12 year old ?UCL tear epicondyle avulsion


#1

Hi. My 12y.o. son started complaining about elbow pain after practice this past week. Pain decreased so he threw again 3 days later and had to stop because it started to hurt again. Couldn’t fully extend the arm. Elbow felt tight, he said it felt like it needed a good stretch. During lesson coach clocked him at 66mph strikes so no loss of speed or accuracy.

History: Never had any pain or injury before. He doesn’t play during the summer, took 3 months off from June to September. Played fall ball and sees a pitching coach once a week. Recent growth spurt 5” in past 12 months October to October, with 3” of those in 6 months from April-October.

Drs appt scheduled for Thursday with Dr Christopher Ahmad.

Have been scouring the web. Possible UCL tear, little league elbow, avulsion…Would appreciate any comments or thoughts. Thank you so much.


#2

Unlikely to be the UCL, as at his age the growth plate at the medial epicondyle is almost certainly not fused, making that growth plate the weakest link in the elbow and the first to give, not the UCL. So, assuming his growth plate at the medial epicondyle is not fused, it could be medial epicondyle apophysitis (inflammation of the growth plate) or medial epicondyle avulsion (fracture of the growth plate). That said, I do know a youth pitcher who tore his UCL and had Tommy John surgery at the ripe old age of 13. There is a long thread on this forum about it, here.


#3

Thank you for the reply and the link. I really appreciate it.


#4

Mykidsmom,

During his recovery period up until he get’s his Dr’s release to rehab, he needs to learn how and why the injury manifested it self in order to mitigate the pathomechanic that caused it. Use is not cause!

“ My 12y.o. son started complaining about elbow pain after practice this past week.”

Ask the Dr. to asses his biological age! The actual Radiologist is best to talk to. This can only be done if you compare his ball side Elbow’s X-ray with a requested X-ray of the glove side Elbow. He may be a delayed, equated or an Advanced maturer by as much as 2.5 years either way. Some pre-pubescent youth players are as much as 5 years apart from Advanced maturers. The more the growth centers are attacked (Adrenaline assisted ballistic reps) the older the ball arm Elbow gets. In other words his ball side Elbow solidifies earlier than the Glove side Elbow giving them lesser time to grow and as much as 2 years worth. My pitching Humerus is ¾ of an inch shorter than my glove side Humerus! This you never get back or recover from.

“During lesson coach clocked him at 66mph strikes so no loss of speed or accuracy.”

Hopefully this lesson came before the injury? Clocking youth players is detrimental! This age group should be learning the skills of pitching, not the power! Maximal effort should not be employed until all growth centers in the Elbow have solidified

“He doesn’t play during the summer”

This is good, now add in Fall and Winter and you’ve got it. It’s best learning and perfecting his skills during Summer, Fall and Winter where he can repeat perfect motor skills with out the debilitating adrenalin assisted competitions that perturb skill building when compared to quality practice time.

“Played fall ball and sees a pitching coach once a week.”

Ask your pitching coach if he understands the pathomechanical (injurious force application) effect of intuitive forearm fly out drive supination on the Elbow?

“Recent growth spurt 5” in past 12 months October to October, with 3” of those in 6 months from April-October.”

This is a huge red flag! Parents should always shut down pitchers during recognized hyper growth periods! There are more coming up until he is biologically 17

“Have been scouring the web.”

Did you run into or had recommended to you the leading overhead throwing Kinesiologist in the world, who specializes in injury mitigation and youth skellatle growth patters? Dr. Mike Marshall.

“Possible UCL tear,”

It’s possible even if Ligaments have no pain receptors! The pain that these injured feel is from their also sprained flexor muscle tendons that lye over the UCL. These tendons also Avulsed off their bone attachments.

“Would appreciate any comments or thoughts. Thank you so much.”

These injuries are eliminated by forearm pronating all pitch types and throwing your arm “inside of vertical” where you see them pop up the Elbow after release.


#5

The growth plates become more vulnerable to injuries during a growth spurt. I’m not a doctor but my bet is on a growth plate injury.


#6

Thanks everyone for commenting. He has a small hairline fracture of the medial epicondyle. Bad, but not as bad as it could have been. Now on to healing.