Issues with ulnar nerve and ucl

#1

I have had arm issues off and on for last two years. Two summers ago I had a partial UCL tear which I rehabbed from although I likely came back too fast. Pitched last spring in college then summer ball. At the start of my fall season I felt a pull on my elbow while playing softball. Went to the doctor and MRI showed nerve inflammation as well as ucl partially torn (I never had follow up MRI after I rehabbed first time so I am unsure if it was showing same partial tear or new injury). Took last winter off/rehab. I have been playing this summer with some nerve discomfort, for example I can pitch pain free (good velo and control) but certain random movements at work for example will give me discomfort. However recently (last two weeks) the nerve discomfort has gotten severely worse to the point I need to have my elbow taped all the time.

I am going to nerve specialist this week to get an EMG but unless there is some miracle cure I don’t see myself avoiding surgery. I was wondering has anyone had any experience with ulnar nerve pain or a combination of this with ligament issues, as I’m a bit worried they will be unable to operate on my nerve without my UCL giving out?

#2

A UCL tear and ulnar nerve discomfort go hand in hand. With the tear or partial tear of the UCL, the nerve will be put under a lot of stress when throwing.

I also had a partial tear to my UCL, but luckily my nerve didn’t get irritated or injured. I tried to rehab my arm but eventually a bone spur grew to large. A partial tear will heal, but never will have the same ligament stregnth. After 3 years with a partial tear, I’m finally getting Tommy John next week.

I would definitely see a doctor about it. Good Luck!

#3

Kaner is correct. Ulnar neuritis from too much gapping or opening on the medial/inside part of your elbow when throwing. If the root cause is indeed your elbow laxity from a partial UCL tear, they may want to address that cause, and/or if surgery is the way to go, they may just move the nerve more anterior (to the front) on your forearm. If you get an increase in symptoms when someone does a valgus stress test on you, good chance they’ll want to reconstruct your UCL. Best of luck. Keep the community posted on your treatment and progress.

Chris

#4

Thanks, the odd thing is pitching does not seem to effect the neuritis symptoms I am getting although I am quite sure ucl damage is contributing. Went to nerve specialist yesterday and had a nerve diagnostic test performed (I believe it was called an EMG). He said my muscles showed sign of nerve irritation but overall nerve looked pretty healthy. I am going to ortho later today and I expect to get a cortisone shot. However the other thing I am balancing in my mind is the possibility of trying to opt for Primary Repair over TJ as I am reasonably sure my ucl is on the way out and missing 7-8 months sounds a lot better then 18. I will let you know how ortho goes. Just a bit frustrating as I have had a breakthrough summer pitching (velo jumped from 79-81ish to 85-86 and feeling more velo gains are on the way)

#5

Trebeck, I feel your “pain”. My 14-year-old son experienced the UCL inflammation for the first time in early April since he started pitching at 11. It was not due to over-pitching. The X-Ray showed no tear and his growth plate was completely closed. He just came back and pitched in his middle school championship game over the weekend and did well and they won. The moral of the story is that you need to learn to “take care of your injury”. You need to allow yourself to heal and you are still young and I read your posts and I interpreted it as you “rushed” back to pitching too soon.

I know many coaches thought I am crazy because I taught my son NOT to throw at “top velocity” most of the time. The goal of a pitcher is to “disrupt” the batter’s timings and forms. There are different strategies in pitching to top of the batting order vs. the bottom. This is particularly true in little league or youth league. My son accumulated 110 innings from Sep., 2015 through Jul., 2016. I recognized it was way too much, so I made him took fall season off and he ran “cross country” to build up his lower body and stamina.

I know you want a “miracle” fix, but you really need to take an “easy”. You have long road ahead of you.

Best luck.

Alex

#6

As a orthopedic physical therapist I treat these diagnoses often. The most important step that is often neglected is teaching the athlete to throw differently and improve his kinematic sequence so stress is applied to the joints and tissues differently. This isn’t something that is never evaluated in the doctor’s office but is crucial to protecting the previously damaged structures from becoming more compromised or reinjured.