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1. Medial Elbow
Injuries – The Ulnar Collateral Ligament
From
the cocked position shown in the picture below, the ulnar collateral ligament –or "UCL" - pulls the forearm forward with the rotating upper
arm. The tremendous tension produced in the relatively small UCL is
close to its limit. When improper mechanics are used or arm muscles
become fatigued, the load placed on the UCL may be increased to more
than it can withstand, causing small "micro"-tears in the UCL. Microtears
in muscles or ligaments can heal when given enough recovery time.
In fact, microtears during exercise followed by healing is how muscles
become bigger and stronger. However, when a pitcher continues to tear
his UCL without allowing enough time for it to heal, the microtears
add up to be one large tear in the ligament. Pitchers with UCL injuries
often describe feeling or hearing a "pop" in the elbow on one particular
pitch. These types of stories lead many people to believe that a pitcher
blows out his UCL on one bad pitch – such as the first pitch on a
cold day or a poorly thrown breaking pitch. Really, this is usually
not the case. Quite frequently the one bad pitch was really just "the
straw that broke the camel’s back" and was the final microtear that
led a series of microtears to become a large tear.
 2. Lateral Elbow
Injuries
A pitcher rotates
his arm back to the cocked position shown in the picture, and then rotates
it forward to throw the ball. Compression between the forearm’s bone (the
radius) and the upper arm’s bone (the humerus) helps the forearm stop
cocking back and start rotating forward. This large crushing force on
tiny bone surfaces sometimes results in small bone chips breaking off.
These bone chips float in the elbow joint and may result in pain, loss
of elbow motion, and diminished pitching performance.
3. Posterior Elbow
Injuries – "Valgus Extension Overload"
From the arm-cocked
position shown in the picture, the arm rapidly rotates forward at the
shoulder and straightens out at the elbow. The elbow straightens out in
less than a tenth of a second (0.1 sec). The combination of this rapid
elbow extension and the forceful forward rotation of the upper arm and
humerus can cause a grinding injury in the posterior-medial elbow (the
"funny bone" area of the elbow). Small bone chips can break off and float
in the elbow joint, which may result in pain, loss of motion, and diminished
pitching performance.
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