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Fatigue or Pain: Don’t Ignore Your Elbow’s Warning Signs

Elbow injuries are among the most common and most serious injuries baseball players suffer.

When the injury is to the ulnar collateral ligament (UCL) — the ligament on the inside of the elbow — it usually requires a procedure, commonly known as “Tommy John surgery,” to repair.

The minimum recovery period for returning from this surgery is nine months, though some athletes are never able to resume playing baseball.

Fatigue from Pitching

Because overthrowing is the primary cause of elbow injuries, pitchers are more susceptible to them than are other baseball players.

Pitch types and pitch counts have been a focus of throwing injury prevention. The best approach is to treat each pitcher individually.

Rest and recovery periods in between pitching should be based on individual needs, and those needs should be determined by evaluating a player’s fatigue.

If... Then...
a player’s shoulder or elbow feels weak, he should not pitch that day, regardless of previous rest.
a particular pitch causes rapid fatigue, the player is not ready to throw that pitch.

Because young athletes’ bodies are still growing and their bones and supportive structures are constantly changing, so, too, are their mechanics.

Athletes who are not yet fully mature have more laxity in their joints and less muscle mass than older athletes. Because of this, adults may sustain injuries different from how young athletes might.

Pain from “Little League Elbow”

The most important thing young athletes can do to avoid major injuries is not play through pain.

With one injury, epicondylitis — commonly known as “little league elbow” — tight, overworked muscles cause pain at the insertion in the elbow.

Once the muscles in the elbow are fatigued, they lose their stability, forcing the UCL to stabilize the entire elbow by itself. This extra stress can cause the UCL to tear.

Preventing Elbow Injuries

Proper training is crucial to preventing elbow injuries.

All baseball players should engage in a sufficient warm-up before practice and a proper cool down after. It's extremely important that pitchers integrate post throwing exercises into their cool down routines.

Coaches, strength and conditioning associates, and athletic trainers should work together year-round to see that baseball players are training properly at all times.

Above all, players must always remember to pay attention to their bodies’ signs of fatigue or pain. Doing so can keep them out of the dugout and on the field.

Customized Training at UPMC Sports Performance

UPMC Sports Performance can custom build a training and conditioning program for baseball players.

For more information, contact:

UPMC Sports Performance
Ron DeAngelo
3300 South Water St.
Pittsburgh, PA 15203


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