Evaluation and management of elbow injuries in the adolescent overhead athlete

Austin M Looney; Paolo D Rigor; Blake M Bodendorfer

doi:10.1177/20503121211003362

Evaluation and management of elbow injuries in the adolescent overhead athlete

SAGE Open Med. 2021 Apr 22:9:20503121211003362. doi: 10.1177/20503121211003362. eCollection 2021.

Authors

Austin M Looney¹, Paolo D Rigor², Blake M Bodendorfer³

Affiliations

¹ Department of Orthopaedic Surgery, Georgetown University Medical Center, Washington, DC, USA.
² School of Medicine, Georgetown University, Washington, DC, USA.
³ Midwest Orthopaedics at Rush, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Abstract

With an increased interest in youth sports, the burden of overhead throwing elbow injuries accompanying early single-sport focus has steadily risen. During the overhead throwing motion, valgus torque can reach and surpass Newton meters (N m) during the late cocking and early acceleration phases, which exceeds the tensile strength (22.7-33 N m) of the ulnar collateral ligament. While the ulnar collateral ligament serves as the primary valgus stabilizer between and degrees of elbow flexion, other structures about the elbow must contribute to stability during throwing. Depending on an athlete's stage of skeletal maturity, certain patterns of injury are observed with mechanical failures resulting from increased medial laxity, lateral-sided compression, and posterior extension shearing forces. Together, these injury patterns represent a wide range of conditions that arise from valgus extension overload. The purpose of this article is to review common pathologies observed in the adolescent overhead throwing athlete in the context of functional anatomy, osseous development, and throwing mechanics. Operative and non-operative management and their associated outcomes will be discussed for these injuries.

Keywords: Orthopedics; occupational therapy; rehabilitation.

Publication types

Review