Negative ulnar variance

[left turn]

What experience do you have with negative ulnar variance?

My DD is a pitcher and she had a terrific high school season. She pitched a lot of innings. There was a two week break between high school and club ball (which began on June 7).

The next weekend (June 14) her wrist was painful after she pitched in pool play on Saturday. We held her out of pitching on Sunday. We called to get the soonest doctors appt which was today (June 24). We also held her out of pitching this past weekend (June 21) as well, pending the appt.

The doctor said it was over use syndrome and negative ulnar variance and that she should not pitch until the fall. He did clear her to play in the field and bat. She will start PT asap.

Have any of your DD's had this? Here there any problems with recovery or afterwards?

Thanks all.

 

[riseball]

The number of innings is moot. What matters is the number of pitches and the frequency. Please tell me you saw a specialist and not your PCP? Suggest you take some time off and if she aspires to play college, quit wasting time playing HS ball. Hopefully the time out of the circle will not be as long as expected. Taking 3 months off sounds pretty extreme. People beat cancer in less time. I would be suspicious of her mechanics and once she starts throwing again post some video.

 

[Amy in AZ.]

I am wondering if she does "wrist snaps?" What other sports does she play and what other softball positions?

 

[left turn]

The number of innings is moot. What matters is the number of pitches and the frequency. Please tell me you saw a specialist and not your PCP? Suggest you take some time off and if she aspires to play college, quit wasting time playing HS ball. Hopefully the time out of the circle will not be as long as expected. Taking 3 months off sounds pretty extreme. People beat cancer in less time. I would be suspicious of her mechanics and once she starts throwing again post some video.

riseball, yes we went straight to a specialist. I assume the recovery time is typical for this condition.

 

[left turn]

I am wondering if she does "wrist snaps?" What other sports does she play and what other softball positions?

No wrist snaps. I see that all the time and I am mystified why they think that is a good idea.

She plays the outfield as well as pitches. However, she has been in the circle much more than she is in the outfield.

When she heard the news, her first response was, "Well that gives me more time to be a better outfielder and hitter." I was really thankful for her level-headed and mature response. She and her brother had already started a running program. That was something they came up with.

 

[left turn]

Some of the issue is the athlete's natural genetics, ie bone length. Then overuse brings the issue to the forefront. It is too soon to tell, but if you relayed how much she pitched plus the pain you would get that diagnosis. If you have the pitcher pitching every day, 3 games or more a week, more than 200 pitches in a tourney day, over 700 pitches a week, only 2-4 weeks off per year, etc. you really don't need a doctor to tell you that is over use.

OILF, you are correct. The central feature of negative ulnar variance is the ulna bone is marginally shorter than the radius bone. The ulna is on the outside of the forearm connecting to the wrist at the pinkie side of the hand. The orthopedist said the condition makes wrist pain more likely. This is a genetic thing, so it has been a part of her anatomy her whole life. It amazes me it is showing up after 6 years of pretty intense pitching, practices and lessons and not sooner. That is a pretty long gestation period for something she is predisposed for. Since it took so long to develop, I am assuming (hoping) her predisposition for wrist pain is slight.

 

[left turn]

In the overall scheme of things I am relieved she has something she can recover from and will not cause her lasting pain. For example Positive Ulnar variance means the ulna is too long and that causes arthritis and structural damage.

The doctor said she can gradually start pitching again in 10 weeks. I wonder how long it will take to get back to full strength. if anyone else out there in DFP-land has experience with the recovery time and timeline for restarting pitching, I would be grateful to hear about it.

 

[MandM]

My two cents, just commenting on OILF thoughts as well as your own. I looked this up too as I am always interested in learning about things I haven't heard of. What struck me were two things, first that this shorter ulna relative to the radius occurs in alot of people, (maybe 15% of the normal population). It seems that in and of itself it does not cause pain, but rather, predisposes to specific injuries that do cause pain like ligamentous injuries, impingement of the ulna onto the radius (like what OILF said), osteonecrosis of the one of the wrist bones and other stuff like that. To manage the problem, maybe knowing specifically what the injury is/was would go along way towards helping to prevent it from recurring in terms of the best PT approach. Stopping pitching for 10 weeks will fix everything, a fracture included (I know this as DD was told she fractured her wrist this spring and we went through recovery scenarios-)- but identifying a specific injury would seem to be helpful knowledge- and maybe your orthopedist ran through the possibilities with you, IDK.

 

[Jojo]

I am wondering if she does "wrist snaps?" What other sports does she play and what other softball positions?

I had a 9yr old once whose back was getting a slight tilt. Parents told the DR she was a pitcher so the Dr told them to also put her other sports to equal out her activity on both sides. So they put her in tennis. I guess she didn't like swimming.

 

[left turn]

My two cents, just commenting on OILF thoughts as well as your own. I looked this up too as I am always interested in learning about things I haven't heard of. What struck me were two things, first that this shorter ulna relative to the radius occurs in alot of people, (maybe 15% of the normal population). It seems that in and of itself it does not cause pain, but rather, predisposes to specific injuries that do cause pain like ligamentous injuries, impingement of the ulna onto the radius (like what OILF said), osteonecrosis of the one of the wrist bones and other stuff like that. To manage the problem, maybe knowing specifically what the injury is/was would go along way towards helping to prevent it from recurring in terms of the best PT approach. Stopping pitching for 10 weeks will fix everything, a fracture included (I know this as DD was told she fractured her wrist this spring and we went through recovery scenarios-)- but identifying a specific injury would seem to be helpful knowledge- and maybe your orthopedist ran through the possibilities with you, IDK.

MandM, yes, the orthopedist ran through this information. She will start therapy very soon. Also she was cleared to play the field and hit and we have 3 or 4 more tourneys left. So she will not be idle. The Dr. said strengthening the muscles in the forearm and hands will prevent the issue from recurring.