Pitcher’s elbow, or medial apophysitis, is the most common elbow injury among baseball players. It is an overuse or repetitive strain injury that occurs most often in baseball or softball players who are undergoing a rapid growth spurt (typically between the ages of 11 and 15). Physical therapy is an excellent solution for healing this type of injury.

What Is Pitcher’s Elbow?

Pitcher’s elbow occurs in the inside section of the elbow joint, where the upper arm connects to the forearm. During rapid growth, the joint is more susceptible to injury. Throwing motions stress this area of the elbow, and if the motions are repeated too frequently without adequate rest, pain and swelling can occur. If not properly treated, pitcher’s elbow can lead to ligament tears and even bone fractures.baseball elbow injury

Symptoms of Pitcher’s Elbow

Common signs of pitcher’s elbow include:

  •         Pain in the inner elbow when throwing that builds as you continue playing or practicing
  •         Lingering soreness in the inner elbow after practice or a game
  •         Swelling and tenderness around the inner elbow
  •         Loss of speed, accuracy, or distance when throwing
  •         Reduced grip strength
  •         Forearm cramping
  •         Restricted range of motion in the elbow
  •         Pain or discomfort when using the forearm in daily life, such as opening a door


Your first appointment will consist of a complete review of your athletic and medical history, along with a detailed physical examination. You will undergo a series of evaluations to check your elbow’s range of motion, strength, flexibility, tenderness, and more. Because the shoulder, neck, and back are also involved in throwing, we may assess those as well.

In most cases, we can diagnose pitcher’s elbow in our office. If you have severe pain or loss of motion, though, we may refer you to an orthopedic doctor for diagnostic imaging, such as an x-ray or MRI.

What to Expect from Physical Therapy

Your physical therapy treatment plan will be individually designed to meet your unique needs and athletic goals. Physical therapy for pitcher’s elbow typically focuses on the following factors:

Range of Motion: The swelling caused by repetitive throwing typically results in stiffness of the elbow joint and possibly the shoulder. Targeted exercises will increase your range of motion, with the goal of returning you to your pre-injury movement capabilities.

Strength Training: When your body is injured, the surrounding muscles work overtime to compensate. In addition, repetitive motion overuses some muscles while allowing others to grow weak. Therefore, you likely have muscle imbalances throughout your upper body. Rebalancing the strength of all the muscles in your back, neck, shoulder, and arm will help you heal and reduce the risk for reinjury by allowing each muscle to properly do its job, evenly dispersing the stresses of throwing.

Manual Therapy: Your physical therapist may use hands-on techniques to gently move and mobilize the joints in your elbow and shoulder, as well as the muscles surrounding them.

Pain Management: Ice, heat, and electrical stimulation may be recommended to help minimize pain during your rehabilitation.

Functional Training: Your physical therapist will assess your movement quality and teach you how to correct form issues with your throwing, reducing the risk of further injury.

Education: Physical therapy is divided into three phases: acute, subacute, and chronic. As you move through the phases, you will slowly return to full training. Your physical therapist will explain your treatment plan, and why you are being asked to do certain things in each phase. You will also learn tips and tricks for cross-training and keeping your entire body fit, healthy, and pain-free.

Ready to Get Started?

If you are ready to start your physical therapy journey with a team you can trust, contact Raritan Physical Therapy at (732) 662-4400 to schedule your appointment.