Thrower's elbow is pain on the inner side and back of the elbow caused by the repeated stress of throwing or overhead hitting. It includes strain of the ulnar collateral ligament (UCL) and pinching at the back of the elbow.
When you throw, serve or smash, the elbow is pushed outwards with great force. The ulnar collateral ligament (UCL) on the inner side of the elbow resists this force. Repeating the movement many times can strain or partly tear the ligament. At the same time, the back of the elbow can be pinched as the arm straightens quickly, which is called valgus extension overload. Over time this may cause bone spurs or loose fragments in the joint.
Thrower's elbow is seen in cricket bowlers and fielders, baseball and softball players, javelin throwers, and in tennis, badminton and volleyball. In children and teenagers who throw, the growth plate on the inner elbow can become irritated instead. This is called medial epicondyle apophysitis, or 'Little League elbow'. It usually settles with rest from throwing, but needs proper assessment.
The doctor asks about your sport, throwing volume and symptoms, then examines the elbow, including gentle stress tests of the ligament and checks of the ulnar nerve. The shoulder, trunk and hips may also be checked.
Where it helps, an ultrasound scan can look at the ulnar collateral ligament, the tendons on the inner elbow and the ulnar nerve. Scanning while the elbow is gently stressed can add useful information.
X-rays can show bone spurs, loose fragments or growth plate changes in younger athletes. An MRI or MRI arthrogram can be arranged by referral if a significant ligament tear is suspected.
If there are ongoing tingling or weakness symptoms in the hand, nerve conduction studies can be arranged by referral.
Your plan depends on what the assessment finds. These are the options we most often discuss.
A period of rest from throwing, while keeping fit in other ways, is usually the first step. This is followed by a structured, gradual return-to-throwing programme.
A programme to strengthen the forearm muscles that support the inner elbow, along with shoulder, trunk and hip work, is a key part of treatment.
Learn moreReviewing throwing volume, rest days and, where useful, technique may help reduce stress on the elbow and lower the chance of recurrence.
Learn moreFor some partial tears of the ulnar collateral ligament, a PRP injection may be considered where assessed as suitable. Evidence is still limited, and it is used alongside rehabilitation, not instead of it.
Learn moreSimple pain relief or anti-inflammatory medicines may be used for a short time, where suitable for you.
A complete ligament tear, troublesome loose fragments or symptoms that do not settle with good rehabilitation may need a surgical opinion. The clinic will refer you to an orthopaedic surgeon.
Recovery depends on which structures are involved. Many people with a mild ligament strain or overload can return to throwing within six to twelve weeks, following a gradual programme. Partial ligament tears often take longer, sometimes several months. Children with Little League elbow often need several weeks away from throwing before a gradual return. If surgery is needed, recovery for throwing athletes can take many months. Time frames vary, and return is usually guided by symptoms and a staged throwing plan.
No, although both cause pain on the inner side of the elbow. Golfer's elbow involves the tendon that attaches the forearm muscles to the inner elbow. Thrower's elbow involves the ligament and joint, which are stressed by throwing. They can occur together, and an examination helps tell them apart.
It is irritation of the growth plate on the inner side of the elbow in children and teenagers who throw a lot. It usually causes inner elbow pain during and after throwing. Rest from throwing and a gradual return often help, and limits on throwing volume may reduce the risk. Sudden pain with swelling needs an X-ray to check for a growth plate injury.
No. Many strains and partial tears are managed with rest, rehabilitation and a gradual return to throwing. Surgery may be considered for complete tears, especially in athletes who want to return to high-level throwing. The clinic will refer you to an orthopaedic surgeon if this is needed.
The ulnar nerve runs close to the inner side of the elbow and can be stretched or irritated by throwing. This may cause tingling in the ring and little fingers. Ongoing tingling or any weakness in the hand should be assessed.
No. Inflexion Clinic is a private GP clinic, so you can book directly. Book online or call the clinic on +65 8997 0659.
Our clinicians will take a proper history, examine you, and give you a clear plan on the day.