Evaluation and nonoperative treatment of the unstable throwing elbow

Abstract

The throwing athlete places supraphysiologic stress across the elbow joint from repetitive throwing motion. Over time, and occasionally acutely, this stress may damage the ulnar collateral ligament (UCL), flexor-pronator mass, ulnar nerve and cause bone exostosis. A detailed history and physical examination, supplemented by imaging, aids in accurate diagnosis. This chapter focuses on diagnosis and nonoperative management of the throwing elbow. This process follows a multiphasic approach that focuses on pain-free functional range of motion (ROM) and strengthening the upper extremity. The rehabilitation program then implements a throwing program for gradual return to play.