Houston Astros pitcher Lance McCullers Jr. will spend the entire 2019 MLB season on the disabled list (DL) after having Tommy John surgery to reconstruct the ulnar collateral ligament. Symptoms of elbow discomfort began on August 4th, 2018 and was originally diagnosed as a right forearm strain that led to 6 weeks on the DL (See Pitcher’s Elbow for more details). His particular problem was described as“pitching through some stuff” (increased elbow discomfort) during his return. Diagnostic tests included an MRI and postseason physical. Treatment is described as gradual elbow/forearm strengthening and rest/ice/compression rehab to work towards a normal pitching routine. Since surgery on November 6th, 2018, McCullers is currently passing all medical clearance checkpoints (according to medical staff) and is expected to make a full recovery. The plan for return to play is spring training for the 2020 season.
Category Archives: Pitcher’s Elbow
Shohei Ohtani UCL Sprain
Angels’ pitcher Shohei Ohtani was placed on the disabled list with what was described as a grade 2 sprain, or partial tear, of the Ulnar Collateral Ligament. The ulnar (or medial) collateral ligament connects the humerus and the ulna on the inside (side closest to the body) of the elbow joint. All professional throwers develop changes in this ligament. After years of throwing a baseball over and over as hard as one can, the elbow and shoulder change under the stress. This is uncommonly an acute injury in the setting of these long-standing changes. More often, it is just a decrease in pitching effectiveness, often related to an increase in pain.
The Angel’s stated that he had a stem cell injection and a platelet rich plasma (PRP) injection (his second in a year) on June 6th. These are two different types of injections that are increasingly used for various problems without evidence that they help. To our knowledge, there is no evidence that stem cells or PRP are better than placebo injections for elbow pain in throwers. He will be reevaluated in 3 weeks.
The team has limited his pitching to basically a Sunday starter like the one’s used in college. so that he can continue to be effective. Apparently they have decided to add a period of rest and some experimental injections. They’ve been unsuccessful and his injury has progressed.
Adam Wainwright Elbow Inflammation
St. Louis Cardinals pitcher Adam Wainwright went on the disabled list on May 16, 2018 with what was described as “elbow inflammation”. Elbow pain is very common among baseball pitchers. The repeated throwing a baseball creates expected changes to the elbow (see the thrower’s elbow).
It was reported on May 16 that “the initial MRI gave inconclusive results so a second MRI test will be issued”. This is misleading because all professional pitchers have changes on MRI. It is difficult to determine when a finding is new or when a finding merits treatment.
Wainwright will be placed on a 60 day disabled list while he rests his elbow and likely works on forearm muscle strengthening exercises and possibly throwing mechanics-exercises that can help people continue throwing effectively as their elbow wears out. There is still no timetable on Wainwright’s return.
This article was created by Paul Bonilla and David Ring.