Ulnar Collateral Ligament Injury
The subject is a 25 year-old, right-handed, MLB pitcher who has played baseball since Little League. He sustained an injury to his right arm while throwing an overhand curveball during the fifth inning of the first Major League game of the season. Upon my reaching the mound, the pitcher was favoring the affected arm and in obvious pain. I asked him where the pain was located and how bad it was. He pointed to his right medial elbow, near the medial epicondyle, and said the pain was moderate and he did not feel he could continue to pitch in the game. Next, I asked him if the pain came suddenly or gradually. He said it was a sudden pain and felt a “pop” or “snapping” sound. I then asked the athlete if he had sustained any previous injury to the right arm/elbow. He said he has dealt with chronic elbow inflammation throughout the course of his career but has never sustained any other injury or had surgery on the arm. Lastly, I asked the pitcher if he had any associated symptoms with the inflammation of the elbow or if there was any swelling or numbness. He replied that he sometimes feels tingling in his right “pinky” and “ring” finger when swelling is present in the elbow.
Following the history, I noted no signs of deformity or discoloration to the elbow joint. However, there was some apparent swelling on the medial side of the right elbow when compared bilaterally, and the fourth and fifth digits of the right hand twitched slightly as the muscles of the hand displayed some spasm. I began palpating at the flexor digitorum superficialis and the flexor carpi ulnaris. No swelling was present and there was no pain reaction from the pitcher. I continued to the flexor carpi radialis and the palmaris longus. There was some mild pain presentation while palpating these muscles. But the pain reaction was most intolerable while palpating the medial aspect of the pronator teres and medial epicondyle of the humerus.
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