Tag Archives: SMU2109

Thrower’s Elbow – 616

Thrower’s elbow is an injury that AT’s and coaches deal with frequently.  What do we need to know as we interact with young throwers?

Thrower's Elbow

The more you throw and the higher velocity you throw at increases your risk for injuries.  As AT’s and coaches, we need to not only be aware of the rules that are in place to protect these young athletes we need to follow them and encourage parents who may have their kids participating in multiple leagues to stay within the guidelines.  The bottom line is the AMOUNT MATTERS.

What should we do when a throwing athlete begins to complain about pain?

When complaints begin we need to take them out.  Shut them down from throwing and begin evaluating what might be going on.   Remember that in developing youth, growth plates are the weakest link. Rest when the pain starts to prevent an injury in the growth plate.  

We hear about the dreaded curveball and why it shouldn’t be thrown by young athletes.  Is this accurate?

We need to change how we think about the curveball.  Any speed off-speed pitch will decrease the forces on the elbow and shoulder.  The more you throw at an increased speed the higher your risk moves. It’s not the curveball that is the problem, it is the fact that most young people don’t have the correct mechanics to throw it.

What about asymmetry?  We are told to expect it in throwing athletes.  At what point should we be concerned?

When you see a greater than 15-20 degree difference between the throwing and non-throwing hand there is a significant increase risk of injury.

If the athlete has this significant difference but isn’t experiencing pain or throwing mechanics haven’t changed, you don’t have to shut them down but you should be working to get them around 10 degrees of motion between their throwing and non-throwing arms.  It’s also important to remember that throwing slows down progress on the range of motion games.  

Should we change our thinking on surgical vs non-surgical treatment of shoulder injuries and thrower's elbow?

It really is a case by case basis.  Young athletes with acute large tears probably should get a surgical consult.  More chronic injuries in a little bit older throwers might choose rest to get them pain-free or to finish out their career.  It’s not cut and dry one way or the other but needs to be evaluated case by case.

What are the biggest barriers to recovery post-injury?

The number one barrier is compliance with treatment.  Staying on top of them and encouraging them to continue with the rehabilitation even once they’ve become pain-free.  Compliance with prevention is also difficult. They need constant reminders and encouragement to follow through.

Are there any prehab thoughts from athletes awaiting UCL repairs?

Braces that prevent valgus and restrict 10-100 degrees are recommended.  Controlling pain and inflammation pre-surgery and reducing the stiffness in the joint is helpful.  The athlete can continue to exercise if they are pain-free and using symptoms as their guide.

Is there anything else AT’s should know regarding throwing injuries?

Young kids are at increased risk because of their growth plates and mechanics.  Be their advocate, and follow the rules.

The Thrower's Elbow – V. Joe Mandola, MD, CAQSM

The Thrower's Elbow – V. Joe Mandola, MD, CAQSM

Posted by Sports Medicine Broadcast on Tuesday, June 11, 2019

Related episodes

Here are other podcasts related to elbow injuries

Contact us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Ray Olivorayolivo1@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

These people LOVE ATs and help the SMB pay the bills:


Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.

Care For The Active Wrist – 582

Dr. Candice Teunis joins Shawn Ready to discuss care for the active wrist.

Can't Miss Injuries of the Hand; care for the active wrist

How do we Care For The Active Wrist

One of the huge tips she continued to share was REFER ANYTHING YOU REDUCE!!!

I have reduced injuries before and since meeting Dr. Teunis I always refer them to get an x-ray before allowing them to return to play.

Mallet Finger:

What is it: Extensor tendon rupture or avulsion involving DP joint.

Treatment– Splint religiously! 6-10 weeks

Alumaform vs. Stax Splint- Not all 1 size fits all. consult with your local hand doctor to see what they prefer and why. discuss ways to ensure patient compliance and seamless transition from office to AT Facility.

NOT ALL Mallet Fingers can be splinted, some require surgical intervention.

Jersey Finger-

What is it – Flexed finger pulled into extension (commonly ring finger, 75%) rupturing flexor tendon.

Treatment:

Dislocations

Dorsal Dislocation-  splint 1 week, then buddy tape

Volar dislocation – much less common, extensor mechanism disruption, hard to reduce

Mimickers-

  • Traumatic Boutonniere
  • Skiers Thumb

Scaphoid Fractures

  • Hard to treat
  • hard to diagnose.
  • Common in football – “see these in December”

Scaphoid fractures…about 40% are missed and that is bad news, they take several months to heal due to poor blood flow. if it dies you get arthritis in your 20s.

Fall on outreached hand (FOOSH)

Need more on Care for the Active Wrist?

Live from Memorial Hermann's Sports Medicine Update 2019 Dr. Teunis lectures on Can't-Miss Injuries of the Hand and you can see that presentation here on Facebook

Can't Miss Injuries of the Hand – Candice Teunis, MD

Can't Miss Injuries of the Hand – Candice Teunis, MD

Posted by Sports Medicine Broadcast on Tuesday, June 11, 2019

Contact us:

Dr. Teunis – Email

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Ray Olivorayolivo1@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

These people LOVE ATs and help the SMB pay the bills:


Frio Hydration – Superior Hydration products.

MioTech – meeting all of your sports medicine supply needs

PhysicalTherapy.com – use promo code “1FREECOURSE” to start for free

DragonflyMax – one-stop EMR

HOIST – no matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some, be entered in a drawing for a second-year free and support the podcast.