Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic posteromedial elbow pain, exacerbated by repetitive overhead throwing or valgus stress. Reports mechanical symptoms including catching, locking, or crepitus during terminal extension. Pain is localized to the olecranon-trochlear articulation. Denies acute trauma, paresthesias, or distal neurovascular deficits.
Clinical Examination Findings
Physical examination reveals tenderness to palpation at the posteromedial olecranon. Valgus extension overload test is positive, reproducing pain at terminal extension with a valgus stress applied. Range of motion demonstrates a flexion contracture or terminal extension deficit. No evidence of ulnar collateral ligament (UCL) laxity on valgus stress testing at 30 degrees of flexion. Distal neurovascular status is intact.
Treatment Protocol
Initial management includes activity modification, cessation of overhead throwing, and a structured physical therapy program focusing on posterior capsule stretching and strengthening of the dynamic stabilizers. NSAIDs for inflammation control. If refractory, consider intra-articular corticosteroid injection or surgical evaluation for arthroscopic debridement of osteophytes and loose bodies.