College Pitcher- Diagnose my elbow pain. No one else Can

I’m a college pitcher playing at a division 1 level. I’ve gone to several baseball specific doctors and explained my story, leaving them scratching their heads. X-rays and contrast MRIs reveal nothing. Everything intact. All healthy.

My story…

Inner elbow pain near the UCL. Ways to feel the pain are… If I was the place my elbow on my stomach and pry into it by rotating my wrist with inward pressure, this would reveal inner elbow pain. If I was to rub my head as if I was shampooing my head with moderate force, this reveals the pain. If I’ve been throwing off and on and with little intensity, I do not feel pain while throwing.

Now when I involve more difficult throwing (bullpens/longtoss)… the initial throws I make decrease the pain felt. (Pain is felt during the accelerating/cocking phase.) Eventually, when fully warm and throwing hard, there isn’t inner elbow pain whatsoever. Once I stop and rest in between innings, maybe 5 minutes, I have a burning elbow pain on the inside of my elbow. If I would start up throwing again, it would take longer for the initial throws to reduce my pain felt. In other words, instead of 5 throws warmup throws to eliminate the pain like in my first session, it would take 10 throws to not feel pain. Once done throwing, my pain is QUICKER to come back and more intense. Instead of 5minutes after throwing, the pain is back in 2 minutes.

If I really wanted to irritate my elbow, I would throw everyday. The pain gradually increases from day to day. The pain is more intense and quicker to come once done with throwing. Near the end of my sophomore season, the pain became scary. The inner elbow pain didn’t go away on the initial throws; it was a constant burning on every throw, regardless of the intensity of the throw. So I shut it down sophomore year.

What’s frustrating is that I took off my entire junior year by red shirting to let the elbow calm down (assuming it was some type of tendonitis.)
Now being a redshirt junior and picking up throwing again, the exact same pain is beginning to come back and increase with pain.

I would love for anyone to give suggestions on what this could be. Sorry for the long response. And no, I don’t feel pain doing the milk test.

How many sets of x-rays and MRI’s were taken? By how many doctors? Maybe you need a second opinion?

Any tingling or numbness in the fingers? Have the doctor(s) considered ulner nerve issues (entrapment, impingemen, etc.)?

You may have a facia injury. Its like the gristle that wraps around the muscle. It has similar composition to a tendon in that its fibroelastic, with poor blood flow. It attaches muscle to muscle, skin, or even bone. The difference between it and a tendon is a tendon is a thickening of it at the end of the muscle while facia is more along a muscle belly. (look at a bone in steak) Yours seems to be related to the wrist flexor muscle groups. I’m sure they did an elbow medial and lateral stress test and your negative which rules out ligaments. Facial inflammation usually lasts 3-4 months. But since you have repeatedly re-injury this it is more severe.

You say light throw relieve it because is has an elastic component and gets stretched out like gum. But after rest the gum shrinks back down and is now irritated beyond its normal inflammation causing more pain. When you throw hard you enter the fibrous part which does not stretch and cause stress on the facia.

For plantar plantar fasciitis the treatment is stretch , although you may be different.
Have you tried to stretch your wrist flexors?

It can be stretched hold for 5 seconds. Then 10 or 20 seconds depending on pain.
What could that feel like?

As noted above mild facia injury is 3-4 months so yours could be much longer.

Disclaimer : this is not medical advise. Do not try this . you know what I mean :roll:

Other examples of your injury is a person that goes hiking and uses two ski poles like canes. The person is generally physcialy fit cardio wise and mentally strong so is able to push hard in hiking. But does not nessassry have strong arms. The person injures the facia of the triceps from multple weekend 1-2 hour long hikes. Severe sharp pain lasted for more then 3 months due to repetitious multiple weekend hikes. Aggravation of pain if the elbow is bent too much, stretching the triceps. Or active elbow extension with resistance, using the triceps.

Anther is a person that is mildly out of shape and take a class that has jumping on a trampoline. Since the activity is fun, the person over exerts, and has sever pain along the calf. Aggravation with calf stretch or pushing down with the toes. The person has a severe limp, unable to put the heel down when walking because it stretches the calf. Pain has been 2 months , but is getting better. Now this person might have had only 1-2 episodes of hard jumping, but has to use the calf for walking although limping limits the aggravation. But with rest, this person got better, although not healed yet.

Where are you located? Maybe I can recommend a doc in your area.

Thanks for the responses everyone. It means a ton.

Roger- I’ve gotten 2 x-rays of the elbows by two different places in the past two years.

I’ve gotten a contrast MRI and an MRI with no dye over the past two years as well from the same place.

No nerve issues. I do not have nor have ever had tingling or numbness in the fingers. I forgot to mention that.

Plaz- I’ve yet to hear any docs about it being a fascia injury. I’m going to look into that.

I must say that I’ve tried elbow rehab with all 6 elbow strengthening exercises including elbow stretches. The first initial elbow exercises evoke pain but decrease over time. Eventually when fully warm, I feel absolutely awesome while doing the exercises and stretches. I feel like I can throw 100 mph. Except, once I cooldown, the pain is more severe than when I started. The stretches and strengthening are deceptively causing more pain if that makes sense.

structuredoc- I’m located in Maryland. I’m willing to travel all along the east coast.

I’ve seen Wiemi Douoguih. Apparently he is the National’s arm doc??? He thought it was a UCL strain. I believe he wrote that down because he had no idea what the issue truly was.

I’ve also seen Phil Donley. He thought it was brachialis tendonitis. I was rock climbing in addition to throwing during my sophomore year when the injury started to come up.

I’ve seen Steve Luca as well. He thinks it’s the pronator muscle group.

Thanks again for the responses.

I was rock climbing in addition to throwing during my sophomore year when the injury started to come up.[/quote]

You didnt mention this earlier. You are very similar to my examples.
I dont think many MD knows about facia problems because its difficult to pinpoint and MD dont spend much time with the patient. Physical Therapist spends a lot more time with the patient and a good one might have prior experience.

Someone with this problem might try stretches only. No strengthening. But stop if the pain returns stronger.

ptothepaul - I sent you a PM

ptothepaul----also sent you a PM.

Did they ever figure out the problem my kid is having same issue

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Did this ever get resolved. This is happening to my son.

There are two possible “cures” for this painful situation. Believe me, I know, which is why I’m throwing again without the inner elbow pain that prevented me from throwing baseballs with power for 20 years. Now I throw pretty hard for a 60 year-old professor of physics without the nagging pain while throwing and after throwing (i.e., days later). Cure #1 Power-Pronation (supinate then pronate). I shared this information already with this pitching site: Power-Pronation

Cure #2 The Neutral Wrist (Read about the fastest fastballer who threw his 110 mph fastball using the neutral wrist): World’s Fastest Fastballer

Good Luck.