I had tommy John on October 2012. I completed all my throwing and rehab so then I was told to shut down until about January. So came january, I started throwing again and now I’m doing bullpens. It seems that whenever I am doing bullpens and really try to throw hard, I get a tingling feeling in my ring and pinky fingers… My doctor said he moved the nerve over my lateral epicondyle so that it would not become compressed again. I don’t know what could be causing this… I also have something called snapping tricep syndrome where my tricep snaps over my bone when I bend my arm past 90 degrees. Could it be from that? What could be wrong ? Should I do longer warm ups?
I would consult with my doctor. He can give you the best explanation of what might be going on
Go consult the doctor who performed the surgery.
I am not a doctor (yet) but I’m pretty sure your ulnar nerve is compressed. This nerve is responsible for sensible innervation of your pinky and ringfinger.
I have no idea how serious this is, but I’m pretty sure it’s not fixable by just doing a better warmup. Your doctor will know
Don’t jump to the conclusion it’s a damaged ulnar nerve and that you need potential career ending surgery. My 18-year-old son had EXACTLY your symptoms 2 years post-T. John 3 weeks ago. Talked to his surgeon. Figured he was done forever. Maybe re-routing the ulnar nerve so it wouldn’t hurt in living his regular life.
Kid went to Dr. Marko Borba in Napa to do nerve testing to see the damage to the nerve. If he’d gone to most any other doctor for the nerve test…they wouldn’t have done ultrasound on the elbow and they wouldn’t have found…
The screw implanted in his elbow to hold the ulnar ligament in place 2 years ago is stick 3 mm above the bone in his elbow and the ulnar ligament rubs against the screw!
The surgeon can simply shave down the screw or totally remove it. The screw is useless. His ligament is attached fine now.
Dr. Borba said he’s NEVER heard of a Tommy John patient with the symptoms be diagnosed…i.e., that the screw had moved and was hitting the ulnar nerve. Dr. Borba said, “I lecture internationally. I’ve never heard of anyone even considering the ulnar nerve symptoms stemming from the screw sticking out. It could be a real breakthrough because lots of pitchers have these symptoms.”
So, my son went from thinking he was done pitching forever to Dr. Borba saying, “We can fix him. We just need to shave the screw down or remove it. It serves no purpose in there now.”
Here’s the key: Borba and his assistant used state-of-the-art ultrasound equipment to look at my son’s ulnar nerve. Almost no doctor would use ultrasound! They’d assume what readers here assumed…ulnar nerve compressed, re-route the nerve, etc.
The assistant saw “something that looked like a piece of metal” in my son’s elbow. She went to Dr. Borba who studied the ultrasound, found the screw and called my son back to his office!!!
He spent 90 minutes patiently looking for that screw via ultrasound and then seeing when and were it hit the nerve. He manipulated my son’s elbow and…when my kid felt that terrible pain…the doctor spotted the screw and did what he does and took x-rays. The x-rays show the screw sticking up 3 mm and the ultra sound shows the ulnar nerve rubbing against it.
I don’t know the odds of this being the case for others. I just know an interational lecturer said it could be a breakthrough. So…specifically ask you doctors to CHECK to see if that screw’s in place. You’re paying THEM.
If you need to have your doctor talk to Dr. Borba…email
The post above is based on bogus info! I wrote it after a doctor tested my son’s ulnar nerve when his surgeon had determined it necessary to re-route the nerve to alleviate pain and numbness…the doctor who said his nerve was 100% healthy also said the nerve was rubbing against the clip used 2 years ago to hold the new ligament in place in my son’s elbow…
We believe what we want to hear…and it turns out that my son’s surgeon talked to Dr. Borba (mentioned above) and said that there’s no way the ulna nerve could rub against the clip…ultrasound and x-rays don’t offer depth perception or pick up all the tissue and bone between the nerve and the spot where the clip is located…so the surgeon, a noted sports surgeon in California, told Dr. Borba that he was wrong…today he explained that lots of doctors who don’t deal every single day with athletes, let alone pitchers, are always misdiagnosing this stuff.
Dr. Arthur Ting, my son’s surgeon, got my son back to pitching quickly. The surgery was performed wonderfully. So…I felt like a dope when he explained where the clip is…how the nerve moves…etc. to us. I take a little pride in knowing the basics about the elbow at this point. I felt like a meathead today.
So…Dr. Ting is going to do the “simple” surgery involved in moving the ulnar nerve above my son’s elbow…then he’ll cover it with fatty tissue to protect it…and after 4-6 weeks…my son will be able to move the elbow without pain…and can pitch after that if he chooses to do so.
Interesting: When my son flexes his elbow…you can SEE the ulna nerve pop up in one spot…then see it move and pop down about an inche below. So, the pain is caused by the fact that the nerve is moving around in there! We can see the problem looking at the elbow.
Ting’s theory on moving the nerve is simple…if the nerve isn’t causing a problem, why do more cutting and more surgery to move it on the off chance it might cause problems later? My son never had a problem with the ulna nerve and it’s 100% healthy…so Ting wouldn’t move the nerve. The nerve broke free and started causing pain well after my son returned to pitching…so Ting will address it now.
As a dad who followed his son through elbow problems from age 13, 14…to the point he was an elite D1/MLB type kid at 16…to Tommy John…to his returning to health but not returning to elite status yet…I agree with Dr. Ting’s conservative approach.
This post may be late advice, and perhaps not timely, but I thought I’d offer it anyway.
Recovering from this kind of injury is time consuming and expensive – as you already know. If you son is going to continue with serious baseball, especailly pitching, here is a suggested itinerary that might prove helpful:
- his primary MD is his health care speicallist that I assume, refered your son to his surgeon. This relationship is a critical one, primary talking with the surgeon. These professionals collectively must provide information down stream that will assist each other, in addtion to keeping the coaching professional informed of what to expect as well as how much, as your son gets back into the swing of things.
- your son’s pitching coach must have a benchmark of his/her own of the quality of progress that your son should be making, session by session. Along with his/her benchmarks, he/she should have a metering system on advice form BOTH your son’s primary and his surgeon.
- your son’s pitching coach should have experience with coaching your son’s age group under these circumstances. He/she must be very senstive to the little things that your son does, especially the ways in which your son may want to overcome pain and discomfort by not showing such, in order to continue with his baseball.
- usually, every two weeks is a good time for a sit down meeting with you, in addtion to providing you with a written report comparing the advice from your son’s primary health care provider and his surgeon, and his/her appraisals of your son’s progress. This written report should be detailed and accompanied by hard copy pictures, and video if possible.
- Since this pitching coach is the professional controller of the limits and goals of your son’s pitching experience …your son, you, your son’s primary health care provider and surgeon, should understand everything in print from this pitching coach. Just remember, he/she is tempering his/her appraisals on what’s expected of your son at his level of play and one step beyond. If he/she feels that this is not realalistic and reasonable, listen to him/her. On the other hand, I’m sure you have a gut feel on what is and what is not reasonable for your boy.
Best wishes on your son’s baseball experience.