@Laphoneman Thanks for your kind words. It does not appear that any particular motion (other than throwing in general) causes this condition as far as I can tell from my research. It is not an entirely uncommon condition for overhead throwing athletes of all kinds.
Sorry you're going through this. I have a player that has been dealing with this for a couple years, not a pitcher. I get flare ups myself, so we have talked about it a few times. She saw several specialists...for whatever reasons they decided not to go for surgery yet. Interestingly, after more than a year of frustration, a new doc suggested that she may be either causing or contributing to the irritation/inflammation by how she slept. Put her in a sleeve that didn't allow her to bend her elbow (put her hand under her head) while sleeping. Doctor said that sleeping with your elbow bent sharply...hand under your head...causes a lot of strain on the nerve. Big improvement, she feels almost normal now...compared to having severe elbow pain and two completely numb fingers. I have pretty much trained myself not to sleep with my hand under my head too...it has helped quite a bit. Just throwing it out there for something to consider...it may be something other than throwing that is causing consistent irritation and inflammation
@Orthodoc Again, can't thank you enough for taking the time to respond here. My dd (who incidentally wants to be an orthopedic surgeon) is adamant that she is ready to do the surgery and get on with rehab. It is also the conclusion I had reached based on my research. I had seen the literature on in situ release vs translocation surgery and I will be asking more questions about that. Thanks so much!
@SB45 You are absolutely correct about sleep position. Forgot to mention it but sleep position may be the most important factor to fix outside of rest from the throwing motion when these symptoms start. There are some splints available (one called pil-o I think) to wear while sleeping that prevent the elbow from bending too much and compressing the nerve.
We made the decision to have the surgery. My dd just didn't want to rest for another 6 to 8 weeks since the first rest period didn't ever completely relieve the symptoms. The doctor was able to push the surgery up to Nov 21, and she has already been to physical therapy once. As it turns out, she would have needed the surgery eventually no matter what. She had developed significant scar tissue around the nerve, and the "extra" anconeus muscle she has was compressing the nerve more than the dr. realized from viewing the MRI. I'll try to post some progress notes here just in case anyone is facing a similar decision. The physical therapist hopes to have her throwing lightly as soon as 6 to 8 weeks post surgery.