Simply put, "Pitcher's Elbow" refers to a sprain or tear of the ulnar collateral ligament (UCL), the main structural ligament that supports and stabilizes the medial (inner) part of the elbow joint. It is fairly common among pitchers due to the repetitive motion of the position, but many non-baseball players can develop it as well. For patients who may be dealing with this type of problem, the team at Valley Sports Physicians & Orthopedic Medicine & Orthopedic Medicine can easily diagnose the issue and offer non-invasive options for treating pitcher's elbow in Glastonbury, CT to fix the underlying source of pain.
Pitchers and other overhead athletes place a tremendous amount of stress on their elbows. In particular, the type of stress is referred to as a valgus stress. This puts significant tension on the UCL. Over time, with forceful repetitive stress, the ligament begins to weaken, and microscopic tears develop. Eventually, the ligament fails and tears completely, resulting in pain and instability of the inner part of the elbow.
UCL tears are diagnosed based on history, physical exam, and imaging studies. X-rays can be helpful to identify problems with the bone they cannot see damage to soft tissue structures such as ligaments and tendons. Diagnostic ultrasound and MRI are the optimal imaging approaches to see ligament damage. One advantage of ultrasound over MRI is the ability to perform dynamic testing. You can stress the elbow and watch under ultrasound to see if the joint space moves more than it should, indicating ligament compromise and joint instability. Ultrasound can also be done right in the office. But an MRI can be helpful to see things that cannot be evaluated by ultrasound, such as damage to the cartilage. Often US and MRI are used in conjunction to get a more complete picture.
For mild sprains, physical therapy, rest and activity modification is the standard and works well in most cases. A home therapeutic ultrasound unit, such as the samSport®, can also speed the healing. If the ligament is completely torn then arthroscopic surgery is indicated. The most common type of surgery is the famous "Tommy John" procedure, named after the professional baseball pitcher who was the first to have the surgery done.
There is somewhat more controversy regarding treatment options for a ligament that is partially, but not completely torn. Some physicians advocate surgery for high performance or elite athletes, while others advocate a more conservative approach. We generally advocate a more conservative, non-surgical, approach when possible. In most cases of a partial tear, it makes little sense to us to tear out the remaining healthy portion of the ligament and perform a fairly radical surgery! Alternatives to surgery include ?Regenerative Medicine Treatments such as Prolotherapy, PRP, and stem cells. * These treatments are designed to stimulate the body's natural healing mechanisms to repair the damage. We've been doing Regenerative Medicine treatments longer than any practice in southern New England, and longer than most in the whole country. To learn more about Regenerative Medicine treatments, click HERE for a free e-book on Regenerative Medicine.
(*NOTE: All Regenerative Medicine treatments are performed by our affiliate practice, the New England Stem Cell Institute.)