What are the signs of this damage to the arm and how is it detected?
The earliest sign is pain with throwing, and as the damage progresses the pain can continue after throwing. If the damage becomes worse there may be swelling about the elbow and even loss of motion. In the shoulder the only symptom is pain, and swelling is rarely seen. The pain usually is worsened only by throwing and not by other activities.
An evaluation by a physician will help confirm the diagnosis. Radiographs, or plain X-rays, will sometimes confirm the diagnosis. On the X-ray the growth plate damage may show up as widening of the growth plate or damage to the joint. If the X-rays are normal then it may be necessary to do other studies, such as a bone-scan or an MRI (Magnetic Resonance Imaging). These tests may show subtle damage not visible on regular X-rays.
How can these conditions be prevented?
Because these problems are due to the stress of throwing a baseball, these conditions may be preventable by limiting the number of times the athlete throws. The guides provided by most leagues are designed to prevent throwing too many pitches or too many innings. However, many players throw at practice or at home on their own. Unfortunately there are probably no definite number of pitches that determine when damage occurs. For this reason it is important that the player be honest about having pain and the adults involved inquire frequently about any discomfort reported by the player. It is important not to try to hide the pain or ignore its presence.
Edward G. McFarland, M.D.
Andrew Cosgarea, M.D.