A Growth Plate Fracture
Is A Bad Thing
10/8/2008
I was on ASMI's web site last night and came across a thread
entitled
Uh oh, my 11 year old son's elbow hurts. In it a father of an
10 year-old baseball pitcher said...
Good news...for now. Took my son to
see the doctor today and after an exam and look at x-rays
(of both elbows to compare) the doctor believes it could be
growth plate related; maybe a stress fracture in the growth
plate. We go back in a few weeks and if the pain persists
they will do an MRI. So, for now, he's in a sling for a
couple of weeks and then we go back to see the doctor again
on October 6th. I'll post an update after the next visit.
This makes me feel a lot better, especially since I've
always monitored him pretty closely and don't think he's
ever over thrown or suffered from arm fatigue. However, he
did do something, so we'll have to work to prevent it from
happening again (or something more serious) in the future.
I tried to explain to the dad what was going on and he
replied...
I am no doctor and don't know much about this
stuff, which is why I looked for information and suggestions
here. Obviously any problem or injury is not a good thing, but
wouldn't you agree that a growth plate issue is less serious
than a UCL/MCL injury?
Believe me, I'm not celebrating that he has a growth plate
injury, but believe it's not as bad as I originally thought. I'm
just looking for ways to prevent injury in the future.
As I told the dad, a growth plate injury is just as bad as a
Ulnar Collateral Ligament (UCL) injury because they are
basically the same injury, or they at least have the same root
cause.
To understand this, you have to
understand the anatomy of the elbow. The UCL attaches to the Medial Epicondyle (the bony bump
on the inside of the elbow) of the Humerus and the Coronoid
Process of the Ulna.
In a pre-pubescent child (e.g. under 16 or so
for boys), the Medial
Epicondyle (ME) is attached to the Humerus by a growth plate, or area of
soft tissue. In a child with an open ME growth plate, the growth plate is weaker than the UCL.
As a result, too
much strain on the elbow — due to overuse or throwing supinated
pitches like the slider — will create problems with the growth
plate rather than the UCL (because a chain is only as strong as its
weakest link). Once the ME growth plate closes at puberty, then the UCL
becomes the weakest link in the chain and pitchers who put too
much strain on their ME/UCL complex end up requiring Tommy John
surgery.
The Bottom Line
The bottom line is that an injury to the growth plate of the Medial
Epicondyle and an injury to the Ulnar Collateral Ligament are
really the same basic injury because they share the same root cause.
The only way to solve the problem of a ME growth plate
strain or fracture in a pre-pubescent pitcher is to limit how
much they throw so that they do not experience an overuse
injury. The only way to solve the problem of a UCL strain or
rupture in an adult pitcher is to learn to pronate all of their
pitches, especially the slider and the cut fastball.
In either case, what you have to do is reduce the
strain on the Medial Epicondyle and the Ulnar Collateral
Ligament.
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