Elbow Injuries in the Throwing Athlete

Overhead throwing athletes place a substantial amount of stress on the elbow during the throwing cycle. In athletes such as baseball players, repetition leads to attritional damage to the elbow. While injury to the medial ulnar collateral ligament is the most publicized, and perhaps most important, of these conditions, a collection of other disorders commonly afflict this population. These injuries include (1) ulnar neuritis, (2) flexor pronator injury, (3) medial epicondylar apophysitis or avulsion, (4) valgus extension overload syndrome with posterior impingement, (5) olecranon stress fractures, and (6) osteochondritis dissecans of the capitellum1. The purpose of the present review article is to describe the biomechanics of the throwing motion and the diagnosis and treatment of elbow injuries common to a thrower other than injuries to the ulnar collateral ligament. The osseous anatomy of the proximal part of the ulna and the olecranon fossa provides primary stability at 120° of flexion. The radial head provides secondary restraint to valgus stress at 30°. The primary coronal stability during the functional arc of an overhead …