Medial Elbow Problems in the Overhead-Throwing Athlete

Chen, Frank S.; Rokito, Andrew S.; Jobe, Frank W.

doi:10.5435/00124635-200103000-00004

Cited by 211 publications

(158 citation statements)

References 29 publications

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“…Complete ligamentous disruption with resultant valgus instability can be detected on physical examination and confirmed with an MRI (8,12). However, subtle partial tears of the medial collateral ligament can occur, characteristically sparing the superficial fibers of the anterior bundle.…”

Section: Medial Collateral Ligament Injurymentioning

confidence: 90%

“…Maximal valgus stress is applied during the late cocking and acceleration phases of throwing (8,12). Forces may exceed the tensile strength of the anterior bundle, resulting in ''valgus extension overload syndrome'' (8,12,13).…”

Section: Medial Collateral Ligament Injurymentioning

confidence: 99%

“…Injuries to the medial collateral ligament are usually treated conservatively, with antiinflammatory medication, splinting, and physical therapy (8,12). Surgical repair or reconstruction of the medial collateral ligament is usually reserved for high-level athletes involved in overhead throwing activities (8,14).…”

Section: Medial Collateral Ligament Injurymentioning

confidence: 99%

“…Medial epicondylitis or ''golfer's elbow'' is less common than lateral epicondylitis and may be seen in highperformance athletes, particularly in sports requiring repetitive valgus and flexion forces at the elbow, such as golf, tennis, racquetball, baseball pitching, javelin, football, archery, and swimming (12,26). Similar to its lateral counterpart, medial epicondylitis is thought to represent an overuse injury, resulting in degeneration and tearing of the flexor-pronator muscle group arising from the medial epicondyle.…”

Section: Medial Tendon Pathologymentioning

confidence: 99%

“…Focal tenderness is present over the medial epicondyle. However, the clinical diagnosis of medial epicondylitis can be more challenging clinically, as similar symptoms can be produced by MCL injuries, ulnar neuritis, or intraarticular pathology (12,26). Therefore, MRI can be extremely helpful in the evaluation of patients with medial elbow pain.…”

Section: Medial Tendon Pathologymentioning

confidence: 99%

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Magnetic resonance imaging of the elbow

Stevens

2010

Magnetic Resonance Imaging

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Elbow pain is frequently encountered in clinical practice and can result in significant morbidity, particularly in athletes. Magnetic resonance imaging (MRI) is an excellent diagnostic imaging tool for the evaluation of soft tissue and osteochondral pathology around the elbow. Recent advances in magnetic field strength and coil design have lead to improved spatial resolution and superior soft tissue contrast, making it ideal for visualization of complex joint anatomy. This article describes the normal imaging appearances of anatomy around the elbow and reviews commonly occurring ligamentous, myotendinous, neural, and bursal pathology around the elbow.

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Section: Medial Collateral Ligament Injurymentioning

confidence: 90%

Section: Medial Collateral Ligament Injurymentioning

confidence: 99%

Section: Medial Collateral Ligament Injurymentioning

confidence: 99%

Section: Medial Tendon Pathologymentioning

confidence: 99%

Section: Medial Tendon Pathologymentioning

confidence: 99%

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Magnetic resonance imaging of the elbow

Stevens

2010

Magnetic Resonance Imaging

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Ultrasonographic prevalence of ulnar nerve displacement at the elbow in young baseball players

Kawabata

Miyata

Tatsuki

et al. 2021

PM&R

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Background Overhead‐throwing athletes are at risk of elbow injury because of valgus stress, leading to unstable ulnar nerves and neuropathy. Studies regarding ulnar nerve damage/displacement have been performed primarily in adults. Objective To determine the prevalence and related factors associated with ulnar nerve displacement at the elbow in young baseball players. Design Cross‐sectional study. Participants Youth baseball players ages 10–12 years were eligible to participate. Exclusion criteria were history of neuropathic pain, trauma, or prior surgery of the upper limb. Fifty‐seven participants were eligible for inclusion in the study. Main Outcome Measurements Demographic data and ultrasonography findings of ulnar nerve dynamics at the cubital tunnel were analyzed in a total of 114 elbows. Elbows were grouped into nondislocation and displacement (subluxation or dislocation) groups according to ultrasound findings. Logistic generalized estimating equations were used to identify factors associated with ulnar nerve displacement. Results Thirty‐six (31.6%) elbows demonstrated sonographic findings of ulnar nerve displacement, with 13 (11.4%) subluxations and 23 (20.2%) dislocations. Fourteen (24.6%) participants experienced nerve displacement in the dominant elbow only, whereas nerve displacement in both elbows occurred in 11 (19.3%) participants. Nerve displacement in the nondominant elbow only was not observed. Hand dominance and tenderness of the arcade of Struthersʼ were factors associated with ulnar nerve displacement (odds ratio, 2.81, and 9.73; 95% confidence interval, 1.34–5.91 and 2.45–38.68; p = .006 and .001, respectively). Conclusion One‐third of the young baseball players evaluated had ultrasonographic findings compatible with ulnar nerve displacement at the elbow. Hand dominance and tenderness of Struthers arcade were the only factors associated with ulnar nerve displacement. Ultrasound may help identify patients with ulnar nerve displacement and contribute to the understanding of its pathophysiology in young baseball players.

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