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Pitcher's Elbow

What is Pitcher’s Elbow?

Pitcher's elbow (medial epicondylitis apophysitis) is a condition that causes pain and inflammation in the tendons that connect the elbow to the forearm. It occurs around the bony bump on the inner side of your elbow. The pain may also be felt into the forearm and wrist.

Pitcher’s Elbow will usually develop as a result of overuse to the muscles in the forearm that enable you to rotate your arm, flex your wrist and grip with your hand. By repeatedly effecting the same throwing movement, considerable stress is placed on the related muscles, tendons, and joints. This over time can cause injury from tiny tears in the tendons.


What are the Symptoms of Pitcher’s Elbow?

In most cases, the pain develops slowly and gradually over weeks and months in the elbow area. It is less common for the symptoms to occur suddenly.

You may feel stiffness in your elbow and it may be painful to make a fist. Pain and tenderness will be felt on the inner side of the elbow and sometimes the forearm too. Some experience numbness and tingling often into the 4th and 5th fingers. Your hand and wrist may feel weaker too.

The pain can be anything from mild discomfort to severe, and it may affect your sleep. It will increase when forcibly trying to stabilize or move the wrist.

Your pain will feel worse when;

  • Shaking hands

  • Using tools

  • Gripping objects e.g. cutlery, pen, computer mouse

  • Fully extending your arm

  • Turning a door knob

  • Lifting

    Who is Prone to Pitcher’s Elbow?

    Pitcher’s Elbow affects around 1-3 percent of people. Sufferers tend to be between the ages of 35 and 50.

    Older players tend to be more prone due to the continuous repetitive movements over time leading to wear and tear of the tendons.

    Less experienced players may also be more likely to get Pitcher’s Elbow due to poor technique causing increased strain on the tendons.

    Anyone who participates in activities that require repetitive and vigorous use of the forearm muscle, especially while gripping something, are more susceptible to this condition. This broadens its reach to a variety of professions; cooks who chop, cleaners who vacuum, butchers, gardeners, assembly- line workers, bowlers and golfers.

    If your forearm muscles are unfit and you suddenly start to play a racquet sport or take on a new DIY project, you are also more likely to get Pitcher’s Elbow.






    This technique involves locating the heart of the trigger/tender point. When this is compressed it may well trigger a specific referred pain map (preferably reproducing your symptoms). This technique involves applying direct, gentle and sustained pressure to the point:


    1. Identify the tender/trigger point you wish to work on (see illustration above). 

    2. Place the host muscle in a comfortable position, where it is relaxed and can undergo full stretch. 

    3. Apply gentle, gradually increasing pressure to the tender point until you feel resistance. This should be experienced as discomfort and not as pain. 

    4. Apply sustained pressure until you feel the tender point yield and soften. This can take from a few seconds to several minutes. 

    5. Steps 3-4 can be repeated, gradually increasing the pressure on the tender/trigger point until it has fully yielded. 

    6. To achieve a better result, you can try to change the direction of pressure during these repetitions.


    There are many reasons why you might have trigger points, so it is important to consider your trigger point pain in the context of the rest of your body. It must be stressed that the techniques offered on this page are not a substitute for therapy from a qualified practitioner; although aches and pains from trigger points are common, there can sometimes be an underlying pathology. It is advisable to always seek a proper diagnosis from a qualified medical practitioner or experienced manual therapist. 




    Stretching is an important part of the rehabilitation process and should begin as soon as pain allows and be continued throughout the rehabilitation program and beyond - Good maintenance prevents re-injury. 


    Adopt position as shown above

    The stretch can be increased by placing something under the elbow to raise it, which increases the amount the upper arm is lifted relative to the shoulder


    Hold stretch for 5 seconds, repeat 5 times and aim to stretch at least 3 times a day


    Pitcher's Elbow Self Help Program - See Details



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