My shoulder NEVER hurts/ but inside elbow gets sore


#1

I’m 28 and ever since I was a kid the soreness I felt after pitching would be in my inside elbow, almost exclusively…When I hear people talk about sore shoulders I can’t relate b/c my shoulder is never sore … sometimes the back of my shoulder is sore the day after a long outing, but that’s it…

I’ve tried to figure out why this is, if there’s some mechanical reason for this … Plus, I wonder if the lack of shoulder soreness means I’m underutilizing my shoulder and therefore robbing myself of power …

Note: I’ve never had a serious arm injury (knock on wood)


#2

When you’re a kid, the pain comes from throwing too much or too hard and irritating the growth plate of the medial epicondyle (the bump on the inside of your elbow). When you’re an adult, the pain comes from the attachment of the Brachialis muscle trying to keep your elbow from rapidly extending to the limits of its stops.

What’s sore is the muscle that is used to slow down your arm. It means that you are throwing harder than your muscles can handle (and could probably use some exercises to strengthen these muscles).

No. The lack of general shoulder soreness means that your mechanics are decent. As I said above, the pain in the back of your shoulder means you are throwing hard (and sometimes harder than your body can handle).


#3

i have the same problem as andrew and u said u can do exercises to strengthen your elbow muscles what a some good ones i have a big rubber band if i can do them with that or anything else


#4

Unfortunately, while you can strengthen the muscles of the shoulder, you can’t strengthen the muscles of the elbow because they aren’t the problem. Instead, the ligament of the elbow are the weak link in the chain and there is nothing you can do to strengthen them.


#5

so is it a bad thing??? is it doing damage to my elbow??


#6

Possibly. It might suggest that you have a mechanical problem.

How old are you?


#7

What’s sore is the muscle that is used to slow down your arm. It means that you are throwing harder than your muscles can handle (and could probably use some exercises to strengthen these muscles).

No. The lack of general shoulder soreness means that your mechanics are decent. As I said above, the pain in the back of your shoulder means you are throwing hard (and sometimes harder than your body can handle).[/quote]

Actually, this could be a mechanical issue. Specifically, if you have an abbreviated follow-through then you are asking your decellerator muscles to stop your arm in a shorter distance than is necessary. That will certainly over-tax those muscles. If this is your case, learn to allow your arm to decellerate through a long, complete follow-through.


#8

i am 17 years old and a junoir in high school left handed.


#9

OK, so you’re probably too old to be having a growth plate problem. More likely the pain is originating in a tendon or ligament.

Do you throw a curveball or a slider? If so, do you twist your wrist and/or forearm when you release the ball?

I ask because if you supinate your forearm (twist it clockwise) as you come through the release point, you can overload your UCL and/or cause the bones of your elbow to slam together.


#10

I agree.

Andy Pettitte’s follow-through (in which he wraps his arm around his body) is an example of what NOT to do. I believe the problems with the back of his rotator cuff are related to his follow-through (which is abbreviated).


#11

Roger… yes, I’ve been told I don’t have a strong complete follow through …

Petite looks to me to be following throught pretty well in that picture.


#12

His follow-through is fairly unusual.

The problem is that his arm is right up against his body, which can cause it to stop short.

What would be better is if he kept turning his shoulders so that his arm was able to keep swinging free of his body. That would give the muscles of his shoulder a greater distance over which to decelerate the arm and reduce the peak force required to slow down the arm.


#13

It scares me when Chris gets on here and gives out medical information that is just plain wrong.

Of course strengthening the muscles and building endurance in the muscles around the elbow can help. Several of the muscle groups around the elbow help to reduce the load on the UCL during throwing. When those muscles get tired or damaged is when the UCL is the most vulnerable.

That doesn’t mean that you can build those muscles up enough to replace the UCL or that you’ll never damage the UCL but you can help maintain your elbow through exercise.

Although ligaments recover from damage much more slowly than muscles and tendons they also can be built up through exercise. The problem is that since it takes them so long to heal and because they don’t heal all that well it is very easy to damage ligaments when you are trying to build them up.

The reality is that almost every pitcher has built up their UCL to some degree and the unfortunate reality is that a lot of pitchers still do permanent damage to their UCL’s and require Tommy John surgery.


#14

The only way to make these muscles effective stabilizers of the UCL is to change your mechanics. For example, pronating through the acceleration phase activates the Pronator Teres muscle and decreases the load on the UCL.

Simply strengthening this muscle is not enough.

There is no reputable science that supports this statement.

There is a difference between an injured ligament healing, and a healthy ligament getting stronger.


#15

Studies using ultrasound have shown that the UCL’s in asymptomatic pitcher’s throwing arms are larger in cross section than those in their non-pitching arms. Wrong again Chris.

Studies have also shown that muscles including the pronator teres take load off the UCL and no you don’t have to pronate for them to take effect. The pronator teres has multiple functions.


#16

Exactly what studies are you talking about?

One thing to keep in mind is that a UCL with a larger cross section isn’t necessarily a stronger UCL. It could be larger due to the accumulation of scar tissue (which is inherently weaker than healthy tissue).

For example, here’s a link to study that says what you are saying but reaches exactly the opposite conclusion…

http://www2.rsna.org/pr/target.cfm?ID=126

Here’s a link to a paper that goes into more detail…

http://radiology.rsnajnls.org/cgi/reprint/227/1/149

Relevant quotes include “We showed that, at rest, the sonographically determined width of the ulnohumeral joint in pitching and nonpitching arms is not significantly different. With stress, however, there is a significant difference, with a mean of 1.4 mm widening in the pitching arms compared to 0.5 mm in the nonpitching arms. Given how common elbow problems are in the throwing athlete, it is reasonable to conjecture that these pitchers’ elbows, although asymptomatic when examined, are on the continuum of chronic repetitive UCL injury.


#17

The pitchers who did not have microtears also had thicker UCLs. Ligaments and bones do remodel, just not very quickly. When ligaments are taken too far they don’t remodel well and that is the risk inherent in pitching. However, if you were to take a UCL that had never been built up through throwing and subject it to the load that a 90 mph pitcher puts on his arm it would snap very quickly.


#18

Excellent posts Cadad! Try as I might I have yet to find a single piece of researched information that says one must or claims “pronating early” has ANY relevance at all to a diminishing the load on the ucl. Im not saying it doesnt or cannot but there is no reseach that directly states pronating early is a instant saviour of the ucl. at least that I have seen. Being I am a member of several sites that offer great info it seems to me I would have stumbled across at least a piece or two that makes the case for early pronation. your comments about ligaments are dead on from what I have experienced as well as seen.


#19

The remodelling that you speak of includes increasing the size of the Coronoid Process into which the Brachialis inserts. That decreases the range of flexion of the elbow and keeps pitchers from being able to comb their hair and brush their teeth as they get older.

That doesn’t sound like a good thing to me.


#20

Chris,
Here’s a quote. I’ll attribute the quote after you tell me what you think of it. No cheating and doing a search first.

OK,
It has been several days and you wouldn’t reply so here’s the source of the quote:
Dr. Mike Marshall.