Relevant Anatomy And Pathophysiology

The anatomy that ultimately is affected in VEO is the medial aspect of the posterior compartment. The posterior compartment includes the overlying capsule, posterior aspect of the trochlea and the olecranon fossa, the proximal two-thirds of the olecranon process, and the posterior aspect of the radiocapitellar joint. The ulnar nerve runs subcutaneously through the cubital tunnel just medial to the olecranon process and also may be involved clinically. Symptoms of ulnar nerve irritation may be present. The soft-tissue structures on the medial aspect of the elbow (i.e., the ulnar collateral ligament and the flexor-pronator mass) also play a role in the pathophysiology of this entity. The physician's ability to diagnose and treat this lesion depends on his or her understanding of the relevant anatomy, biomechanics, and pathophysi-ology in the elbow of a throwing athlete.15

The biomechanics of throwing has been well described, and baseball pitching is recognized as one of the most demanding activities on the elbow in sports.16,17 The acceleration phase of throwing has been implicated in VEO (see Chapter 2). With repetitive valgus stress incurred during the acceleration phase over time, the ulnar collateral ligament (UCL), the humeroulnar articulation, and the flexor-pronator mass can weaken. As a result, when the elbow is brought into extension, the olecranon is wedged against the medial aspect of the trochlear groove and olecranon fossa. Because of this contact, impingement, chondromalacia, osteophyte production, and loose-body formation can occur (Fig. 10.1). Similar lesions can be seen, although less commonly, in the elbows of other athletes, such as tennis and volleyball players who place similar stresses on their elbows.

Baseball For Boys

Baseball For Boys

Since World War II, there has been a tremendous change in the makeup and direction of kid baseball, as it is called. Adults, showing an unprecedented interest in the activity, have initiated and developed programs in thousands of towns across the United States programs that providebr wholesome recreation for millions of youngsters and are often a source of pride and joy to the community in which they exist.

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