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Preface: He is going to a specialist first thing Mon, but wondering if anyone has ideas in the meantime.

Catcher, first game of summer. Normal warmup, no issues up to point of injury. Backpick to 1B in 2nd inning. Says he feels/senses a “pop” either in the load or the release of the throw, can’t be certain. No pain immediately, finished inning, but as he’s coming off the field, notices outer elbow up to tricep is hurting. Pulls himself out of abundance of caution.

Iced it last night, did all the recovery items he knows to do. Awoke with it swollen, very stiff. Urgent Care visit shows no broken bone, no UCL injury. Initial diagnosis is tricep tendinitis, but needs MRI/specialist to render verdict.

We don’t think it’s a torn tricep, as he has full strength of resistance (can even do tricep push-ups). He had a strained anconeous earlier this year, but this feels different, according to him. Current symptoms are:

- Swelling anterior of right elbow

- Pain in range of motion at approx 3/4 of full extension (only there, nowhere else in range of motion).

- Pain in supination against resistance

Any thoughts? Any experience with a similar injury? Obviously not the way he wants to start his 17U summer….

Last edited by Senna
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I think there's a lot of positives here. Able to perform tricep push up,  no severe weakness, doesn't sound like there's any gross deformity (which you'd see if he completely tore the tendon), able to complete the inning.

It'll probably be something along the lines of relative rest from anything that makes it worse, find a starting point that is tolerable and build up from there while managing symptoms. But yeah, not the ideal way to start the 17U summer, unfortunately.

Hoping for the best, good luck!

Thanks for the input, XFactor.

Had Xray today back home, nothing broken/fractured. Pain continues to lessen as does the swelling. MRI is scheduled for tomorrow, followed by ortho appt.

Ortho says that it sounds most likely to be radial tunnel syndrome, barring any annular ligament tear or sprain. So fingers crossed that it's the former, and a cortisone shot + therapy can work it all out.

Update after MRI and ortho appt:

MRI showed all ligaments, muscles, and cartilage were fine. Fluid buildup around the joint, mainly around the humerus/olecranon process. Also could see that bones are still growing.

So with ortho, the diagnosis is swelling around growth plate. Dr believes his continued growth is causing this to happen periodically, as the muscles/tendons are not able to keep up with bone growth as quickly as they need to with an athlete like himself. Nerve entrapment may be something else that is there, and it may be irritated, but is not the cause of this.  

No cortisone, as he is still growing and that can stunt it. He is shut down from overhand throwing for 1 month. No PT on it either for 1 month. He can hit as soon as he can swing without pain (has 2 weeks of Meloxicam to help heal it). Getting a second opinion next Thu. Not to get him throwing sooner, but to make sure that this is not something more chronic that needs fixing.

Good news - Ortho agrees that there's no tendon/ligament/muscle issues. All looks solid. Also, he dismissed the bone growth being a factor. Said his arms are done growing. So not worried about growth plate issue.

Bad news - He can't find the exact cause. Concerned there may be a hairline stress fracture that he can't see, as SOMETHING has to be causing the joint effusion. So prescription is no overhand throwing OR hitting for 5 more weeks (July 20th). Which means 17U summer is gone in terms of games/tourneys.

Next step is a day of mourning, then sort out what he can continue doing for the next 5 weeks. So far we have:

  • Study for second SAT
  • Lift/run
  • Catch pens
  • One arm hitting
  • WIN Reality

Sorry to read. My kid rested several months due to a chronic stress fracture on his elbow and was close to getting screws. He is now playing and working his back in to throwing max velo. He was wallowing in self pity but a solid showing at a recent HA D3 camp resulted in a good call from the coach and he wanted transcripts and provided a plan where he would play on the team, restored his confidence quickly.  There is still time for your kid and plenty of opportunities. I like the Win VR too, but it could end up as an expensive video game. Good luck

Senna, Sorry to hear about your son's issue. Have you had his shoulder range of motion checked? This may sound weird, but if you lack shoulder mobility, mainly extension, it is harder to get into layback when you throw. That means the throw becomes more pushy, and then the tricep has to take over/has more stress placed on it. I was having a ton of tricep tightness after I pitched, and finally saw a PT who tested my shoulder mobility and then gave me the explanation above (Definitely more technical than how I just wrote it).

Obviously this isn't 100% what your son has, but if all the scans are clean there's a chance it could be. For me as I started to gain back the shoulder mobility the problem has started to dissipate. If you have any video of him throwing , you may be able to see that he leads with the tricep. Personally I would suggest trying to get in to see a physical therapist who deals with a lot of baseball players. They'll probably do a bigger screen, and may find the problem, or at the very least have some exercises or treatment that can help to make sure the pain doesn't come back.

@anotherparent @2022NYC, thanks for the kind words. He’s going to find a way. And he’s been loving WIN for the last 5 months. Only he doesn’t use it on game days, as he says it’s hard to adjust back to reality.

@LHP15, thanks for the post. That’s an interesting thought (and I like that you asked if I have video of him throwing…😉).

He has a really solid trainer that he’s been working with for over 3 years who does specialize in baseball players (and is highly recommended by the ortho he saw), as well as a PT who does baseball specialization. So he definitely has the resources.

That said, he doesn’t normally work with the trainer Jan-May b/c the load of school + baseball just doesn’t give him time. So he’s only been back at it with him since mid-May…..and he’s been working on some slightly new mechanics on his throwdowns. Plus, he’s done a ton of work on pops from knees. In fact, the Wed before his injury, he probably did 25+ throws from his knees in a workout. Said he felt great after, no pain, just some slight (usual) muscle soreness, but who knows. Just typing out loud, as they say…..

Anyway, that’s definitely something worth looking at. If the mechanics changed during the spring, and resulted in a loss of that mobility, that may be at least part of the chain of events causing this. Thanks for the thought, he’ll talk to his trainer about it.

1 month later:

Followup visit 2 weeks ago and he was cleared to start swinging, as exhibited no pain. Ramped up leading to WWBA, got in 4 ABs and went 1-4 with 3 RBIs, a sac fly, a single, a groundout, and an 11-pitch K. He was very pleased overall, as all the power and pitch recognition was still there. Just a bit early/out front (due as much to just DYING to hit as it was timing). Looking forward to DHing this week at PBR.

He has another appointment next Tue to see about getting cleared for throwing.

Following up on the other input/thoughts from everyone above:

His trainer did an assessment on the 17th. Lots of detail here, but again, keeping this out here to hopefully help someone else in the future:

1. the scaps both sits a little elevated
2. Small amount of upward rotation present at rest(not bad but could get a few more degrees)
3. Shoulders sit in front of elbows a little bit
4. Upper traps have a lot of tone
5. Missing some movement in both shoulder flexion and shoulder abduction
6. Missing a few degrees of thoracic rotation
7. Would like to get more shoulder external rotation aka layback on throwing side

The scaps are elevated which could potentially be from over active upper traps, shorten fibers. These may be pulling him into a more rounded position. From this round position it makes it harder to “layback” in the throw. Getting some length in the lats could really help this.

Because the upper traps are overactive the power traps and smaller stabilizers can’t do their job in getting the scapula to move.

Why does this matter for the elbow? In my opinion some of this shortness/stiffness/imbalance is has caused a loss of “layback” (shoulfer external rotation) when he throws. To throw a baseball hard we need layback. If you don’t have layback as a thrower, you will find a way. Usually “that way” is to crank hard on the elbow and drive the elbow in, also know as valgus elbow. This is where we see guys have growth plate or to Tommy John issues .

Summary. Let’s get some soft tissue work done.
Let’s work on balance out the back and smaller scapular stabilizers
Let’s work on getting the scaps In a better starting position and let’s work on getting more external rotation.

By doing all these things I think we will take a lot of stress of the elbow....

So: he's working on that (some tissue work, some acupuncture, specific exercises).

Will update soon!

my son had 2 MRI's...nothing showed up either time of concern for orthos...went on for over 9 months...pain when throwing, diagnosed with gird, sick scapula....toughed through a season at 3b, is normally a catcher.  After the season we got really lucky and the old Marlins PT moved to my town...he said he had impingement in his shoulder and that doesnt show up on scans...he measured strength of each shoulder and range of motion....strength of non throwing shoulder was greater than throwing forward one month of working with him and rotator cuff treatment and hes on a throwing program (Light) with no pain at all...threw football (2 way player D2) 15 yards x35 of luck I know this is miserable for you all

Ortho visit yesterday went well. No pain, all his movements were pain-free, and he's cleared to start throwing again. We did 10 minutes of arc tossing yesterday in the driveway in between rain showers. Was fun to start breaking in the new glove the family got me for Father's Day.

One of the concerns (beyond the above items from his trainer) is that he has a flaw in his throwing mechanics. But it's hard to analyze that when he can't throw with intent. So the plan is:

  • Starting today, he's going to follow the Pro Off-Season ramp up plane from Jaeger ( This will give him 3 weeks of base building, then 5 weeks of throwing progression/long toss/pull downs. Barring any setbacks, he should be at the end of week 8 and finished by Sept 15. This will be the strictest buildup he's ever done, so we're hoping this will develop a solid base for him, let him start really working on feeling his shoulder, etc..
  • Week 8 will coincide with first or second fall tournament, so (again, barring setbacks) he'll be able to play
  • After week 8, get the throw analyzed.
  • Unless he has a dangerous flaw (one that may cause another injury imminently), maintain current form for the 4-6 weeks of fall tournaments
  • At end of fall tournaments, rebuild his throwing mechanics as needed
  • Once mechanics are corrected, velocity work to build up to HS ball

Will give an update in another few weeks. In the meantime, any ideas/questions are welcome.

Throwing the ball properly is important no matter what position you play. If you don’t throw well you are severely limited on what positions you can effectively play defensively. Many people have told me that backside arm action is natural and can’t be taught. I beg to differ. I was taught to throw as a child using a tennis racquet as a teaching aid, and I have successfully used it with young players to teach them the way to properly internally rotate the elbow - which is the most common problem I see with bad arm action. The proper arm action for throwing is the same as serving a tennis ball.

My kid is in the OR getting a screw placed in his elbow and UCL repair. Unfortunately even with improve throwing mechanics, the increase in velocity achieved by HS players will result in more throwing related injuries. He dinged his throwing lever during run and guns, a warning to those with kids with throwing issues. He is going to miss his final HS season which he was fine with given they are not going beyond the region to compete so they will most likely win their "league", unlike their nationally ranked lacrosse team which they play nationally to find the best competition for their players. If all goes well he will be ready to play in the college wood bat league in June and more importantly restore his confidence in throwing again. Happy Thanksgivong everyone and safe travels.

@Senna posted:

@2022NYC, I’m so damn sorry to hear about that. I hope the prognosis is solid. Assume that you were specific in your statement that he’s getting it repaired and not replaced? And was there a fracture necessitating the screw?

Kid had a fracture in the elbow at the growth plate that never closed due to frequent stress from throwing. The ortho put 2 screw in the elbow to close the plate. He also had ligament damage that was repaired with the newer procedure with suture anchoring and an internal brace.

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