UCL sprain

might as well get an mri just to be safe...ill send you a PM

bballman,

My 16 year old son was diagnosed with a UCL sprain just prior to the start of his varsity season this past year. Like your son, he was advised to take four weeks off from throwing and do PT. He came back after four weeks and felt strong enough to play the OF, but we did not have him pitch. Fast-forward to the end of the season, and he was sore again. I took him back to the Orthopaedic Surgeon, and ended up having an MRI done. Turned out that he still had a UCL sprain (original diagnosis was correct), so we rested his arm another five weeks and now his arm is almost 100 percent again...knock on wood!

I agree with BackStopMa, if possible, try and get your son an MRI just to be safe. The X-Ray will not pick up any ligament damage. Good luck to your son, I'm sure everything is going to work out just fine!

Thanks guys. Got your PM BacsStopMa. His follow up appointment is on Dec. 1 and I am sure if it is not looking good at that time, we'll have an MRI. We already talked about that with the doc. bsbl247, I think you're the first one I've heard of having the UCL strain. I personally have not heard of it much. Glad your son is doing well. I'll be hoping for the best.

After the rest period and with approval by the doc, we'll start a throwing program again and after a little while I think we're taking him over to ASMI for their biomechanical evaluation to make sure his mechanics are sound. He has had lessons for pitching since he was 9, but it never hurts to have things checked out by the best.

I'll let you all know how it goes as time passes. Any other feedback is still appreciated.

When pitchers have Tommy John Surgery it is for a UCL sprain. The degree of damage can be very minor up to a complete tear of the UCL. Ligaments generally heal all but the most minor damage with scar tissue so the ligament often remains susceptible to further damage after conservative treatment.

You need to see a doctor who is intimately familiar with UCL problems and pitchers. I'd recommend going to asmi.org and using their forum to ask about specialists in your area. In fact, given that you can go to ASMI you should be able to go see Dr. Andrews. He's one of, if the not the best in the world with UCL injuries.

CADad, we are seeing a doctor that was recommended by and trained at ASMI. Hoping this issue is fairly minor since the doctor told us during the exam that he did not think the ligament was torn. Maybe he meant not torn significantly. As I stated earlier, he recommended rest and PT. Didn't think an MRI was necessary at this time. He also recommended a biomechanical evaluation after the rest period. He actually recommended Dartfish. However, I have spoken with one of the biomechanists at ASMI and we will be going there for that. Dr. Fleisig also emailed me to confirm the doctor we are seeing is good and looks forward to seeing us out there for the evaluation.

I think I now understand that a sprain is a tear, but there is a very wide spectrum of how severe the tear could be. I am hoping we dodged a bullet and things will turn out OK. I suppose only time will tell. Thanks for the response CADad. I'll follow up as I learn more.

Sounds like you are doing all the right things. Good luck.

Unfortunately, my experience is based on 3 different players out of our HS program. 2 had similar experiences as freshmen where they had very minor problems that were treated conservatively. One a position player has recovered just fine. Another, a pitcher, managed to last his entire HS career but finished throwing in pain and never ended up having much of a fastball. I go back to the time when as a junior in a spring break tournament he threw 3 innings throwing almost entirely sliders then came back the next day and threw 3 more innings throwing almost entirely sliders. After that the only question was how long before his elbow blew out. The last one didn't get his problems until after his junior season. He was kept on JV and was the workhorse of their staff throwing quite a few complete games. I don't know how his problems worked out. The last I heard they were looking for a second opinion before getting surgery. All of this was for a coaching staff who often brought up Wally Pip as an example to the kids.

quote:

Originally posted by CADad:
All of this was for a coaching staff who often brought up Wally Pip as an example to the kids.

Not sure what that means. Are you saying that, from your experience, once you have a small problem, you will inevitibly have a major problem within the next couple of years?

Sounds like with the second two kids, they suffered from overuse issues. Could be wrong, but throwing almost all sliders for six innings doesn't sound good even if the kid never had a problem in the first place.

Maybe you could clarify what using "Wally Pip as an example to the kids" means. I'm a little lost on that one. Thanks.

Wally Pip was the player who sat out for an injury and was replaced by Lou Gehrig for a game or 2130. The implication was that you should play through pain or lose your position. All three resulted from overuse and all three were afraid to report their pain. The position player at least told his dad who got him to a doctor early.

No, it isn't inevitable by any means. Just like a lot of things it is a bit more likely to recur once it has happened the first time. There are a lot of success stories with conservative treatment. One of the more recent success stories was Takashi Saito who used PRP as a treatment rather than surgery. I'm not sure but I think Ervin Santana also took the conservative route and finished this season well.

It is important to check with the doctor as to success rates with conservative therapy because if it turns out to be more than just micro tears then the rehab takes a long time and there's a fair possibility of still having to have the surgery.

Poor Wally Pip! Kind of like whoever was a shortstop in the Orioles organization for 17 years.

Fortunately, son's coaches, both HS and Summer, are very concerned with and aware of overuse issues. I am as well and would not be shy about stating my opinion to either of them. Son is not shy about letting us know when he is sore or hurting either. I can tell the difference and he will tell me the difference between when someting hurts and when it is just sore. Believe me, we'll be keeping an eye on it. We got him to the Dr. on the second day after he pitched and said it was hurting. No lollygagging.

I hear you talking about conservative therapy. My understanding in talking with both son's doctor as well as Dr. Fleisig at ASMI is that they recommend rest and PT first (guess that is conservative therapy) before any kind of surgery. By mentioning conservative therapy, you imply there is another way to go early in the process. Are you advocating surgery early on, or is there another course of action you are suggesting?

I'm not advocating anything. Every situation is different and the only thing you should do is keep talking to his doctor. PRP (Platelet Rich Plasma) can be an adjunct to conservative therapy in some cases. I doubt very much that any insurance companies would pay for it though.

BTW, my son's old hitting instructor was a SS who came up behind Ozzie and then was traded to the Orioles.

Whew. That's a tough spot to be in!! Not much chance of making it to the MLB no matter how good you are in that situation.

He made it to the bigs but never did much more than backup. In his words he was Ozzie's caddy. He played a bit of 3rd base with the Orioles. He got a bit of playing time with the Reds in between his stints with the Cardinals and the Orioles.

BTW,
Just heard that another kid from the same HS team a year previous had to have TJ surgery.

Update. Son had the follow up visit with his doc today. Got the go-ahead to start throwing again. He is on the ASMI program to build back up arm strength after not throwing for a month.

Asked doc about the sprain issue. He said he never thought it was any kind of significant tear. He said it may have just stretched some. He basically said even one little strand tearing is a sprain. Bottom line is, he says it looks real good and we should get on the throwing program.

I'll update again once he starts throwing off the mound and see how he feels then. Thanks for all the feedback.

Just a quick update. We have been throwing for about 2 1/2 weeks. Everything going fine. No pain, no soreness. Son went to first pitching lesson yesterday. Did not throw off mound, but pitched to a catcher from in front of the mound to start. All went well. No pain or soreness there either. He said he was throwing about 75%, just taking it easy. Anyway, so far, so good. Next lesson is on Tuesday evening. Will let you know how that goes.

We have gotten 4 opinions: 2 ortho's(different groups) and 2 radiologists(same group). 3 say no tear and 1 ortho (the most experienced and recognized) says no doubt there is a tear. What to do? The "popping" sensation must have meant something - no?

quote:

We have gotten 4 opinions: 2 ortho's(different groups) and 2 radiologists(same group). 3 say no tear and 1 ortho (the most experienced and recognized) says no doubt there is a tear. What to do? The "popping" sensation must have meant something - no?

How long has he had the problem? Has he done any rehab?

Happened 3 weeks ago on a single pitch - popping felt in elbow followed by pain. No pain prior to pitch. In fact arm strongest it ever was. We just want to know what popping could have been if it was not a tear.

You supposedly have 4 opinions from "experts" in the field---why do you think you will find an answer on this site with laymen?

not looking for a medical answer, or diagnosis, just whether others have had the experience of mulitple conflicting diagnosis' on a UCL sprain/injury.