Pitching Injuries (Continued)
Ross Hauser, M.D.

He noted, “The changes were in direct proportion to the amount and type of throwing.” Torg and associates made similar observations, noting 70 percent of a group of 13 year old pitchers had symptoms about the elbow or shoulder during a season. Why are all of these elbows getting injured? Are athletes throwing too much? Should the athlete just stop throwing?

The answers to these questions come when you consider the main stabilizing forces about the joints. Because these tissues are constantly injured during pitching, they ultimately cause the condition called Little League Elbow, which encompasses a myriad of symptoms.

The medial side of the elbow takes the brunt of the force during the late cocking and the acceleration phase of the throwing motion. This can apply to any throwing motion of the elbow, including the baseball pitch, javelin throw, or tennis serve. Stability of the elbow is provided by a combination of the bony congruity provided by the articular geometry, and the capsuloligamentous structures. The main ligament supporting the medial side of the elbow is the ulnar collateral ligament (UCL). The relative contribution to elbow stability by the bony and ligamentous structures is range-of-motion dependent. With the elbow in complete extension, the UCL and bony articulation of the ulnohumeral joint each contribute 31 percent of the restraining force to resist valgus stress.

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