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Actions such as repeated overhand throwing can cause tiny fractures of the cartilage where the elbow is growing. The result is irritation and pain that develops on the inner (medial) part of the elbow. A similar condition happens in the knee, called Osgood-Schlatter disease.An injury that occurs in adult athletes from repetitive throwing involves stress on the ulnar collateral ligament that is sometimes treated with “Tommy John surgery.”
Medial epicondyle apophysitis typically starts with a gradual onset of pain associated with hard throwing and similar activity. At first, the pain shows up only by throwing, but if it persists, normal daily motion and elbow use can be painful. Other times, there may be a “pop” heard and felt during a hard throw. There may be numbness, tingling or weakness of the forearm, wrist and hand.
The diagnosis is primarily made based on your child’s health history and a physical exam. The inside of the elbow is tender and painful in certain positions. Occasionally there may be swelling. X-rays may be ordered, and advanced imaging such as an MRI may help find the condition.
Ice and anti-inflammatories often help reduce inflammation and pain. Typically, your child will need to stop throwing for six weeks. After that, a specially trained physical therapist (not a pitching coach) will oversee a progressive throwing program. They work on proper throwing mechanics with the arm and highlight core and leg strengthening, as these help with throwing strength and endurance. Your child is allowed to return to practices and games when the pain is gone.