcher) appear to be the big issues.

Doesn't he have to be examined by school affiliate Ortho staff to be cleared to play and practice?  

 

Yes he will be examined and cleared prior to practice by the team dr. He has reviewed the MRI and agrees with the plan.  My question was just out of curiousity. That and my negative mind always preparing for the worst. Seeing if this did not work the first time, how much more time would he have.
On a side note, drs and physical therapist believe he caught this very early and stopped throwing before anything major was done and are optimistic that with rest and PT then an interval throwing program all should go fine.