Not Every Painful Pop In A Pitchers’ Elbow is a UCL Injury. What Else Could It Be?
The Snapping Ulnar Nerve
Acute elbow pain with a snap sensation in a pitcher is always concerning for a UCL injury and possible need for Tommy John surgery. Another less common injury that has a similar presentation is acute instability or snapping of the ulnar nerve.
Subluxing Ulnar Nerve
Treatment for Snapping Ulnar Nerve
Unfortunately, once the nerve becomes unstable it is challenging to resume high velocity throwing without surgery. Bracing of the elbow with the elbow position towards full extension can manage acute symptoms and in some cases can allow a player to rehab and get back to throwing.
More commonly the snapping of the ulnar nerve is resolved with a surgical procedure called ulnar nerve transposition. In this procedure, the ulnar nerve is positioned in front of the arm and stabilized using either subcutaneous tissues or a dense tissue adjacent to the nerve called the intermuscular septum.