Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with medial elbow pain following repetitive overhead throwing or acute valgus stress injury. Reports localized tenderness, "popping" sensation at time of injury, and subjective instability during the acceleration phase of throwing. Notable decrease in velocity and accuracy. No numbness or tingling in the ulnar nerve distribution.
Clinical Examination Findings
Inspection reveals mild swelling over the medial epicondyle. Palpation demonstrates point tenderness at the UCL origin/insertion. Range of motion is full but painful at end-range extension. Positive Moving Valgus Stress Test; positive Milking Maneuver. Ulnar nerve is stable in the cubital tunnel with no Tinelβs sign. Neurovascular status is intact distally.
Treatment Protocol
Initial management includes cessation of overhead throwing, cryotherapy, and NSAIDs. Referral for MRI arthrogram to confirm tear severity. Physical therapy initiated focusing on scapular stabilization and rotator cuff strengthening. If high-grade tear or failure of conservative management, discuss surgical reconstruction (UCL reconstruction/Tommy John surgery) with autograft or allograft.