Pitcher's elbow in adolescents.

Intraarticular and periarticular changes of the elbow secondary to the throwing motion have been documented in pitchers of all ages, Although others have focused attention on children, this study evaluates a group of 73 older pitchers (average age 17 years). Forty-two (58%) players reported pain while throwing at the time of evaluation (before interscholastic play) or developed pain during the season. However, only four (5%) missed one or more pitching rotations. No significant relationships were found between occurrence of symptoms and number of seasons played, individual pitching traits, asymmetry on physical examination, or asymmetry on radiographic evaluation of the elbow. In the symptomatic group there tended to be a slightly greater number of seasons' experience (average 7.8 seasons vs. 6.0 seasons) and more players with asymmetry upon physical examination. We believe this study supports the concept that increasing age and exposure, along with other factors as yet unquantitated, may determine the occurrence of symptoms in pitchers.