Golfer's Elbow - Medial Epicondylitis

I know looking for medical advice online isn't the best path, but DD has gone to doctor and doing PT, just looking for additional information from any of you that have successfully dealt with this as I am not finding much information online in regards to this and fastpitch.

15 yr. old DD has been diagnosed with golfer's elbow at the end of HS season. Never heard of this before, but similar to tennis elbow just on the inside of the elbow versus the outside. The ortho doc felt it was a combination of overuse and improper warm up when coming in games to pitch. HS coach would bring her in quite a bit middle of games with no additional warm up other than what she did before the game. DD actually was playing CF one game (when our regular CF was hurt) and tried to make a throw home when this first started. Pitched quite a bit the rest of the season and felt some discomfort but never enough pain that she ever told us. Now that HS is over and the real season has started its bothering her enough that she hasn't pitched in her first tournament and backed out of the pitching session of a showcase camp. Throwing overhand or hitting has not bothered her as long as she has warmed up properly. It will start to hurt after warming up to pitch and throwing 10-20 full speed pitches.

She has been going to physical therapy (seem to be working more on her shoulder than her elbow?), doing stretches/exercises we found online, icing and aleve/ibuprofen. Its been 3 weeks since the diagnosis and doesn't seem to be getting much better. She has pitched just a couple times since the diagnosis to try and gauge if its getting any better, she will do her normal warm ups and can pitch 50-75% without any problems, but once going all out will start to feel pain within 10 or so pitches. Doctor told her she is not restricted and just to stop once the pain exceeds a 3 out of 10.

We have tried the elbow braces that have the tendon relief pads and they help after it is hurting, but they do not help while she is pitching and I am worried they could cause other problems since they are tight on the forearm muscle.

Any information you guys have would be greatly appreciated.

It sounds like what I have. Playing catch with my DD, I threw too hard too soon, and felt a tightness and pain in the inside of my right elbow. Hoping it would loosen up, I kept throwing - wrong choice. It's been over a month, and it hasn't gotten better. I also keep irritating it during my day to day life. Anything more than easy throws causes pain. Hitting causes pain. Lifting a bag of groceries causes pain. Underhanded throws/pitches, however, are okay for me.

Eric F .... I went through this at one point. What worked well for me was a series of the "Graston Technique Treatments", some time off, and returning with a focus on better mechanics.

Example ....

My DD recently had some similar issues. Obviously the most important information and advice will come from a medical professional. But I will gladly share some of what I have learned through DD's injury.

Are you sure that it is just medial epicondylitis? Or is the swelling/inflammation also causing ulnar nerve entrapment? If she is feeling tingling or numbness in her pinky and ring finger, I would ask the doctor to test the ulnar nerve. I would also suggest asking her to squeeze one of your fingers with the pinky and thumb from her non-injured arm. Then do the same with the pinky and thumb from the injured arm. Is there a noticeable difference in strength? If so, the ulnar nerve could also be a cause. Again, I am not an expert, so please discuss this with a professional!!

DD had a combination of both. Ultimately it required a 6 week shutdown with no activity, during which she did PT 2 or 3 times per week. She now wears a golfer's elbow support strap from Mueller Sports and doesn't have any issues at all. She is capable of throwing fastballs, drops, and change ups without the brace, but as soon as she attempts to throw a screwball or riseball, she will feel discomfort. With the support strap, she can throw any pitch.

Daughter went through something similar. I would tend to think it is overuse. We did do a PRP treatment just as a precaution (They do cost some money). If it was my kid, I would probably recommend several weeks of rest from throwing. Let her play, but as a positional (low amount of throwing/DP) player. We had to end up taking off around 12 weeks from all throwing and playing (Mine would also have pain when hitting). Remember: Ounce of prevention is worth a pound of cure. I know you want to pitch her now, but you may risk a lot in the future.

I second Graston if you can find someone. Neat technique but I have never been able to find anyone in my area.

I've dealt with this myself from weightlifting and would recommend you find an Active Release Technique (ART) person in your area who specializes in sports injuries. You can go to Active Release Techniques: A.R.T. and search for licensed practitioners. ART is amazing with any type of soft tissue damage like golf/tennis elbow among other things and I can't say enough good things about it given how helpful it has been with me.

My DD had this but our Orthopedic called it Little Leaguer's Elbow. She had actually separated her growth plate! She too was a pitcher but the injury came at tryout time a few years ago while she was making long throws from the outfield. She started throwing side arm and complaining about it a lot. After a few weeks of "just take an Advil and suck it up" we took her to the doctor. He sat her for 6 weeks and PT 3x a week. When we returned for a recheck he twisted her arm a certain way and said she is healed. He said since the plate had healed she should not have it happen again. He also said it was not from pitching but from overhand throws. Every now and then she drops her elbow and throws side arm, so we have to remind her. It really messed her up! Make sure it isn't structural before you go any further....


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Eric F said:

It sounds like what I have. Playing catch with my DD, I threw too hard too soon, and felt a tightness and pain in the inside of my right elbow. Hoping it would loosen up, I kept throwing - wrong choice. It's been over a month, and it hasn't gotten better. I also keep irritating it during my day to day life. Anything more than easy throws causes pain. Hitting causes pain. Lifting a bag of groceries causes pain. Underhanded throws/pitches, however, are okay for me.

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I hear you, between my thumb from catching her drop, left shoulder from chasing wild pitches and just the amount of overall throws made have taken its toll...wouldn't have it any other way though...

FiveFrameSwing said:

Eric F .... I went through this at one point. What worked well for me was a series of the "Graston Technique Treatments", some time off, and returning with a focus on better mechanics.

Example ....

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FFS...thank you I will definitely look into this.

FP26 said:

My DD recently had some similar issues. Obviously the most important information and advice will come from a medical professional. But I will gladly share some of what I have learned through DD's injury.

Are you sure that it is just medial epicondylitis? Or is the swelling/inflammation also causing ulnar nerve entrapment? If she is feeling tingling or numbness in her pinky and ring finger, I would ask the doctor to test the ulnar nerve. I would also suggest asking her to squeeze one of your fingers with the pinky and thumb from her non-injured arm. Then do the same with the pinky and thumb from the injured arm. Is there a noticeable difference in strength? If so, the ulnar nerve could also be a cause. Again, I am not an expert, so please discuss this with a professional!!

DD had a combination of both. Ultimately it required a 6 week shutdown with no activity, during which she did PT 2 or 3 times per week. She now wears a golfer's elbow support strap from Mueller Sports and doesn't have any issues at all. She is capable of throwing fastballs, drops, and change ups without the brace, but as soon as she attempts to throw a screwball or riseball, she will feel discomfort. With the support strap, she can throw any pitch.

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FP26, I can't say for sure. She has not mentioned any tingling or numbness. My wife took her to the doctor so not sure all she tested for, but I will definitely double check. Glad to hear your DD has recovered or at least has it under control with the brace. Thank you for the information.